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HIV in the critically ill 

HIV in the critically ill
Chapter:
HIV in the critically ill
Author(s):

Mark Hull

and Steven C. Reynolds

DOI:
10.1093/med/9780199600830.003.0291
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date: 25 February 2020

It has been over 30 years since the recognition of the acquired immune deficiency syndrome (AIDS), linked to infection with human immunodeficiency virus (HIV). Opportunistic infections arise in the setting of decreases in the CD4+ T-lymphocyte count. Advances in the safety, and effectiveness of combination antiretroviral therapy (cART) have led to substantial improvements in life-expectancy for individuals accessing successful therapy. As such individuals are likely to be admitted to the intensive care unit (ICU) for conditions un-related to HIV, although presentations due to opportunistic infections and malignancies must be considered in those with previously undiagnosed infection or in those patients non-adherent to cART.. Individuals receiving cART must undergo careful evaluation for potential drug–drug interactions with other medications. Treatment interruption of cART is not generally advised due to risk of rebound viraemia and potential development of resistance.. Immune reconstitution inflammatory syndrome may be considered in those with recent cART initiation.

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