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  • Poster presentation
  • Open Access

HIV-infected patients in the ICU in the current era of high-activity antiretroviral treatment

  • 1,
  • 1,
  • 1,
  • 1,
  • 1 and
  • 1
Critical Care201115 (Suppl 1) :P512

https://doi.org/10.1186/cc9932

  • Published:

Keywords

  • Organ Support
  • Chronic Respiratory Disease
  • Alcohol Consumer
  • Admission Time
  • Renal Support

Introduction

Our purpose is to study the effect of high-activity antiretroviral treatment (HAART) on the epidemiology and outcome of human inmunodefficiency virus (HIV) patients in the ICU. HAART has modified the outcome of patients infected with HIV, increasing survival and reducing infectious complications. In the first years of HAART use a significant change in the diagnosis and prognosis of ICU-admitted HIV patients has been identified, but there are no studies investigating this issue in the most recent years.

Methods

A retrospective study. HIV patients admitted to a 36-bed ICU, between January 2005 and December 2009 (HIV incidence in our population: 42 cases/million hab/year). We studied demographic characteristics, having or not HAART, final diagnosis, need for organ support and outcome (length of stay (LOS) and mortality).

Results

One hundred and five HIV-infected patients (70.5% being male), 52 (49.5%) having HAART. Mean age: 41 ± 8.57 years. More common co-morbidities were: hepatic disease (61%), cirrhosis in a 10.5%, followed by chronic respiratory disease and dyslipemia (12.4%), cardiac disease (5.7%), solid and hematologic malignancy (5.7% and 2.9%, respectively). A total 70.5% had a history of intravenous drugs use, and 13.3% were heavy alcohol consumers. Average CD4 count was 275.4 ± 362/ml, mean viral load was 3,656 ± 3,000/ml. A total 52.1% were on their CD4 nadir at admission time. Most frequent final diagnosis (grouped): infectious disease, 58.3% (focus: lung 66.7%, CNS 16.7%), cardiac disease (12.7%), intoxication and trauma (5.8% each one). Average APACHE II: 20.9. A total 48.6% of patients needed support with vasopressors, 64.7% mechanical ventilation and 15.2% renal support. A total 69.5% of patients needed at least one organ support. ICU LOS: 8.7 ± 9.9 days, hospital LOS: 29 ± 29.5. ICU mortality: 28.6%, hospital mortality: 35.2%.

Conclusions

Despite the beneficial effects of HAART on inmune status, infection (especially pneumonia) remains the most common cause of ICU admission. Our results confirm the trend to a lower mortality saw in early HAART period studies.

Authors’ Affiliations

(1)
CHU A Coruña, A Coruña, Spain

References

  1. Powell , et al.: Survival for patients with HIV admitted to the ICU continues to improve in the current era of combination antiretroviral therapy. Chest 2009, 135: 11-17. 10.1378/chest.08-0980PubMed CentralView ArticlePubMedGoogle Scholar
  2. Croda , et al.: Benefit of antirretroviral therapy on survival of human immunodeficiency virus-infected patients admitted to an intensive care unit. Crit Care Med 2009, 37: 1605-1611. 10.1097/CCM.0b013e31819da8c7PubMed CentralView ArticlePubMedGoogle Scholar

Copyright

© Cortés et al. 2011

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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