Pharmacological Considerations in Human Immunodeficiency Virus–Infected Adults in the Intensive Care Unit

The Centers for Disease Control and Prevention¹  estimate that 1.2 million persons in the United States are infected with human immunodeficiency virus (HIV) and that the infection is undiagnosed in 20%. Today, persons infected with HIV are admitted to the intensive care unit (ICU) more often than in the past.^2,3  The introduction of antiretroviral therapy (ART) has led to enhanced management of HIV disease, allowing infected persons to live longer and thus increasing their likelihood of being admitted to an ICU during their lifetime.²  Additionally, opportunistic infections are common causes of ICU admission for persons infected with HIV who are unaware of their HIV status.² 

Common causes for ICU admission include opportunistic infections, complications of ART, and/or medical-surgical issues not directly related to HIV infection.³  HIV-related opportunistic infections that may lead to admission to the ICU include Pneumocystis pneumonia, toxoplasmosis-associated encephalitis, cryptococcal meningitis,...