title: Outcome of critically ill human immunodeficiency virus-infected patients in the era of highly active antiretroviral therapy.
abstract: The purpose of this study was to determine the effect of prior use of highly active antiretroviral therapy (HAART) on outcome of human immunodeficiency virus (HIV)- patients admitted to intensive care units (ICUs). This study was a retrospective chart review of 242 HIV-infected patients who required 259 consecutive admissions to a university-affiliated hospital ICU during a 3-year period. Patient demographics, CD4 count, admission diagnosis, prior HAART, Pneumocystis jiroveci prophylaxis, length of stay, and ICU and hospital mortality were determined. Overall hospital mortality was 39%. Comparing patients who had received HAART before an ICU admission to those who had not, we found no difference between ICU or hospital mortality, need of mechanical ventilation, ICU and hospital length of stay, and incidence of P jiroveci. Pulmonary diagnosis was the most frequent ICU admission diagnosis (30%). Logistic regression analysis showed HIV-related illness and mechanical ventilation were significant independent predictors of increased hospital mortality.
authors.affiliation: St. Luke's-Roosevelt Hospital Center, Columbia University College of Physicians and Surgeons, New York, New York 10019, USA. hkhouli@chpnet.org
authors.forename: Hassan
authors.initials: H
authors.lastname: Khouli
authors.forename: Ardavan
authors.initials: A
authors.lastname: Afrasiabi
authors.forename: Muhamad
authors.initials: M
authors.lastname: Shibli
authors.forename: Rizan
authors.initials: R
authors.lastname: Hajal
authors.forename: C Redington
authors.initials: CR
authors.lastname: Barrett
authors.forename: Peter
authors.initials: P
authors.lastname: Homel
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active; D016638:Critical Illness / Q000401:mortality / Q000628:therapy; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000401:mortality*; D017052:Hospital Mortality; D006785:Hospitals, University; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D016896:Treatment Outcome; D014505:Urban Population
chemical_list: D019380:Anti-HIV Agents