• Antoine Gaillet, Elie Azoulay, Etienne de Montmollin, Maité Garrouste-Orgeas, Yves Cohen, Claire Dupuis, Carole Schwebel, Jean Reignier, Shidasp Siami, Laurent Argaud, Christophe Adrie, Bruno Mourvillier, Stéphane Ruckly, Jean-Marie Forel, and Jean-Francois Timsit.
• Medical Intensive Care Unit, Henri Mondor University Hospital, APHP, 1 Rue Gustave Eiffel, 94010, Créteil Cedex, France. gaillet.antoine75@gmail.com.
• Crit Care. 2023 Mar 13; 27 (1): 108108.

PurposeDespite antiviral therapy (ART), 800,000 deaths still occur yearly and globally due to HIV infection. In parallel with the good virological control and the aging of this population, multiple comorbidities [HIV-associated-non-AIDS (HANA) conditions] may now be observed.MethodsHIV adult patients hospitalized in intensive care unit (ICU) from all the French region from university and non-university hospital who participate to the OutcomeRea™ database on a voluntary basis over a 24-year period.ResultsOf the 24,298 stays registered, 630 (2.6%) were a first ICU stay for HIV patients. Over time, the mean age and number of comorbidities (diabetes, renal and respiratory history, solid neoplasia) of patients increased. The proportion of HIV diagnosed on ICU admission decreased significantly, while the median duration of HIV disease as well as the percentage of ART-treated patients increased. The distribution of main reasons for admission remained stable over time (acute respiratory distress > shock > coma). We observed a significant drop in the rate of active opportunistic infection on admission, while the rate of active hemopathy (newly diagnosed or relapsed within the last 6 months prior to admission to ICU) qualifying for AIDS increased-nonsignificantly-with a significant increase in the anticancer chemotherapy administration in ICU. Admissions for HANA or non-HIV reasons were stable over time. In multivariate analysis, predictors of 60-day mortality were advanced age, chronic liver disease, past chemotherapy, sepsis-related organ failure assessment score > 4 at admission, hospitalization duration before ICU admission > 24 h, AIDS status, but not the period of admission.ConclusionWhereas the profile of ICU-admitted HIV patients has evolved over time (HIV better controlled but more associated comorbidities), mortality risk factors remain stable, including AIDS status.© 2023. The Author(s).

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