{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T17:59:14Z","timestamp":1781027954145,"version":"3.54.1"},"reference-count":31,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2025,7,4]],"date-time":"2025-07-04T00:00:00Z","timestamp":1751587200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"Australian National Health and Medical Research Council","award":["GNT22022415"],"award-info":[{"award-number":["GNT22022415"]}]},{"DOI":"10.13039\/501100021954","name":"Tour de Cure grant","doi-asserted-by":"publisher","award":["RSP-237\u20132024"],"award-info":[{"award-number":["RSP-237\u20132024"]}],"id":[{"id":"10.13039\/501100021954","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,2,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Before the advent of effective antiretroviral therapy, intensive care unit (ICU) admission rates for people with advanced human immunodeficiency virus HIV disease (AHD) were low, reflecting high mortality and limited treatment options. Despite improvements in ICU and HIV care, longitudinal outcome data in critically ill people with AHD are limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We performed a retrospective cohort study of ICU admissions in Australia and New Zealand between January 1993 and December 2022 in patients with a comorbid diagnosis of AHD. AHD was defined according to Acute Physiology and Chronic Health Assessment-IIIj (APACHE-IIIj), requiring an HIV diagnosis plus AHD-defining complication. Descriptive analysis was performed. Longitudinal changes in mortality were reported. Admissions were stratified by decade.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>There were 1505 ICU admissions with comorbid AHD over the study period. Between the first and third decades, the Sequential Organ Failure Score increased (median 3, interquartile range [IQR] 2\u20135 vs median 4, IQR 2\u20136, P &amp;lt; .001), as did patient age (median 41 years, IQR 34\u201352 vs median 53 years, IQR 44\u201363, P &amp;lt; .001). The proportion of patients with 1 or more chronic comorbidities using APACHE-IIIj scoring increased over time (18% vs 26%; P = .009). Crude hospital mortality reduced significantly from 36% in 1993\u20132002 to 14% in 2013\u20132022 (P &amp;lt; .001). Mortality improvements remained significant after adjustment for acute and chronic illness severity (using APACHE-IIIj risk of death) and hospital type (adjusted odds ratio of death by decade 0.43; 95% confidence interval, .35\u2013.53).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Despite advances in HIV care, a subset of people with AHD require ICU admission. Mortality in this group has improved by more than 50%.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/cid\/ciaf362","type":"journal-article","created":{"date-parts":[[2025,7,3]],"date-time":"2025-07-03T07:55:48Z","timestamp":1751529348000},"page":"93-99","source":"Crossref","is-referenced-by-count":4,"title":["Outcomes of Critical Illness in People With Advanced HIV Disease: 30 Years of Binational Data"],"prefix":"10.1093","volume":"82","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0560-0406","authenticated-orcid":false,"given":"Bryan","family":"Tan","sequence":"first","affiliation":[{"name":"Monash Health, Monash Infectious Diseases , Melbourne, Victoria ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannah","family":"Webster","sequence":"additional","affiliation":[{"name":"Monash Health, Monash Infectious Diseases , Melbourne, Victoria ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sushena","family":"Krishnaswamy","sequence":"additional","affiliation":[{"name":"Monash Health, Monash Infectious Diseases , Melbourne, Victoria ,","place":["Australia"]},{"name":"Faculty of Medicine, Nursing and Health Sciences, Monash University , Melbourne, Victoria ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2332-8186","authenticated-orcid":false,"given":"Aleece","family":"MacPhail","sequence":"additional","affiliation":[{"name":"Monash Health, Monash Infectious Diseases , Melbourne, Victoria ,","place":["Australia"]},{"name":"Faculty of Medicine, Nursing and Health Sciences, Monash University , Melbourne, Victoria ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8939-7985","authenticated-orcid":false,"given":"David","family":"Pilcher","sequence":"additional","affiliation":[{"name":"Department of Intensive Care, Alfred Health , Melbourne, Victoria ,","place":["Australia"]},{"name":"Australia and New Zealand Intensive Care Society Centre for Outcome and Resource Evaluation , Melbourne, Victoria ,","place":["Australia"]},{"name":"School of Public Health and Preventative Medicine, Monash University , Melbourne, Victoria ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,7,4]]},"reference":[{"key":"2026020904082056000_ciaf362-B1","volume-title":"Guidelines for managing advanced HIV disease and rapid initiation of antiretroviral therapy, July 2017","author":"World Health Organization","year":"2017"},{"key":"2026020904082056000_ciaf362-B2","volume-title":"Consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection","year":"2016","edition":"2nd ed"},{"key":"2026020904082056000_ciaf362-B3","doi-asserted-by":"crossref","first-page":"262","DOI":"10.1164\/rccm.2111025","article-title":"Intensive