People living with HIV comprise a substantial number of the patients admitted to intensive care. This number varies according to geography, but all areas of the world are affected. In lower-income and middle-income countries, the majority of intensive care unit (ICU) admissions relate to infections, whereas in high-income countries, they often involve HIV-associated non-communicable diseases diagnoses. Management of infections potentially resulting in admission to the ICU in people living with HIV include sepsis, respiratory infections, COVID-19, cytomegalovirus infection, and CNS infections, both opportunistic and non-opportunistic. It is crucial to know which antiretroviral therapy (ART) is appropriate, when is the correct time to administer it, and to be aware of any safety concerns and potential drug interactions with ART. Although ART is necessary for controlling HIV infections, it can also cause difficulties relevant to the ICU such as immune reconstitution inflammatory syndrome, and issues associated with ART administration in patients with gastrointestinal dysfunction on mechanical ventilation. Managing infection in people with HIV in the ICU is complex, requiring collaboration from a multidisciplinary team knowledgeable in both the management of the specific infection and the use of ART. This team should include intensivists, infectious disease specialists, pharmacists, and microbiologists to ensure optimal outcomes for patients.

中文翻译：

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艾滋病毒感染者因感染而患上危重疾病。


接受重症监护的患者中有相当一部分是艾滋病毒感染者。这个数字因地理位置而异，但世界所有地区都受到影响。在低收入和中等收入国家，大多数重症监护病房 (ICU) 入院与感染有关，而在高收入国家，往往涉及与艾滋病毒相关的非传染性疾病诊断。对可能导致 HIV 感染者入住 ICU 的感染进行管理，包括败血症、呼吸道感染、COVID-19、巨细胞病毒感染和中枢神经系统感染，包括机会性和非机会性感染。了解哪种抗逆转录病毒疗法 (ART) 是合适的、何时进行治疗的正确时间以及了解任何安全问题以及与 ART 潜在的药物相互作用至关重要。虽然 ART 对于控制 HIV 感染是必要的，但它也可能导致 ICU 相关的困难，例如免疫重建炎症综合征，以及机械通气胃肠道功能障碍患者 ART 给药相关的问题。在 ICU 中管理艾滋病毒感染者的感染非常复杂，需要熟悉特定感染管理和抗逆转录病毒疗法使用的多学科团队的合作。该团队应包括重症医生、传染病专家、药剂师和微生物学家，以确保患者获得最佳结果。