Review Article Intensive Care of Patients with HIV Infection

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Review Article Intensive Care of Patients with
HIV Infection
Laurence Huang, M.D., Andrew Quartin, M.D.,
M.P.H., Denis Jones, M.D., and Diane V. Havlir,
M.D.
N Engl J Med Volume 355(2)173-181 July 13, 2006
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Summary

• The intensive care of patients with human
  immunodeficiency virus (HIV) infection is
  increasingly complex and may involve difficult
  decisions about the initiation or continuation of
  antiretroviral therapy.
• In some critically ill patients, the diagnosis of
  HIV has not been established, and there are legal
  implications for many important clinical
  decisions.
• Care may also be complicated by HIV-related
  pulmonary, cardiac, or renal impairment.

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Outline

• Complications Associated with HIV Infection
• Pulmonary Disease
• Cardiac Disease
• Liver Disease
• Renal Disease
• HIV Testing and Disclosure in the ICU
• Antiretroviral Therapy in the ICU
• Drug Delivery, Absorption, and Doses
• Drug Interactions and Toxicity
• Treatment Strategies
• Conclusions

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Principal Diagnosis Received by Patients with HIV
on Admission to the Medical or Surgical ICU at
San Francisco General Hospital between 1981 and
2003
Huang L et al. N Engl J Med 2006355173-181
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Important Characteristics of Antiretroviral
Medications
Huang L et al. N Engl J Med 2006355173-181
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Potentially Life-Threatening and Serious Adverse
Effects of Antiretroviral Agents
Huang L et al. N Engl J Med 2006355173-181
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Treatment Strategies for Patients with HIV on
Admission to the ICU
Huang L et al. N Engl J Med 2006355173-181