Epidemiology and Outcomes in Critically Ill Patients with Human Immunodeficiency Virus Infection in the Era of Combination Antiretroviral Therapy
Joint Authors
Bagshaw, Sean M.
Eurich, Dean T.
Turvey, Shannon L.
Sligl, Wendy I.
Source
Canadian Journal of Infectious Diseases and Medical Microbiology
Issue
Vol. 2017, Issue 2017 (31 Dec. 2017), pp.1-9, 9 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2017-02-27
Country of Publication
Egypt
No. of Pages
9
Main Subjects
Abstract EN
Purpose.
The impact of critical illness on survival of HIV-infected patients in the era of antiretroviral therapy remains uncertain.
We describe the epidemiology of critical illness in this population and identify predictors of mortality.
Materials and Methods.
Retrospective cohort of HIV-infected patients was admitted to intensive care from 2002 to 2014.
Patient sociodemographics, comorbidities, case-mix, illness severity, and 30-day mortality were captured.
Multivariable Cox regression analyses were performed to identify predictors of mortality.
Results.
Of 282 patients, mean age was 44 years (SD 10) and 169 (59%) were male.
Median (IQR) CD4 count and plasma viral load (PVL) were 125 cells/mm3 (30–300) and 28,000 copies/mL (110–270,000).
Fifty-five (20%) patients died within 30 days.
Factors independently associated with mortality included APACHE II score (adjusted hazard ratio [aHR] 1.12; 95% CI 1.08–1.16; p<0.001), cirrhosis (aHR 2.30; 95% CI 1.12–4.73; p=0.024), coronary artery disease (aHR 6.98; 95% CI 2.20–22.13; p=0.001), and duration of HIV infection (aHR 1.07 per year; 95% CI 1.02–1.13; p=0.01).
CD4 count and PVL were not associated with mortality.
Conclusions.
Mortality from an episode of critical illness in HIV-infected patients remains high but appears to be driven by acute illness severity and HIV-unrelated comorbid disease rather than degree of immune suppression.
American Psychological Association (APA)
Turvey, Shannon L.& Bagshaw, Sean M.& Eurich, Dean T.& Sligl, Wendy I.. 2017. Epidemiology and Outcomes in Critically Ill Patients with Human Immunodeficiency Virus Infection in the Era of Combination Antiretroviral Therapy. Canadian Journal of Infectious Diseases and Medical Microbiology،Vol. 2017, no. 2017, pp.1-9.
https://search.emarefa.net/detail/BIM-1141599
Modern Language Association (MLA)
Turvey, Shannon L.…[et al.]. Epidemiology and Outcomes in Critically Ill Patients with Human Immunodeficiency Virus Infection in the Era of Combination Antiretroviral Therapy. Canadian Journal of Infectious Diseases and Medical Microbiology No. 2017 (2017), pp.1-9.
https://search.emarefa.net/detail/BIM-1141599
American Medical Association (AMA)
Turvey, Shannon L.& Bagshaw, Sean M.& Eurich, Dean T.& Sligl, Wendy I.. Epidemiology and Outcomes in Critically Ill Patients with Human Immunodeficiency Virus Infection in the Era of Combination Antiretroviral Therapy. Canadian Journal of Infectious Diseases and Medical Microbiology. 2017. Vol. 2017, no. 2017, pp.1-9.
https://search.emarefa.net/detail/BIM-1141599
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-1141599