Русский
The experience of an intensive care unit for HIV-infected patients
DOI: https://dx.doi.org/10.18565/epidem.2020.10.3.131-6
Voznesensky S.L., Samotolkina E.S., Ermak T.N., Kozhevnikova G.М., Klimkova P.V., Korneva I.A.
1) Peoples’ Friendship University of Russia, Moscow, Russia; 2) Infectious Diseases Clinical Hospital Two, Moscow Healthcare Department, Moscow, Russia; 3) Central Research Institute of Epidemiology, Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being, Moscow, Russia
Objective. To provide the experience of the intensive care unit (ICU) in Infectious Diseases Clinical Hospital Two as the first specialized one for HIV-infected people in the Russian Federation, by taking into account the patients’ clinical and epidemiological parameters that can become prognostic factors for a favorable outcome in the future.
Materials and methods. The clinical and epidemiological parameters were analyzed in 563 patients admitted to the ICU in 2018.
Results. The main distinguishing feature of the ICU is its staff having a 3-fold load reduction (compared with that working in a routine therapeutic unit for HIV-infected patients), by considering disease severity in the patients. In 2018, the survival rate among ICU patients was 29.4%. The clinical and laboratory parameters suggested that the examinees had severe immunodeficiency and a high viral load. Stage 4B HIV infection was diagnosed in 85.3% of the patients. Secondary co-infections were present in 38.4% of patients, which deteriorated their health status and required a personalized therapeutic approach. The short prehospital period and the use of antiretroviral therapy in the unit became favorable prognostic factors for survival.
Conclusion. The emerging experience of the ICU can serve as a basis for optimizing the structure of medical care for HIV-infected patients.
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About the Autors
Sergey L. Voznesensky, Cand. Med. Sci., Associate Professor, Department of Infectious Diseases with Courses of Epidemiology and Phthisiology, Medical Institute, Peoples’ Friendship University of Russia, Moscow, Russia; e-mail: voznesenskiy_sl@ pfur.ru; ORCID: http://orcid. org/0000-0001-5669-1910
Elena S. Samotolkina, Infectiologist, Intensive Care Unit for HIV-Infected Patients, Infectious Diseases Clinical Hospital Two, Moscow Healthcare Department, Moscow, Russia; e-mail: bolnica2@yandex.ru
Tatiana N. Ermak, MD, Leading Researcher, Central Research Institute of Epidemiology, Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being, Moscow, Russia; e-mail: t.ermak@hiv-russia.ru; ORCID: http://orcid.org/0000-0001-9490-7129
Prof. Galina M. Kozhevnikova, MD, Head, Department of Infectious Diseases with Courses of Epidemiology and Phthisiology, Medical Institute, Peoples’ Friendship University of Russia, Moscow, Russia; e-mail: kozhevnikova_gm@ pfur.ru; ORCID: https://orcid.org/0000-0003-2758-9313
Polina V. Klimkova, Infectiologist, Intensive Care Unit for HIV-Infected Patients, Infectious Diseases Clinical Hospital Two, Moscow Healthcare Department, Moscow, Russia; e-mail: bolnica2@yandex.ru
Irina A. Korneva, Infectiologist, Intensive Care Unit for HIV-Infected Patients, Infectious Diseases Clinical Hospital Two, Moscow Healthcare Department, Moscow, Russia; e-mail: bolnica2@yandex.ru
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