care of human immunodeficiency virus\u2013infected patients during the era of highly active antiretroviral therapy","volume":"166","author":"Morris","year":"2002","journal-title":"Am J Respir Crit Care Med"},{"key":"2026020904082056000_ciaf362-B4","doi-asserted-by":"crossref","first-page":"853","DOI":"10.1056\/NEJM199803263381301","article-title":"Declining morbidity and mortality among patients with advanced human immunodeficiency virus infection","volume":"338","author":"Palella","year":"1998","journal-title":"N Engl J Med"},{"key":"2026020904082056000_ciaf362-B5","doi-asserted-by":"crossref","first-page":"1397","DOI":"10.1001\/jama.2013.2963","article-title":"Management of human immunodeficiency virus infection in advanced age","volume":"309","author":"Greene","year":"2013","journal-title":"JAMA"},{"key":"2026020904082056000_ciaf362-B6","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1186\/s13054-023-04325-9","article-title":"Outcomes in critically ill HIV-infected patients between 1997 and 2020: analysis of the OUTCOMEREA multicenter cohort","volume":"27","author":"Gaillet","year":"2023","journal-title":"Crit Care"},{"key":"2026020904082056000_ciaf362-B7","doi-asserted-by":"crossref","first-page":"751","DOI":"10.1586\/14787210.2015.1029917","article-title":"Opportunistic infections and immune reconstitution inflammatory syndrome in HIV-1-infected adults in the combined antiretroviral therapy era: a comprehensive review","volume":"13","author":"Manzardo","year":"2015","journal-title":"Expert Rev Anti Infect Ther."},{"key":"2026020904082056000_ciaf362-B8","doi-asserted-by":"crossref","first-page":"ofae213","DOI":"10.1093\/ofid\/ofae213","article-title":"Managing modern antiretroviral therapy in the intensive care unit: overcoming challenges for critically ill people with human immunodeficiency virus","volume":"11","author":"Chastain","year":"2024","journal-title":"Open Forum Infect Dis"},{"key":"2026020904082056000_ciaf362-B9","doi-asserted-by":"crossref","first-page":"1308","DOI":"10.1001\/jama.2014.2637","article-title":"Mortality related to severe sepsis and septic shock among critically ill patients in Australia and New Zealand, 2000\u20132012","volume":"311","author":"Kaukonen","year":"2014","journal-title":"JAMA"},{"key":"2026020904082056000_ciaf362-B10","doi-asserted-by":"crossref","first-page":"481","DOI":"10.1056\/NEJM200102153440703","article-title":"Noninvasive ventilation in immunosuppressed patients with pulmonary infiltrates, fever, and acute respiratory failure","volume":"344","author":"Hilbert","year":"2001","journal-title":"N Engl J Med"},{"key":"2026020904082056000_ciaf362-B11","doi-asserted-by":"crossref","first-page":"e4","DOI":"10.1258\/ijsa.2009.009341","article-title":"The long-term outcome of HIV-infected patients after intensive care admission","volume":"23","author":"Foo","year":"2012","journal-title":"Int J STD AIDS"},{"key":"2026020904082056000_ciaf362-B12","doi-asserted-by":"crossref","first-page":"583","DOI":"10.1007\/s15010-024-02402-x","article-title":"Epidemiological changes and outcomes of people living with HIV admitted to the intensive care unit: a 14-year retrospective study","volume":"53","author":"Mart\u00ednez","year":"2025","journal-title":"Infection"},{"key":"2026020904082056000_ciaf362-B13","doi-asserted-by":"crossref","first-page":"2355","DOI":"10.1097\/QAD.0000000000003019","article-title":"HIV-infected medical ICU (MICU) survivors without CD4 cell recovery are at increased risk for poor outcomes regardless of viral suppression in a national cohort","volume":"35","author":"Akg\u00fcn","year":"2021","journal-title":"AIDS"},{"key":"2026020904082056000_ciaf362-B14","doi-asserted-by":"crossref","first-page":"2169","DOI":"10.1097\/QAD.0000000000003683","article-title":"Changes in short-term (in-ICU and in-hospital) mortality following intensive care unit admission in adults living with HIV: 2000\u20132019","volume":"37","author":"Kanitkar","year":"2023","journal-title":"AIDS"},{"key":"2026020904082056000_ciaf362-B15","doi-asserted-by":"crossref","first-page":"467","DOI":"10.5694\/mja2.51933","article-title":"Mortality among people admitted to Australian intensive care units for reasons other than COVID-19 during the COVID-19 pandemic: a retrospective cohort study","volume":"218","author":"Tan","year":"2023","journal-title":"Med J Aust"},{"key":"2026020904082056000_ciaf362-B16","doi-asserted-by":"crossref","first-page":"1458","DOI":"10.1097\/CCM.0b013e31827caa46","article-title":"Medical ICU admission diagnoses and outcomes in human immunodeficiency virus\u2013infected and virus\u2013uninfected veterans in the combination antiretroviral era","volume":"41","author":"Akg\u00fcn","year":"2013","journal-title":"Crit Care Med"},{"key":"2026020904082056000_ciaf362-B17","author":"Australian New Zealand Intensive Care Society Centre for Outcomes Resource Evaluation","year":"2022"},{"key":"2026020904082056000_ciaf362-B18","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1016\/j.jcrc.2005.11.010","article-title":"Development and implementation of a high-quality clinical database: the Australian and New Zealand