[HIV/AIDS patients in a Critical Care Unit: The experience of a general hospital in a developing country].

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[HIV/AIDS patients in a Critical Care Unit: The experience of a general hospital in a developing country].

Rev Chilena Infectol. 2015 Jun;32(3):294-303

Authors: Verdugo F, Pinto F, Charpentier P, Von Mühlenbrock C, Soto A, Dabanch J, Fica A

Abstract
INTRODUCTION AND AIMS: Despite general availability of HAART in Chile, admissions of HIV/AIDS patients to Intensive-Intermediate Care Units (IICU) are still happening, and a characterization of patient's profile, mortality and potentially avoidable admissions is necessary.
METHODS: Observational retrospective study in one general hospital in Chile of HIV/AIDS patients admitted to IICU during 9 years.
RESULTS: During 2005-2013, 32 patients were admitted to IICU, with 87,5% in AIDS stage, only 53,1% knew his/her condition, 43,8% were receiving HAART and 16.6% chemoprophylaxis for opportunistic infections, A CD4 count < 200/µL was registered in 75,9% of patients. Most admissions were driven by infectious conditions (84,4%) and 48,1% developed septic shock, IICU hospitalizations were motivated by respiratory failure, neurologic compromise, sepsis or a mixture of them (87,5%), By univariate analysis, admissions by respiratory failure were associated to no HAART, oral candidiasis or CD4 < 250/µL (p < 0.01). Eight patients died during their first hospitalization (25%) and other 5 in the following month after discharge. Death during hospitalization was significantly associated to vasoactive drug use ≥ 7 days (OR 16.5; IC95 2.1-128 p < 0.01). In multivariate analysis, APACHE score ≥ 18 was associated with death during hospitalization of after discharge (OR 3,3 IC95 1,1-10; p < 0,05), Four patients (12,5%) had potentially avoidable admissions.
CONCLUSIONS: Despite HAART availability in Chile, hospitalizations of patients with HIV/AIDS are still happening, affecting those that either are unaware of his/her condition, are not receiving HAART and/or chemoprophylaxis. These admissions generate premature deaths and happen even after discharge in severely ill patients.

PMID: 26230436 [PubMed - as supplied by publisher]