Even though the risk of post-operative infection is minimal and could potentially be reduced by ART treatment; surgeons may still decline to operate on this group of patients as there is also a concern that surgery in HIV patients could lead to a decline in the CD4 counts and possibly accelerate the progression to AIDS by additional stimulation of the immune system and surgical stress [32] This review does not look at this additional risk for the HIV patient. Here, CD4 is linked to infection.