Critical care of HIV-infected patients: still a dilemma for Italian intensivists--results of a multicentre survey.
OBJECTIVE
To survey the Italian intensivist policy towards critically ill patients with HIV or AIDS in the era of highly active antiretroviral therapy (HAART).


METHODS
This was a multicentre questionnaire survey involving all of the 239 ICUs of the GiViTI (Italian Group for Evaluation of Interventions in ICU) network. In January 2006, a detailed questionnaire (see Appendix) was e-mailed to the GiViTI referring ICU physician in each of the 239 ICUs on the GiViTI list. There were no interventions.


RESULTS
A total of 126 ICU physicians (52.7%) responded. The number of referred yearly admissions was low: 85.7% of ICUs usually admit five or fewer patients infected with HIV or AIDS per year; only 10.2 and 4.2% of them admitted at least 15 HIV-infected and at least 15 AIDS patients, respectively; the admission of patients with HIV or AIDS is perceived as always appropriate in only 30.4 and 14.3% of ICUs, respectively. A bivariate correlation was found between the presence of an infectious disease ward and the number of referred yearly admissions of both HIV-infected (Spearman rho=0.295, P<0.05) and AIDS patients (Spearman rho=0.304, P<0.05) and the decision to admit or not patients with HIV or AIDS patients to ICU. If an infectious disease ward was available, the intensivist was more likely to take the decision to admit a patient with HIV (Spearman rho=0.637, P<0.05) or AIDS in consultation with an infectious disease specialist (Spearman rho=0.578, P=0.01).


CONCLUSIONS
The recorded wide variation in intensivists' approach towards patients with HIV or AIDS requires the production of high-quality evidence to identify an optimal shared policy for such patients.
Corona
Alberto
A
ICU Department, Azienda Ospedaliera Luigi Sacco, Milano-Polo Universitario, Milan, Italy.
Raimondi
Ferdinando
F
D000163:Acquired Immunodeficiency Syndrome; D023241:Antiretroviral Therapy, Highly Active; D003422:Critical Care / Q000706:statistics & numerical data* / Q000639:trends; D015658:HIV Infections; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D007558:Italy; D010343:Patient Admission / Q000706:statistics & numerical data* / Q000639:trends; D011795:Surveys and Questionnaires