Pulmonary Infections and Outcomes in AIDS Patients with Respiratory Failure: A 10-Year Retrospective Review

Abstract

Background

Respiratory failure in acquired immunodeficiency syndrome (AIDS) patients was the leading cause of intensive care unit (ICU) admission in our center. We aimed to describe the pulmonary infections and outcomes for respiratory failure in AIDS patients.

Methods

A retrospective study was conducted on AIDS adult patients with respiratory failure who were admitted to the ICU in Beijing Ditan hospital, China, from January 2012 to December 2021. We investigated pulmonary infections complicated by respiratory failure in AIDS patients. The primary outcome was ICU mortality, and a comparison between survivors and nonsurvivors was performed. Multiple logistic regression analysis was used to identify predictors of ICU mortality. The Kaplan-Meier curve and Log rank test were used for survival analysis.

Results

A total of 231 AIDS patients were admitted to ICU with respiratory failure over a 10-year period with a male predominance (95.7%). Pneumocystis jirovecii pneumonia was the main etiology of pulmonary infections (80.1%). The ICU mortality was 32.9%. In multivariate analysis, ICU mortality was independently associated with invasive mechanical ventilation (IMV) [odds ratio (OR), 27.910; 95% confidence interval (CI, 8.392–92.818; p = 0.000) and the time before ICU admission (OR, 0.959; 95% CI, 0.920–0.999; p = 0.046). In the survival analysis, patients with IMV and later admission to ICU had a higher probability of mortality.

Conclusion

Pneumocystis jirovecii pneumonia was the primary etiology for respiratory failure in AIDS patients admitted to the ICU. Respiratory failure remains a severe illness with high mortality, and ICU mortality was negatively associated with IMV and later admission to ICU.

Keywords:

• acquired immunodeficiency syndrome
• AIDS
• respiratory failure
• pulmonary infections
• ICU mortality

Data Sharing Statement

The dataset consisting of de-identified participants’ data is available from the corresponding author on reasonable request.

Ethics Approval and Consent to Participate

This retrospective study was approved by the Ethics Committee of Beijing Ditan Hospital, Capital Medical University, No. 2018-005-01, on March 1, 2018, and complies with the principles of the Declaration of Helsinki. The Ethics Committee of Beijing Ditan Hospital waived the need for specific informed consent for this retrospective study.

Acknowledgments

We acknowledge the work of HIV health care providers for their diagnosis, nursing and treatment of patients with HIV/ AIDS in Beijing Ditan Hospital.

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

The authors declare that they have no competing interests in this work.

Additional information

Funding

This work was supported by the Capital Development Special Program of Beijing Hospital Authority, China (NO. 2018-1-2171). The funder had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.