In-Hospital Deaths Down for HIV Patients

Hospital mortality rates decrease for HIV ICU patients

(RxWiki News) In the 1980s, people with HIV weren't allowed to enter intensive care units because they were too close to death. But now, more and more HIV patients are coming out of the ICU alive.

According to a new study, the number of deaths of HIV-positive patients in hospital intensive care units (ICU) has significantly declined over the past sixteen years.

The credit goes to antiretroviral drugs, an effective combination of medicines that fight the virus and other infections that used to be a death sentence.

However, the study also turned up the darker finding that chronic diseases and bloodstream infections are also on the rise among HIV patients in the ICU.

"Ask your doctor about antiretroviral drugs for HIV treatment."

The study was led by Monica Bhargava, MD, MS, of Stanford University’s Division of Pulmonary and Critical Care Medicine, and presented at the American Thoracic Society conference in San Francisco.

Antiretroviral therapy (ART) is a combination, or cocktail of drugs that combat HIV in the patient's bloodstream. The 1990s ushered in what's called the “ART era.”

The ART era has seen a dramatic decrease in deaths from AIDS, as well as longer lives for people diagnosed with HIV. But the impact of these powerful drugs had not been assessed on a nationwide scale, according to the authors of the study.

For the study, the researchers used a database that is frequently used to assess nationwide healthcare trends. It tracks inpatient stays in hospitals.

They were particularly interested in HIV-positive patients who required mechanical ventilation, a machine that assists or replaces breathing.

“We found that, although nationally, the number of HIV positive requiring mechanical ventilation rose from 7,632 in 1993 to 10,775 in 2008, mortality in that population declined from over 63 percent in 1993 to 41.4 percent in 2008, with the sharpest decline occurring in 1996-1997, the beginning of the ART era,” Dr. Bhargava said in a statement.

In other words, although the number of patients requiring assistance breathing went up in a span of 16 years, fewer people died in that state. The impact of antiretroviral drugs is punctuated in the data.

Antiretroviral drugs prevent what are called opportunistic infections, other illnesses that take advantage of the patient's weakened immune system. Pneumonia is a common infection for people on mechanical ventilation and, during the period of the study, rates of infection were nearly cut in half.

The length of a patient's hospital stay also decreased. But it's not all good news.

Survival rates were still poor for ethnic minorities. And there have been increases of chronic diseases and sepsis, a bacterial infection in the blood stream.

Dr. Bhargava said that future research should look at why these negative statistics persist.

The study was presented in May 2012.

Review Date: 
June 1, 2012