Survival for Patients With HIV Admitted to the ICU Continues to Improve in the Current Era of Combination Antiretroviral Therapy

Powell, Krista; Davis, J. Lucian; Morris, Alison; Chi, Amy; Bensley, M; Huang, Laurence

doi:10.1378/chest.08-0980

Cited by 122 publications

(197 citation statements)

References 27 publications

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“…The prognostic factors of mortality in HIV-infected patients admitted to the ICU are acute illness severity, poor functional status, low albumin rate, and respiratory failure requiring mechanical ventilation [47][48][49][50][51][52][53]. However, specific HIV characteristics (CD4 cell count, plasma HIV-RNA load, HIV-related diagnosis, or antiretroviral therapy) have not been clearly identified as predictors of ICU mortality [4,15,37,38,[49][50][51][52][54][55][56][57][58][59], although some reports have associated CD4…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Mortality of patients infected with HIV in the intensive care unit (2005-2010): significant role of chronic hepatitis C and severe sepsis

Medrano¹,

Álvaro-Meca²,

Boyer³

et al. 2014

Critical Care

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Section: Discussionmentioning

confidence: 99%

“…However, specific HIV characteristics (CD4 cell count, plasma HIV-RNA load, HIV-related diagnosis, or antiretroviral therapy) have not been clearly identified as predictors of ICU mortality [4,15,37,38,[49][50][51][52][54][55][56][57][58][59], although some reports have associated CD4…”

Section: Discussionmentioning

confidence: 99%

Mortality of patients infected with HIV in the intensive care unit (2005-2010): significant role of chronic hepatitis C and severe sepsis

Medrano¹,

Álvaro-Meca²,

Boyer³

et al. 2014

Critical Care

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“…Further studies, connected with the introduction of HAART, have demonstrated improved survival, even amongst PCP patients [7,8]. At present, respiratory failure is still the most common indication for ICU admission [9,10], although PCP as a cause of respiratory failure is substantially less common. After the introduction of HAART, the number of hospitalizations related to AIDS decreased, while the incidence of sepsis as a reason for ICU admission increased [11].…”

Section: Discussionmentioning

confidence: 99%

Przyczyny hospitalizacji chorych zakażonych wirusem HIV na oddziale intensywnej terapii — jednoośrodkowe badanie obserwacyjne

Łojko¹,

Piechota²

2015

Anaesthesiol Intensive Ther

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Background: There are no Polish data regarding the reasons for and incidence of ICU hospitalisations of HIV-infected patients. The aim of the study was to determine the reasons for and incidence of hospitalisations of HIV-infected patients in the Department of Anaesthesiology and Intensive Therapy of the Dr W. Biegański Regional Specialist Hospital in Łódź in the years 2010−2014. Methods: Preliminary research enabled to identify all the patients with laboratory-confirmed HIV, including those hospitalised in the ICU. Patients` medical records were analysed. Analysis involved epidemiological data, underlying diagnosis, coexisting diseases and conditions, as well as biochemical, hematologic, virusologic, bacteriologic, mycologic and immunologic tests. Results: In the years 2010−2014, new HIV infections were diagnosed in 224 individuals; 8 of them required ICU hospitalization (10 hospitalisations) -5 men (62.5%) and 3 women (37.5%). The age of patients ranged from 24 to 46 years. All the patients were diagnosed with AIDS. Three of them died. The patients with HIV constituted 1.30% of all patients hospitalised in the ICU over the period of 5 years. Conclusions: Low number of HIV-infected patients hospitalised in the ICU in the years 2010−2014 was associated with low HIV incidence rates in the Łódź province and generally available modern antiretroviral therapy rather than restrictive admission policy. Reasons for admission as well as coexisting diseases and conditions, including opportunistic infections, of patients hospitalised in the ICU in 2010−2014 are similar to those in West European countries and the United Stated.

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“…[1][2][3][4][5][6][7][8][9] Hospital admission patterns for patients with HIV have changed in the modern antiretroviral therapy era. 2,10,11 Patients are less likely to be hospitalized for AIDS-related opportunistic infections.…”

Section: Introductionmentioning

confidence: 99%

Outcomes for Critically Ill Patients With HIV and Severe Sepsis in the Era of Highly Active Antiretroviral Therapy

Greenberg

Lennox

Martin

2012

Survey of Anesthesiology

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RATIONALE-With the advent of Highly Active Antiretroviral Therapy (HAART), sepsis has become a more frequent ICU diagnosis for patients with HIV infections. Yet, little is known about the etiologies of acute infections in critically ill patients with HIV and the factors that affect inhospital mortality.METHODS-Cases of patients with HIV requiring intensive care specifically for severe sepsis were identified over 27 months. Demographic information, variables related to acute illness severity, variables related to HIV infection, and all acute infections contributing to ICU stay were recorded.RESULTS-Of 990 patients admitted to the ICU with severe sepsis, 136 (13.7%) were HIVinfected. There were 194 acute infections among the 125 patients with full data available; 112 of the infections were nosocomial/healthcare-associated, 55 were AIDS-related, and 27 were community-acquired. Patients with nosocomial/healthcare-associated and AIDS-related infections had lower CD4 counts and were less likely to be on HAART (p<0.05). The inpatient mortality was 42%. In a multivariable logistic regression model, only the APACHE II score (odds ratio, OR 1.12, 95% CI 1.02-1.23) was significantly associated with hospital mortality, although any HAART use (OR 0.53, 95% CI 0.22-1.33, p=0.18) approached statistical significance.

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Survival for Patients With HIV Admitted to the ICU Continues to Improve in the Current Era of Combination Antiretroviral Therapy

Abstract: Background-The highly active antiretroviral therapy (ART) era (1996-present) has been associated with improved survival among HIV-infected outpatients, but ICU data from 2000-present are limited.

Cited by 122 publications

References 27 publications

Mortality of patients infected with HIV in the intensive care unit (2005-2010): significant role of chronic hepatitis C and severe sepsis

Mortality of patients infected with HIV in the intensive care unit (2005-2010): significant role of chronic hepatitis C and severe sepsis

Przyczyny hospitalizacji chorych zakażonych wirusem HIV na oddziale intensywnej terapii — jednoośrodkowe badanie obserwacyjne

Outcomes for Critically Ill Patients With HIV and Severe Sepsis in the Era of Highly Active Antiretroviral Therapy

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