HIV

Asian Intensive Care: coming of age
International intensive care conference, Hong Kong, December 14th-15th
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Thomas Li & Charles Gomersall

Epidemiology

• 40 million patients worldwide
• 28.2 million in sub-Saharan Africa

Acquisition

• sexual practices
• needlestick injury
  • risk of transmission 1/300
• vertical transmission
• blood products
  • unusual with screening programs

Serious life threatening conditions

• Pulmonary
  • Bacterial

    • Streptococcus pneumoniae

    • Haemophilus influenzae

    • Staphylococcus aureus

    • Klebsiella pneumoniae

    • Pseudomonas aeruginosa

    • Nocardia asteroides

  • Fungal
    • Pneumocystis jiroveci pneumonia

    • Cryptococcus neoformans

    • Penicillium marneffei

  • Mycobacterium
    • TB

    • Mycobacterium avium intracellulare (end-stage HIV disease)

  • Parasitic

    • Toxoplasma gondii

    • Strongyloides stercoralis

  • Viral
    • CMV

    • Influenza, parainfluenza, rhinovirus, adenovirus

• CNS
  • Cryptococcus
  • Toxoplasma
• Acute bacterial infections

Prognosis

• ~70% of HIV +ve patients admitted to ICU are dead at 6 months
• ICU mortality in HIV +ve patients without AIDS similar to HIV -ve patients

©Charles Gomersall, October, 2009 unless otherwise stated. The author, editor and The Chinese University of Hong Kong take no responsibility for any adverse event resulting from the use of this webpage.
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