Coronary artery bypass grafting in a patient with human immunodeficiency virus - Role of perioperative active anti-retroviral therapy

In a patient with severe ischemic heart disease and advanced human immunodeficiency virus (HIV) infection, vigorous perioperative treatment with anti-retroviral agents was given and coronary artery bypass surgery using cardiopulmonary bypass was successfully performed. This strategy could become the standard for patients with cardiovascular disease and advanced HIV infection: The following aspects of this case require further investigation: (1) lack of a reactive increase in the neutrophil count, (2) transient extreme reduction of lymphocytes, and (3) a relative decrease in the CD8+ cell ratio.