title: Critical Care in Human Immunodeficiency Virus-Infected Patients.
abstract: Intensive care unit (ICU) survival has been improved significantly for HIV-infected patients since the advent of antiretroviral therapy (ART). Non-AIDS conditions account for the majority of ICU admission diagnoses in areas with access to ART. However, opportunistic infections such as Pneumocystis jirovecii pneumonia still account for a significant proportion of ICU admissions, particularly in newly diagnosed HIV-infected patients, and are associated with increased ICU mortality. We discuss risk factors and outcomes for HIV-infected admitted to the ICU in the current ART era. We review the changing patterns in ICU admission diagnoses over time and how common ICU conditions are managed in HIV-infected compared with uninfected patients. We next address issues specific to the care for HIV-infected patients in the ICU, focusing on immune reconstitution inflammatory syndrome, ART continuation or initiation, and some common and potentially life-threatening ART-associated toxicities.
authors.affiliation: Section of Pulmonary, Critical Care and Sleep, Department of Medicine, VA Connecticut, West Haven, CT.
authors.forename: Kathleen M
authors.initials: KM
authors.lastname: Akgün
authors.affiliation: Research Department of Infection and Population Health, University College London, London, United Kingdom.
authors.forename: Robert F
authors.initials: RF
authors.lastname: Miller
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000453:epidemiology / Q000628:therapy*; D019380:Anti-HIV Agents / Q000009:adverse effects / Q000627:therapeutic use; D003422:Critical Care / Q000379:methods*; D015658:HIV Infections / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D017052:Hospital Mortality; D006801:Humans; D007362:Intensive Care Units; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D019380:Anti-HIV Agents