HIV/AIDS infection in critical care: epidemiological profile and risk factors for mortality in a Colombian cohort
Introduction: Outcomes of human immunodeficiency virus (HIV) infected patients admitted to intensive care units (ICU) have improved with antiretroviral therapy (ART). However, whether the outcomes have improved in low- and middle-income countries, paralleling those of high-income countries is unkno...
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The Journal of Infection in Developing Countries
2023-01-01
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| Series: | Journal of Infection in Developing Countries |
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| Online Access: | https://jidc.org/index.php/journal/article/view/15859 |
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| author | Sara Penagos Gaviria Natalia Zapata Pablo Villa Carlos A Agudelo Francisco J Molina Marco A González Laura V Durango Silvana Zapata Carlos Galeano Jonathan Cardona Sebastián Rivera Alicia I Hidron |
| author_facet | Sara Penagos Gaviria Natalia Zapata Pablo Villa Carlos A Agudelo Francisco J Molina Marco A González Laura V Durango Silvana Zapata Carlos Galeano Jonathan Cardona Sebastián Rivera Alicia I Hidron |
| author_sort | Sara Penagos Gaviria |
| collection | DOAJ |
| description |
Introduction: Outcomes of human immunodeficiency virus (HIV) infected patients admitted to intensive care units (ICU) have improved with antiretroviral therapy (ART). However, whether the outcomes have improved in low- and middle-income countries, paralleling those of high-income countries is unknown. The objective of this study was to describe a cohort of HIV-infected patients admitted to ICU in a middle-income country and identify the risk factors associated with mortality.
Methodology: A cohort study of HIV-infected patients admitted to five ICUs in Medellín, Colombia, between 2009 and 2014 was done. The association of demographic, clinical and laboratory variables with mortality was analyzed using a Poisson regression model with random effects.
Results: During this time period, 472 admissions of 453 HIV-infected patients were included. Indications for ICU admission were: respiratory failure (57%), sepsis/septic shock (30%) and central nervous system (CNS) compromise (27%). Opportunistic infections (OI) explained 80% of ICU admissions. Mortality rate was 49%. Factors associated with mortality included hematological malignancies, CNS compromise, respiratory failure, and APACHE II score ≥ 20.
Conclusions: Despite advances in HIV care in the ART era, half of HIV-infected patients admitted to the ICU died. This elevated mortality was associated to underlying disease severity (respiratory failure and APACHE II score ≥ 20), and host conditions (hematological malignancies, admission for CNS compromise). Despite the high prevalence of OIs in this cohort, mortality was not directly associated to OIs.
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| format | Article |
| id | doaj-art-f6ec23adcd5e407c8b28bd032e80b7cf |
| institution | DOAJ |
| issn | 1972-2680 |
| language | English |
| publishDate | 2023-01-01 |
| publisher | The Journal of Infection in Developing Countries |
| record_format | Article |
| series | Journal of Infection in Developing Countries |
| spelling | doaj-art-f6ec23adcd5e407c8b28bd032e80b7cf2025-08-20T02:57:52ZengThe Journal of Infection in Developing CountriesJournal of Infection in Developing Countries1972-26802023-01-01170110.3855/jidc.15859HIV/AIDS infection in critical care: epidemiological profile and risk factors for mortality in a Colombian cohortSara Penagos Gaviria0Natalia Zapata1Pablo Villa2Carlos A Agudelo3Francisco J Molina4Marco A González5Laura V Durango6Silvana Zapata7Carlos Galeano8Jonathan Cardona9Sebastián Rivera10Alicia I Hidron11School of Health Sciences, Universidad Pontificia Bolivariana, Medellín, ColombiaSchool of Health Sciences, Universidad Pontificia Bolivariana, Medellín, ColombiaSchool of Health Sciences, Universidad Pontificia Bolivariana, Medellín, ColombiaSchool of Health Sciences, Universidad Pontificia Bolivariana, Medellín, ColombiaSchool of Health Sciences, Universidad Pontificia Bolivariana, Medellín, ColombiaSchool of Health Sciences, Universidad Pontificia Bolivariana, Medellín, ColombiaSchool of Health Sciences, Universidad Pontificia Bolivariana, Medellín, ColombiaSchool of Health Sciences, Universidad Pontificia Bolivariana, Medellín, ColombiaSchool of Health Sciences, Universidad Pontificia Bolivariana, Medellín, ColombiaSchool of Health Sciences, Universidad Pontificia Bolivariana, Medellín, ColombiaSchool of Health Sciences, Universidad Pontificia Bolivariana, Medellín, ColombiaSchool of Health Sciences, Universidad Pontificia Bolivariana, Medellín, Colombia Introduction: Outcomes of human immunodeficiency virus (HIV) infected patients admitted to intensive care units (ICU) have improved with antiretroviral therapy (ART). However, whether the outcomes have improved in low- and middle-income countries, paralleling those of high-income countries is unknown. The objective of this study was to describe a cohort of HIV-infected patients admitted to ICU in a middle-income country and identify the risk factors associated with mortality. Methodology: A cohort study of HIV-infected patients admitted to five ICUs in Medellín, Colombia, between 2009 and 2014 was done. The association of demographic, clinical and laboratory variables with mortality was analyzed using a Poisson regression model with random effects. Results: During this time period, 472 admissions of 453 HIV-infected patients were included. Indications for ICU admission were: respiratory failure (57%), sepsis/septic shock (30%) and central nervous system (CNS) compromise (27%). Opportunistic infections (OI) explained 80% of ICU admissions. Mortality rate was 49%. Factors associated with mortality included hematological malignancies, CNS compromise, respiratory failure, and APACHE II score ≥ 20. Conclusions: Despite advances in HIV care in the ART era, half of HIV-infected patients admitted to the ICU died. This elevated mortality was associated to underlying disease severity (respiratory failure and APACHE II score ≥ 20), and host conditions (hematological malignancies, admission for CNS compromise). Despite the high prevalence of OIs in this cohort, mortality was not directly associated to OIs. https://jidc.org/index.php/journal/article/view/15859HIVICUmortality |
| spellingShingle | Sara Penagos Gaviria Natalia Zapata Pablo Villa Carlos A Agudelo Francisco J Molina Marco A González Laura V Durango Silvana Zapata Carlos Galeano Jonathan Cardona Sebastián Rivera Alicia I Hidron HIV/AIDS infection in critical care: epidemiological profile and risk factors for mortality in a Colombian cohort Journal of Infection in Developing Countries HIV ICU mortality |
| title | HIV/AIDS infection in critical care: epidemiological profile and risk factors for mortality in a Colombian cohort |
| title_full | HIV/AIDS infection in critical care: epidemiological profile and risk factors for mortality in a Colombian cohort |
| title_fullStr | HIV/AIDS infection in critical care: epidemiological profile and risk factors for mortality in a Colombian cohort |
| title_full_unstemmed | HIV/AIDS infection in critical care: epidemiological profile and risk factors for mortality in a Colombian cohort |
| title_short | HIV/AIDS infection in critical care: epidemiological profile and risk factors for mortality in a Colombian cohort |
| title_sort | hiv aids infection in critical care epidemiological profile and risk factors for mortality in a colombian cohort |
| topic | HIV ICU mortality |
| url | https://jidc.org/index.php/journal/article/view/15859 |
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