HIV infection and critical illness: Complicating conditions

While hospital admissions for HIV-associated disorders in the United States and abroad are declining overall, a substantial number of infected patients are being admitted to the hospital for a variety of complicating but unrelated conditions, including respiratory and renal failure, CNS infections, GI hemorrhage, and sepsis. The most common pathogens implicated in the development of bacterial pneumonia unrelated to Pneumocystis carinii pneumonia in these patients are Streptococcus pneumoniae, Haemophilus influenzae, and Staphylococcus aureus. Different factors influence the decision to admit patients to the ICU and ultimately affect prognoses. Patients admitted pose special challenges: a complicating condition may disclose the existence of HIV infection, and in other cases, treatment has not been initiated, cannot be tolerated, or simply has been ineffective.