Title: HIV, ART, and the ICU<br/>Author: Michael Winters<br/><a href='http://umem.org/profiles/faculty/141/'>[Click to email author]</a><hr/><p>
        <strong><u>HIV, ART, and the ICU</u></strong></p>
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                Though survival has dramatically improved for patients with HIV, there has been no decrease in the quantity of ICU admissions for this select patient population.</li>
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                One of the most common reasons for ICU admission is now adverse effects of antiretroviral therapy (ART).</li>
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                When managing a critically ill HIV patient in the ED or ICU, consider the following effects of ART as an etiology:
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                                Lactic acidosis
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                                                Seen with nucleoside reverse transcriptase inhibitors (NRTIs): greatest risk with didanosine, stavudine, and zidovudine</li>
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                                                Presentation: fatigue, malaise, vomiting, abdominal pain, hepatomegaly</li>
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                                                Lactate often > 10 mmol/L</li>
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                                Abacavir hypersensitivity
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                                                Usually within first 6 weeks of drug initiation</li>
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                                                Presentation: rash, fever, shortness of breath, vomiting, abdominal pain</li>
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                                                Can rapidly progress to cardiovascular collapse</li>
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<fieldset><legend>References</legend>

                <p>
        Tan DHS, Walmsley SL. Management of persons infected with human immunodeficiency virus requiring admission to the intensive care unit. <em>Crit Care Clin</em> 2013; 29:603-20.</p>
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