Virus de la inmunodeficiencia humana en la era TARGA. Experiencia en un hospital de referencia

Abstract

INTRODUCTION: The cause of ICU admission of HIV patients has changed during the HAART era. OBJECTIVE: To analyze HIV + patients admitted in the ICU of a tertiary university hospital, reference in HIV patients, during the HAART era. To describe the epidemiology of the disease in the ICU, cause of admission and comorbidities. Material and METHODS: Descriptive, retrospective study. HIV + patients admitted to the ICU from May 2013 to November 2017. Collected data: HIV diagnosis, HIV related previous illnesses, previous admissions, HBV coinfection, HCV, lymphocytes, CD4, adherence to treatment, cause of admission, microbiological isolation, severity scores (SOFA, SAPS II, APACHE II), mechanical ventilation, vasoactive drugs, albumin, intra ICU mortality). RESULTS: 1,511 patients were analyzed, 27 had previous diagnosis of HIV +, 5 (18.9%) were not adherent to treatment. Cause of admission: 13 patients altered level of consciousness. 7 patients acute respiratory failure. Seven patients shock. DISCUSSION: Patients who were not adherent to treatment or coinfected with HCV-HBV had lower average of CD4, lymphocyte, albumin and hemoglobin values which were associated with higher mortality and need for vasoactive drugs. (p < 0.005). Non treatment adherent HIV patients admitted to the ICU with infection have higher mortality percentages than those who comply with treatment (p < 0.005).