Abstract
The use of intensive care units (ICU) resources for HIV-Infected patients has been controversial since the first reported cases, raising practical ethical and economic issues about aggressive treatment. The aim of this review of the literature is to provide current information on the epidemiology of human immunodeficiency virus (HIV)-infected patients admitted to ICU during the era of highly active antiretroviral therapy (HAART) and to highlight issues related to HAART that are relevant to the intensivist. Overall mortality of critically ill HIV-infected patients in ICU has decreased in the HAART era and patients are more commonly admitted with non-HIV-related illnesses. Use of HAART in ICU is problematic, however it may be associated with improved outcomes. More HIV-infected patients surviving ICU admission are more likely to need critical care for problems unrelated to HIV infection or for conditions related to HAART toxicity. Intensivists need to be familiar with HAART (i) to recognize life-threatening toxicities unique to these drugs; (ii) to avoid drug interactions, which are extremely common and potentially life-threatening; (iii) to avoid enhancing HIV drug resistance, an occurrence that could have devastating consequences for the patient following ICU discharge.
Keywords: HIV infection, epidemiology, hospitalization, critically ill patients, ICU, highly active antiretroviral therapy
Current HIV Research
Title: Caring for HIV-Infected Patients in the ICU in The Highly Active Antiretroviral Therapy Era
Volume: 7 Issue: 6
Author(s): Alberto Corona and Ferdinando Raimondi
Affiliation:
Keywords: HIV infection, epidemiology, hospitalization, critically ill patients, ICU, highly active antiretroviral therapy
Abstract: The use of intensive care units (ICU) resources for HIV-Infected patients has been controversial since the first reported cases, raising practical ethical and economic issues about aggressive treatment. The aim of this review of the literature is to provide current information on the epidemiology of human immunodeficiency virus (HIV)-infected patients admitted to ICU during the era of highly active antiretroviral therapy (HAART) and to highlight issues related to HAART that are relevant to the intensivist. Overall mortality of critically ill HIV-infected patients in ICU has decreased in the HAART era and patients are more commonly admitted with non-HIV-related illnesses. Use of HAART in ICU is problematic, however it may be associated with improved outcomes. More HIV-infected patients surviving ICU admission are more likely to need critical care for problems unrelated to HIV infection or for conditions related to HAART toxicity. Intensivists need to be familiar with HAART (i) to recognize life-threatening toxicities unique to these drugs; (ii) to avoid drug interactions, which are extremely common and potentially life-threatening; (iii) to avoid enhancing HIV drug resistance, an occurrence that could have devastating consequences for the patient following ICU discharge.
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Corona Alberto and Raimondi Ferdinando, Caring for HIV-Infected Patients in the ICU in The Highly Active Antiretroviral Therapy Era, Current HIV Research 2009; 7 (6) . https://dx.doi.org/10.2174/157016209789973592
DOI https://dx.doi.org/10.2174/157016209789973592 |
Print ISSN 1570-162X |
Publisher Name Bentham Science Publisher |
Online ISSN 1873-4251 |
Call for Papers in Thematic Issues
HIV vaccine development
The development of a safe and effective vaccine that impedes HIV-1 transmission and/or limits the severity of infection remains a public health priority. The HIV-1/AIDS pandemic continues to have a disproportionate impact on vulnerable and under-served communities in the USA and globally. In the USA, minority communities that have relatively ...read more
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