THE TREATMENT OF ORGAN DYSFUNCTION IN HIV-POSITIVE PATIENTS

Aim: To evaluate the clinical and viro-immunological status in order to manage multiple organ disfunction of HIV-infected patients admitted to Intensive Care Unit (ICU) during active antiretroviral therapy. Material and Methods: Retrospective study, using medical data of HIV infected patients from the Regional HIV/AIDS Center of the “Sf. Parascheva” Infectious Diseases Clinical Hospital Iasi, admitted to the ICU, between 1st January 2016-31 December 2018. Results: In this study were included 21 patients with different HIV/AIDS stages and a depressed clinical status requiring evaluation and monitoring in the ICU. They were predominantly male with an average age of 34 years old. The viral-immunological status revealed the CD4 lymphocytes value less than 50 cells/mmc for most of the cases (19 patients), and a viral load significantly increased. As opportunistic infections were recorded: Tuberculosis (8 cases), Cryptococcal meningitis (1 case), Mycobacterium avium infection (1 case), Cytomegalovirus infection (6 cases). The most common complications were: respiratory distress syndrome and bacterial pneumonia (8 cases); and severe sepsis (4 cases), being evaluated and surveilled in ICU. Nine patients needed oral tracheal intubation and vasopressor support. All patients received antiretroviral therapy in association with specific antibiotherapy or antifungals depending on complication. Only one case had favorable evolution, the rest of the patients died. Conclusions: The survival rate of HIV-infected patients admitted to the ICU was extremely low even if they had critical care for severe complications and opportunistic infections.