Intensive care of patients with HIV infection.
Despite the improvements in the prognosis associated with the development of highly active antiretroviral therapy (HAART), more than 410,000 people in the United States were reported to have died from acquired immune deficiency syndrome (AIDS) by the end of 1998. The number of people living with human immunodeficiency virus (HIV) infection and AIDS in the United States continues to increase, estimated at more than 370,000 in 1998, and there is good reason for optimism that HIV infection may be a controllable disease in many people. Nevertheless, an estimated 27,000 persons still died of AIDS in the United States in 1997, and AIDS is still a leading cause of death in the age group 25 to 44 years. Despite the dramatic treatment advances for HIV infection and improving survival following an AIDS diagnosis, many patients still present with life-threatening complications of HIV infection for three major reasons. Highly active antiretroviral therapy and prophylaxis against Pneumocystis carinii and other infections are not effective in all patients, despite rigorous adherence to treatment. Others adhere to these therapies poorly. Finally, many patients present with advanced disease, unaware that they have HIV infection until they develop a serious opportunistic infection. Therefore, the AIDS epidemic and its burden of illness will continue, and decisions regarding the appropriateness of intensive care for individual patients will be inevitable. The impact of AIDS in Africa and Asia is far more devastating than in the United States and Europe, and most HIV-infected persons in the world live in the underdeveloped nations where intensive care is often unavailable. This article will deal with intensive care in patients with HIV in developed nations.
Rosen
M J
MJ
Division of Pulmonary and Critical Care Medicine, Beth Israel Medical Center, Albert Einstein College of Medicine, New York, New York 10003, USA.
D000163:Acquired Immunodeficiency Syndrome / Q000453:epidemiology*; D000328:Adult; D003422:Critical Care; D016638:Critical Illness; D015658:HIV Infections / Q000453:epidemiology*; D006801:Humans; D014481:United States / Q000453:epidemiology