Abstract
Highly active antiretroviral therapy (HAART) for human immunodeficiency virus (HIV) infection has produced significant declines in morbidity and mortality from acquired immunodeficiency syndrome (AIDS). Despite improved treatment with HAART, the mortality of HIV infected patients admitted to the ICU with multiple organ failure (MOF) remains high. We encountered a case of respiratory and renal failures in an HIV infected patient. A 29-year-old male was admitted to our ICU for treatment of renal failure with continuous hemodiafiltration (CHDF) and respiratory failure with mechanical ventilation. The patient had a P/F ratio of 117, serum creatinine of 7.7 mg · dl-1 and CD4 lymphocytes of 2.5 μl-1. With mechanical support and administration of antibiotics and endovenous corticosteroids, the patient's respiratory and renal functions were gradually improved. He was weaned from mechanical ventilation and CHDF and was discharged from the ICU. HAART was started at the hospital to which the patient was transferred. The number of newly reported HIV infections and AIDS diagnoses continues to increase steadily, making Japan an exception among high-income countries. Although intensive care for HIV infected patients is associated with various problems, such as the criteria for ICU admission and risk of infection to healthcare workers, the number of HIV infected patient who receive intensive care are likely to increase.
