The comments and added information in the letters of Petrosillo et al and Puro et al were much appreciated.
We concur that wound infection rates may be increased in human immunodeficiency virus–positive patients but believe that this is directly related to the immunological status of the patient. For example, Emparan et al1 noted a significant increase in infections after abdominal surgery when the CD4 count was less than 200 cells/mL. On the other hand, Buehrer et al2 reported no significant differences between the wound infection rates of human immunodeficiency virus–positive and human immunodeficiency virus–negative hemophiliacs unless they had progressed to AIDS. Clearly, the patients' immunocompetency is a major factor in postoperative wound infection as we would expect.
Wilson SE, Williams R. Surgical Site Infections in Patients With Human Immunodeficiency Virus—Reply. Arch Surg. 2006;141(6):612. doi:10.1001/archsurg.141.6.612-a