Intensive Care Society Adult Patient Database","volume":"21","author":"Stow","year":"2006","journal-title":"J Crit Care"},{"key":"2026020904082056000_ciaf362-B19","doi-asserted-by":"crossref","first-page":"1619","DOI":"10.1378\/chest.100.6.1619","article-title":"The APACHE III prognostic system: risk prediction of hospital mortality for critically III hospitalized adults","volume":"100","author":"Knaus","year":"1991","journal-title":"Chest"},{"key":"2026020904082056000_ciaf362-B20","doi-asserted-by":"crossref","first-page":"R161","DOI":"10.1186\/cc7160","article-title":"Evaluation of SOFA-based models for predicting mortality in the ICU: a systematic review","volume":"12","author":"Minne","year":"2008","journal-title":"Crit Care"},{"key":"2026020904082056000_ciaf362-B21","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1016\/S0749-0704(05)70114-7","article-title":"Scoring systems for assessing organ dysfunction and survival","volume":"16","author":"Vincent","year":"2000","journal-title":"Crit Care Clin"},{"key":"2026020904082056000_ciaf362-B22","author":"Australia Government Department of Aged Care"},{"key":"2026020904082056000_ciaf362-B23","doi-asserted-by":"crossref","first-page":"487","DOI":"10.1093\/cid\/ciae051","article-title":"National hospitalization rates and in-hospital mortality rates of HIV-related opportunistic infections in the United States, 2011\u20132018","volume":"79","author":"Bielick","year":"2024","journal-title":"Clin Infect Dis"},{"key":"2026020904082056000_ciaf362-B24","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1111\/hiv.13737","article-title":"Comparing short-term mortality between people with and without HIV admitted to the intensive care unit: a single-centre matched cohort study (2000\u20132019)","volume":"26","author":"Bakewell","year":"2025","journal-title":"HIV Med"},{"key":"2026020904082056000_ciaf362-B25","doi-asserted-by":"crossref","first-page":"e269","DOI":"10.1016\/S2352-3018(22)00003-0","article-title":"Delayed presentation of HIV among older individuals: a growing problem","volume":"9","author":"Justice","year":"2022","journal-title":"Lancet HIV"},{"key":"2026020904082056000_ciaf362-B26","doi-asserted-by":"crossref","first-page":"1906","DOI":"10.1007\/s00134-014-3481-7","article-title":"Temporal trends in critical events complicating HIV infection: 1999\u20132010 multicentre cohort study in France","volume":"40","author":"Barbier","year":"2014","journal-title":"Intensive Care Med"},{"key":"2026020904082056000_ciaf362-B27","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1002\/bjs.1800790513","article-title":"Attitudes of cardiothoracic surgeons in the UK to human immunodeficiency virus","volume":"79","author":"Roxburgh","year":"1992","journal-title":"J Br Surg"},{"key":"2026020904082056000_ciaf362-B28","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/1472-6939-14-S1-S6","article-title":"Stigmatization of people living with HIV\/AIDS by healthcare workers at a tertiary hospital in KwaZulu-Natal, South Africa: a cross-sectional descriptive study","volume":"14","author":"Famoroti","year":"2013","journal-title":"BMC Med Ethics"},{"key":"2026020904082056000_ciaf362-B29","doi-asserted-by":"crossref","first-page":"1185","DOI":"10.1016\/j.jhep.2017.07.024","article-title":"Declining mortality in critically ill patients with cirrhosis in Australia and New Zealand between 2000 and 2015","volume":"67","author":"Majumdar","year":"2017","journal-title":"J Hepatol"},{"key":"2026020904082056000_ciaf362-B30","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1186\/s13054-024-04932-0","article-title":"Sepsis mortality among patients with haematological malignancy admitted to intensive care 2000\u20132022: a binational cohort study","volume":"28","author":"MacPhail","year":"2024","journal-title":"Crit Care"},{"key":"2026020904082056000_ciaf362-B31","doi-asserted-by":"crossref","first-page":"326","DOI":"10.1177\/0310057X1704500308","article-title":"Assessing contemporary intensive care unit outcome: development and validation of the Australian and New Zealand risk of death admission model","volume":"45","author":"Paul","year":"2017","journal-title":"Anaesth Intens Care"}],"container-title":["Clinical Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/cid\/advance-article-pdf\/doi\/10.1093\/cid\/ciaf362\/63671759\/ciaf362.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/cid\/article-pdf\/82\/1\/93\/63671759\/ciaf362.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/cid\/article-pdf\/82\/1\/93\/63671759\/ciaf362.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,9]],"date-time":"2026-02-09T09:08:41Z","timestamp":1770628121000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/cid\/article\/82\/1\/93\/8186333"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,4]]},"references-count":31,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,7,4]]},"published-print":{"date-parts":[[2026,2,9]]}},"URL":"https:\/\/doi.org\/10.1093\/cid\/ciaf362","relation":{},"ISSN":["1058-4838","1537-6591"],"issn-type":[{"value":"1058-4838","type":"print"},{"value":"1537-6591","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,1,15]]},"published":{"date-parts":[[2025,7,4]]}}}