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. 2012 Feb;27(1):51-7.
doi: 10.1016/j.jcrc.2011.08.015. Epub 2011 Oct 26.

Outcomes for critically ill patients with HIV and severe sepsis in the era of highly active antiretroviral therapy

Jared A Greenberg  1 , Jeffrey L Lennox, Greg S Martin
Affiliations

Outcomes for critically ill patients with HIV and severe sepsis in the era of highly active antiretroviral therapy

Jared A Greenberg et al. J Crit Care. 2012 Feb.

Abstract

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 in-hospital 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 HIV-infected. There were 194 acute infections among the 125 patients with full data available; 112 of the infections were nosocomial/health care-associated, 55 were AIDS-related, and 27 were community-acquired. Patients with nosocomial/health care-associated and AIDS-related infections had lower CD4 counts and were less likely to be on HAART (P < .05). The inpatient mortality was 42%. In a multivariable logistic regression model, only the APACHE II score (odds ratio, 1.12; 95% confidence interval, 1.02-1.23) was significantly associated with hospital mortality, although any HAART use (odds ratio, 0.53; 95% confidence interval, 0.22-1.33, P = .18) approached statistical significance.

Conclusions: In this large cohort study, nosocomial/health care-associated infections were common in ICU patients with HIV and severe sepsis. Hospital mortality was associated with acute illness severity, but not clearly associated with variables related to HIV infection. Interventions that aim to prevent or more effectively treat nosocomial infections in critically ill patients with HIV may favorably impact clinical outcomes.

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References

    1. Coquet I, Pavie J, Palmer P, Barbier F, Legriel S, Mayaux J, Molina JM, Schlemmer B, Azoulay E. Survival trends in critically ill HIV-infected patients in the highly active antiretroviral therapy era. Crit Care. 2010;14:R107. - PMC - PubMed
    1. Casalino E, Wolff M, Ravaud P, Choquet C, Bruneel F, Regnier B. Impact of HAART advent on admission patterns and survival in HIV-infected patients admitted to an intensive care unit. AIDS. 2004;18:1429–33. - PubMed
    1. Morris A, Creasman J, Turner J, Luce JM, Wachter RM, Huang L. Intensive care of human immunodeficiency virus-infected patients during the era of highly active antiretroviral therapy. Am J Respir Crit Care Med. 2002;166:262–7. - PubMed
    1. Narasimhan M, Posner AJ, DePalo VA, Mayo PH, Rosen MJ. Intensive care in patients with HIV infection in the era of highly active antiretroviral therapy. Chest. 2004;125:1800–4. - PubMed
    1. Khouli H, Afrasiabi A, Shibli M, Hajal R, Barrett CR, Homel P. Outcome of critically ill human immunodeficiency virus-infected patients in the era of highly active antiretroviral therapy. J Intensive Care Med. 2005;20:327–33. - PubMed

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