Examination of the Relationship Between HIV Status, CD4 Count, and Surgical Outcomes at Federal Teaching Hospital, Ido-Ekiti, South West Nigeria

People living with HIV undergoing surgery represent a clinically complex population, and the relationship between HIV serostatus, immune status as measured by CD4 count, and surgical outcomes in Nigerian teaching hospitals has not been analytically examined. This study investigates the impact of HIV status and CD4 count on postoperative complications and mortality at the Federal Teaching Hospital, Ido-Ekiti, Ekiti State, South West Nigeria. A retrospective cohort design is applied to records of all patients who underwent elective or emergency surgical procedures between 2019 and 2023, stratifying the cohort by HIV status. Among HIV-positive patients, CD4 count at the time of surgery is recorded. Outcome variables include wound infection rate, pneumonia, length of hospital stay, re-operation, and 30-day mortality. Multivariable logistic regression in SPSS adjusts for confounders including malnutrition, operative urgency, and procedure complexity. Available HIV surgery literature from South West Nigerian settings identifies CD4 count below 200 cells per microlitre as the strongest immune predictor of postoperative complications, independent of antiretroviral therapy status. The WHO HIV Testing in Clinical Settings framework and BHIVA surgical guidelines inform the analytical design. Findings will support the hospital in developing pre-operative HIV screening and immune optimisation protocols. Keywords: HIV, CD4 count, surgical outcomes, postoperative complications, South West Nigeria.