In a prospective study of 214 patients who had elective extensive
operations for fractures, we compared the relative frequencies of
postoperative infections in the seventeen patients who were seropositive
for human immunodeficiency virus and had associated clinical symptoms, in
the twenty-six patients who were seropositive and had no associated
clinical symptoms, and in the 171 patients who were seronegative. The
relative frequency of postoperative infection was significantly higher in
patients who were seropositive and had associated clinical symptoms (four
of seventeen) than in patients who were seronegative (eight of 171) (Fisher
exact test, p = 0.01). In all patients who were seropositive and had a
postoperative bacterial infection, treatment with antibiotics was
effective. The results of this study suggest that people who are
seropositive for human immunodeficiency virus and have associated symptoms
are at increased risk for postoperative infection.