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Semin Respir Crit Care Med. 2016 Apr;37(2):303-17. doi: 10.1055/s-0036-1572561. Epub 2016 Mar 14.

Critical Care in Human Immunodeficiency Virus-Infected Patients.

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Section of Pulmonary, Critical Care and Sleep, Department of Medicine, VA Connecticut, West Haven, CT.
Research Department of Infection and Population Health, University College London, London, United Kingdom.


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.

[Indexed for MEDLINE]

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