Neurological complications of HIV infection in critically ill patients: Clinical features and outcomes

Sonneville, Romain; Ferrand, Hermine; Tubach, Florence; Roy, Carine; Bouadma, Lila; Klein, Isabelle; Foucrier, Arnaud; Régnier, B.; Mourvillier, Bruno; Wolff, Michel

doi:10.1016/j.jinf.2011.02.003

Cited by 31 publications

(17 citation statements)

References 36 publications

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“…repetitive sharp wave complexes over the temporal lobes or periodic lateralizing epileptiform discharges in HSV‐1 encephalitis); (e) abnormal results of neuroimaging suggestive of encephalitis. Exclusion criteria were (i) missing data on outcome; (ii) Streptococcus pneumoniae or Neisseria meningitidis bacterial meningitis; (iii) isolated brain abscess; (iv) AIDS‐defining central nervous system (CNS) diseases, including cerebral toxoplasmosis, cryptococcal meningitis, progressive multifocal leukoencephalopathy and HIV‐associated encephalopathy, as the prognosis of these conditions has been previously described ; (v) alternative acute CNS disease. Patients with HIV infection admitted to the ICU for acute encephalitis with no evidence of CNS opportunistic infection or HIV‐associated encephalopathy were kept in the final cohort.…”

Section: Methodsmentioning

confidence: 99%

Clinical spectrum and outcomes of patients with encephalitis requiring intensive care

Sonneville

Gault

Montmollin

et al. 2014

Euro J of Neurology

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Section: Methodsmentioning

confidence: 99%

Clinical spectrum and outcomes of patients with encephalitis requiring intensive care

Sonneville

Gault

Montmollin

et al. 2014

Euro J of Neurology

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“…Short-term outcomes of critically ill HIV-infected patients trend to equal those of seronegative subjects with similar demographics, chronic health status and underlying diseases (e.g., HCV or malignancy), reason for admission, and extent of organ dysfunction [32]. CD4 cell count, HIV viral load, prior cART use and an admission for an AIDS-related event (versus other diagnoses) are no longer associated with hospital survival [5,6,49,50].…”

Section: Similarities Between Critically Ill Hiv-infected and Seronegmentioning

confidence: 99%

Management of HIV-infected patients in the intensive care unit

et al. 2020

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The widespread use of combination antiretroviral therapies (cART) has converted the prognosis of HIV infection from a rapidly progressive and ultimately fatal disease to a chronic condition with limited impact on life expectancy. Yet, HIV-infected patients remain at high risk for critical illness due to the occurrence of severe opportunistic infections in those with advanced immunosuppression (i.e., inaugural admissions or limited access to cART), a pronounced susceptibility to bacterial sepsis and tuberculosis at every stage of HIV infection, and a rising prevalence of underlying comorbidities such as chronic obstructive pulmonary diseases, atherosclerosis or non-AIDS-defining neoplasms in cART-treated patients aging with controlled viral replication. Several patterns of intensive care have markedly evolved in this patient population over the late cART era, including a steady decline in AIDS-related admissions, an opposite trend in admissions for exacerbated comorbidities, the emergence of additional drivers of immunosuppression (e.g., anti-neoplastic chemotherapy or solid organ transplantation), the management of cART in the acute phase of critical illness, and a dramatic progress in short-term survival that mainly results from general advances in intensive care practices. Besides, there is a lack of data regarding other features of ICU and post-ICU care in these patients, especially on the impact of sociological factors on clinical presentation and prognosis, the optimal timing of cART introduction in AIDS-related admissions, determinants of end-of-life decisions, long-term survival, and functional outcomes. In this narrative review, we sought to depict the current evidence regarding the management of HIV-infected patients admitted to the intensive care unit.

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“…54 Delirium is diagnosed in 11% to 29% of hospitalized patients with HIV-AIDS. 11 There are no data regarding specific or distinguishing symptom characteristics for the delirium seen in patients with HIV.…”

Section: Psychiatric Disorders In Human Immunodeficiency Virus–aids Amentioning

confidence: 99%

Neuropsychiatric Aspects of Infectious Diseases

Munjal

Ferrando

Freyberg

2017

Critical Care Clinics

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Neurological complications of HIV infection in critically ill patients: Clinical features and outcomes

Cited by 31 publications

References 36 publications

Clinical spectrum and outcomes of patients with encephalitis requiring intensive care

Clinical spectrum and outcomes of patients with encephalitis requiring intensive care

Management of HIV-infected patients in the intensive care unit

Neuropsychiatric Aspects of Infectious Diseases

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