Prognostic factors of a favourable outcome of treating HIV-infected patients in an intensive care unit
The objective. Identifying the predictors of survival in patients at the late stage of HIV infection. Patients and methods. A retrospective review of the history cases was undertaken .The study involved 74 HIV-infected patients admitted to the intensive care unit at the Second State Infectious Clinical Hospital Moscow. Results. ICU mortality rates in HIV-positive patients was about 61.9% in 2015. A group of HIV-Infected survivors of critical illnesses transferred to post-intensive care unit after improved conditions was reviewed. The most recorded opportunistic diseases were CMV infection (28.6%) and cerebral toxoplasmosis (16.3%), however underlying diseases occured significantly: bacterial pneumonia (46.9%) and meningoencephalitis unspecified etiology (24.5%). As a result of this patient coducted empiric etiotropic treatment. The course of the study revealed factors responsible for disease severity such as late diagnosis and hospitalization of patients and also the poor adherence to ART. Considering these aspects in the outpatient management of these patients may lead to improved survival rate of HIV-infected patients. Conclusion. The main predictors of survival in patients at the late stages of HIV infection were prompt initiation of ART with a high degree of adherence to therapy, early detection and treatment of opportunistic infections, as well as early admission of patients in ICU requiring intensive care and constant monitoring health conditions.