Characteristics and Outcomes of HIV-Infected Patients in the ICU-A Single Medical Center Experience in Mid-Taiwan Region

Abstract

Background and Objective: To survey the characteristics of critically ill patients with HIV infection admitted to ICU in a single medical center in Taiwan.Methods: A clinical chart based, retrospective study was conducted from January 2001 to December 2009 in a single medical center of mid-Taiwan region. Hospitalized patients with HIV infection were included. We further investigated those admitted to the ICU. Clinical and laboratory data were collected and analyzed.Results: A total of 279 HIV infected patients were admitted to our hospital during the survey period. Twenty-nine patients (10.4%) were referred to ICU. The overall in ICU mortality was 31%. Six patients (20.7%) were not known for HIV infection before ICU admission and had a higher mortality rate of 66.67%. High mortality rate was also associated with low CD4 count. Illegal drug user composed a major group of infected patient (51.7%) and generally had a better outcome (13.33%). Opportunistic infections (31%), mainly suspected pneumocystis jiroveci pneumonia (PJP) and CNS infection, were the leading reasons for ICU admission. Others suffered from illegal drug overdosed (17.2%), trauma (17.2%), GI bleeding (10.3%), hepatic failure (6.9%), and sepsis (6.9%).Conclusions: HIV infected patients were admitted to the ICU mainly due to opportunistic infection. Our mortality rate was similar to other countries where HAART is available. It was higher in patients not alerted of their HIV infection and correlated with low CD4 count. Illegal drug use played an important role in transmission routes and admission cause in our facility. However, mortality rate was relatively low in this group. In the era of HAART, HIV infection is not considered as futile anymore and intensivist should be ready for the challenge of managing various problems in this group.