People living with HIV, HCV and HIV/HCV coinfection in intensive care in a German tertiary referral center 2014-2019.
Autor: | Schlabe S; Department of Internal Medicine I, University Hospital Bonn, Bonn, Germany. stefan.schlabe@ukbonn.de.; German Centre of Infection Research, Partner-Site Cologne-Bonn, Bonn, Germany. stefan.schlabe@ukbonn.de., Boesecke C; Department of Internal Medicine I, University Hospital Bonn, Bonn, Germany.; German Centre of Infection Research, Partner-Site Cologne-Bonn, Bonn, Germany., van Bremen K; Department of Internal Medicine I, University Hospital Bonn, Bonn, Germany.; German Centre of Infection Research, Partner-Site Cologne-Bonn, Bonn, Germany., Schwarze-Zander C; Department of Internal Medicine I, University Hospital Bonn, Bonn, Germany.; German Centre of Infection Research, Partner-Site Cologne-Bonn, Bonn, Germany., Bischoff J; Department of Internal Medicine I, University Hospital Bonn, Bonn, Germany.; German Centre of Infection Research, Partner-Site Cologne-Bonn, Bonn, Germany., Yürüktümen A; Department of Internal Medicine II, University Hospital Bonn, Bonn, Germany., Heine M; Department of Internal Medicine III, University Hospital Bonn, Bonn, Germany., Spengler U; Department of Internal Medicine I, University Hospital Bonn, Bonn, Germany.; German Centre of Infection Research, Partner-Site Cologne-Bonn, Bonn, Germany., Nattermann J; Department of Internal Medicine I, University Hospital Bonn, Bonn, Germany.; German Centre of Infection Research, Partner-Site Cologne-Bonn, Bonn, Germany., Rockstroh JK; Department of Internal Medicine I, University Hospital Bonn, Bonn, Germany.; German Centre of Infection Research, Partner-Site Cologne-Bonn, Bonn, Germany., Wasmuth JC; Department of Internal Medicine I, University Hospital Bonn, Bonn, Germany.; German Centre of Infection Research, Partner-Site Cologne-Bonn, Bonn, Germany. |
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Jazyk: | angličtina |
Zdroj: | Infection [Infection] 2023 Dec; Vol. 51 (6), pp. 1645-1656. Date of Electronic Publication: 2023 Apr 13. |
DOI: | 10.1007/s15010-023-02032-9 |
Abstrakt: | Purpose: The epidemiology of HIV-infected individuals on the Medical Intensive Care Units (MICU) has changed after profound progress in treatment of AIDS-defining illnesses and anti-retroviral therapy (ART). Changes of MICU utilization of Hepatitis C (HCV) patients following roll-out of direct-acting antivirals (DAA) are yet to evaluate. Methods: We performed a retrospective study on all patients with HIV, HIV/HCV and HCV admitted to the MICU of University Hospital Bonn 2014-2019. We assessed sociodemographic data, available clinical data from HIV patients (CDC stage, CD4 + lymphocyte cell count, HIV-1-RNA, ART) and HCV patients (HCV-RNA, stage of liver cirrhosis, treatment history) and outcome. Results: 237 patients (46 HIV, 22 HIV/HCV, 169 HCV; 168 male, median age 51.3 years) with 325 MICU admissions were included. Admission criteria for HIV patients were infections (39.7% AIDS-associated, 23.8% with controlled HIV-infection) and cardiopulmonary diseases (14.3%). HIV/HCV coinfected patients had infections in controlled/uncontrolled HIV-infection (46.4%), cardiopulmonary diseases and intoxication/drug abuse (17.9% each). Reasons for HCV-mono-infected patients were infections (24.4%), sequelae of liver disease (20.9%), intoxication/drug abuse (18.4%) and cardiopulmonary diseases (15%). 60 patients deceased; most important risk factor was need for mechanical ventilation. The number of HCV-patients admitted to MICU with chronic active disease and sequelae of liver disease decreased while the proportion of patients with completed DAA-treatment increased. Conclusion: Infections remain the most important reason for MICU admission in patients with HIV and/or HCV infection while non-AIDS related conditions increased. DAA roll-out has a beneficial effect on liver-associated morbidity in HCV patients admitted to MICU. (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.) |
Databáze: | MEDLINE |
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