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01-05-2004 | Original

Characteristics and outcomes of HIV-infected patients in the ICU: impact of the highly active antiretroviral treatment era

Authors: Benoît Vincent, Jean-François Timsit, Marc Auburtin, Frédérique Schortgen, Lila Bouadma, Michel Wolff, Bernard Regnier

Published in: Intensive Care Medicine | Issue 5/2004

Abstract

Objective

To examine whether the introduction of highly active antiretroviral therapy (HAART) has changed the rate of admission, the clinical spectrum, and the mortality of HIV-infected ICU patients.

Design

Observational study.

Setting

Infectious diseases ICU in a teaching hospital, Paris, France.

Patients

All HIV-infected patients admitted during a pre-HAART era (1995–1996; n=189) and a HAART era (1998–2000; n=236).

Interventions

None.

Measurements and results

At the HAART era, 79% of patients had derived no or little benefit from the availability of HAART at ICU admission: 44% had no history of antiretroviral (ARV) medications and 35% had failed to respond to ARV. As compared with the pre-HAART era, the rate of hospitalized HIV-infected patients requiring the ICU stay increased (HAART, 5.9% vs pre-HAART, 4.4%; p=0.004). The admission was more likely to occur through the emergency room (45 vs 29%, p=0.0004), and the patients to be foreigners (38.1 vs 28.6%; p=0.04). After adjustment for significant prognostic covariates (AIDS-related tumors at admission, CD4 count <50/mm³, poor functional status (Knaus score C or D), SAPSII, and need for mechanical ventilation), ICU survival was unchanged (adjusted OR=0.613, 95% CI=0.312–1.206), but 3-month survival was significantly improved (adjusted OR=0.57; 95% CI=0.32–0.99; p=0.045).

Conclusion

The number of HIV-infected patients admitted to the ICU remained high in the HAART era. Underutilization of HAART and limited access to health care are possible explanations. The ICU mortality has remained unchanged, but 3-month mortality has decreased.

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Title: Characteristics and outcomes of HIV-infected patients in the ICU: impact of the highly active antiretroviral treatment era
Authors: Benoît Vincent
Jean-François Timsit
Marc Auburtin
Frédérique Schortgen
Lila Bouadma
Michel Wolff
Bernard Regnier
Publication date: 01-05-2004
Publisher: Springer-Verlag
Published in: Intensive Care Medicine / Issue 5/2004
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-004-2158-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Characteristics and outcomes of HIV-infected patients in the ICU: impact of the highly active antiretroviral treatment era

Abstract

Objective

Design

Setting

Patients

Interventions

Measurements and results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objective

Design

Setting

Patients

Interventions

Measurements and results

Conclusion

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