title: Antiretroviral therapy at the end of life: the experience of an academic HIV clinic.
abstract: BACKGROUND
  There are no guidelines regarding the discontinuation of antiretroviral therapy at the end of life.
  
  
  METHODS
  We retrospectively reviewed our databases and identified patients with HIV/AIDS who died over the last 12 months in our HIV clinic.
  
  
  RESULTS
  A total of 41 patients from our HIV clinic died in a period of 12 months. Seventy-three percent of the patients were on antiretroviral therapy during the last clinic visit. During the last 3 months of life, 32% (13 of 41) were off antiretroviral therapy, with 77% (10 of 13) of them having intermittent therapy due to noncompliance. The remaining 23% (3 of 13) decided to stop antiretroviral therapy after discussion among families, patients, and providers.
  
  
  CONCLUSIONS
  Discussions among providers, patients, and families are encouraged to establish goals of care and role of antiretrovirals during the last months of life.
authors.affiliation: Department of Medicine, Section of Geriatric Medicine, Louisiana State University Health Sciences Center New Orleans, New Orleans, LA, USA mruiz@lsuhsc.edu.
authors.forename: Marco
authors.initials: M
authors.lastname: Ruiz
authors.affiliation: Department of Psychology, Louisiana State University Health Sciences Center New Orleans, New Orleans, LA, USA.
authors.forename: Megan
authors.initials: M
authors.lastname: Armstrong
authors.affiliation: Department of Medicine, Section of Geriatric Medicine, Louisiana State University Health Sciences Center New Orleans, New Orleans, LA, USA.
authors.forename: Tom
authors.initials: T
authors.lastname: Reske
authors.affiliation: Department of Medicine, Section of Geriatric Medicine, Louisiana State University Health Sciences Center New Orleans, New Orleans, LA, USA.
authors.forename: Charles
authors.initials: C
authors.lastname: Cefalu
authors.affiliation: Department of Medicine, Tulane School of Medicine, New Orleans, LA, USA.
authors.forename: Dominique
authors.initials: D
authors.lastname: Anwar
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000188:drug therapy; D000328:Adult; D044966:Anti-Retroviral Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D005260:Female; D015658:HIV Infections / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012189:Retrospective Studies; D013727:Terminal Care
chemical_list: D044966:Anti-Retroviral Agents
keywords: HIV; antiretrovirals; discontinuation; end of life