Delayed autograft loss in HIV-positive patients: two cases

Two cases that show delayed autograft loss secondary to late polymicrobial infection in patients whose test results are positive for the human immunodeficiency virus (HIV-positive patients) are presented. Mechanisms of immune dysfunction in HIV-positive patients are reviewed, and speculation on the possible contribution of polymorphonuclear or other immune dysfunction to the graft failure in these patients is presented. Questions are raised regarding the prognostic importance of HIV positivity in patients with burns and the need for special surgical considerations in these patients. The issue of transmissibility of HIV in the burn unit setting is addressed, and infection control is discussed.