Epidemiology and outcome of HIV-infected patients admitted to the ICU in the current highly active antiretroviral therapy era

Vidal-Cortés, P.; Álvarez-Rocha, L.A.; Fernández-Ugidos, P.; Pérez-Veloso, M.A.; Suárez-Paul, I.M.; Virgós-Pedreira, A.; Pértega-Díaz, S.; Castro-Iglesias, Á.C.
doi:10.1016/j.medin.2019.02.012
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">The introduction of antiretroviral therapy &#40;ART&#41; has meant a drastic change in HIV-infected patients&#8217; prognoses&#46; Since its introduction&#44; survival rates have continued to increase&#44; even in developing countries&#46;<a class="elsevierStyleCrossRefs" href="#bib0200"><span class="elsevierStyleSup">1&#8211;3</span></a> Moreover&#44; high activity ART &#40;HAART&#41; has reduced the incidence of AIDS-related diseases and hospitalizations&#46;<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">4</span></a> Among patients with good immunovirological conditions&#44; HIV infection has become a chronic disease&#46; However&#44; immune system restoration is incomplete in these patients and there remains an inflammatory condition which&#44; in the long-term&#44; is related to pathologies such as cancer and cardiovascular diseases&#46; This chronic inflammatory profile&#44; along with longer survival and possible toxicity accumulation from HAART&#44; will mean that HIV-infected elderly patients have a high burden of &#8220;special&#8221; comorbidities known as HIV-associated non-AIDS &#40;HANA&#41;<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">5</span></a> which will cause their hospital admissions&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">HAART has also led to a significant change in both the profile and prognosis of HIV patients admitted to intensive care units &#40;ICU&#41;&#46; At the start of the pandemic in the early 1980s&#44; 70&#37; of admissions were due to respiratory failure secondary to pneumonia caused by <span class="elsevierStyleItalic">Pneumocystis jiroveci</span> &#40;formerly known as <span class="elsevierStyleItalic">Pneumocystis carinii</span>&#44; hence its acronym&#58; PCP&#41;&#46; However&#44; since HAART was introduced&#44; the rate of patients admitted to the ICU with AIDS-related diseases has dropped&#44; as has the associated mortality&#46; In Europe and North America&#44; short-term mortality of approximately 20&#8211;30&#37; &#40;survival higher than 90&#37; in the ICU&#41; has been reported&#44; as has survival of 85&#37; at one year and higher than 70&#37; at two years&#46;<a class="elsevierStyleCrossRefs" href="#bib0225"><span class="elsevierStyleSup">6&#8211;23</span></a> Although with higher mortality than in Europe and North America&#44; decreased mortality has also been observed in countries such as Brazil&#44; Mexico&#44; China&#44; Taiwan and Australia&#44; where intra-ICU and hospital mortality varies from 37&#37; to 68&#37; and 48&#37; to 68&#37;&#44; respectively&#46;<a class="elsevierStyleCrossRefs" href="#bib0315"><span class="elsevierStyleSup">24&#8211;30</span></a> In Spain&#44; higher mortality has been published compared with other developed countries &#40;36&#46;5&#37;&#44; 67&#46;9&#37; and 80&#46;9&#37; at 30&#44; 60 and 90 days&#44; respectively&#41;<a class="elsevierStyleCrossRef" href="#bib0350"><span class="elsevierStyleSup">31</span></a> without evidence of a decrease over the HAART period&#46;<a class="elsevierStyleCrossRef" href="#bib0355"><span class="elsevierStyleSup">32</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">However&#44; despite the decreased mortality in HIV patients admitted to the ICU&#44; this is still greater than in non-HIV patients&#46;<a class="elsevierStyleCrossRefs" href="#bib0295"><span class="elsevierStyleSup">20&#44;23&#44;31</span></a> Results from analyses of prognostic factors in this patient group have varied&#46; Some study authors have concluded that the patient&#39;s immunovirological condition determines the prognosis&#44;<a class="elsevierStyleCrossRefs" href="#bib0325"><span class="elsevierStyleSup">26&#44;28</span></a> while others have stated that prognosis depends on disease severity that led to ICU admission<a class="elsevierStyleCrossRefs" href="#bib0290"><span class="elsevierStyleSup">19&#44;21&#44;22&#44;25&#44;27&#44;33</span></a> and comorbidities&#46;<a class="elsevierStyleCrossRefs" href="#bib0300"><span class="elsevierStyleSup">21&#44;22&#44;31</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">Our study aim was thus to describe the epidemiology of critical pathology in HIV patients in a cohort of patients admitted to ICU&#44; during the current HAART period and to identify factors that predict mortality during hospital admission&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Methods</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Study scope</span><p id="par0025" class="elsevierStylePara elsevierViewall">The study was performed in the ICUs of Complexo Hospitalario Universitario de A Coru&#241;a &#40;36 beds&#41; and Complexo Hospitalario Universitario de Ourense &#40;22 beds&#41;&#44; two public hospitals located in the northwest of Spain&#44; serving an approximate population of 500&#44;000 inhabitants&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Study period</span><p id="par0030" class="elsevierStylePara elsevierViewall">Data were collected from 1 January 2000 to 31 December 2014&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Study design</span><p id="par0035" class="elsevierStylePara elsevierViewall">This was a longitudinal&#44; retrospective&#44; observational study&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Inclusion criteria</span><p id="par0040" class="elsevierStylePara elsevierViewall">Inclusion criteria included&#58; ICU admission from the community&#44; hospital ward or another hospital&#59; HIV infection diagnosed previously or during ICU admission&#59; age older than 18 years&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Exclusion criteria</span><p id="par0045" class="elsevierStylePara elsevierViewall">Patients readmitted to the ICU during the same hospital admission were excluded&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Patient recruitment</span><p id="par0050" class="elsevierStylePara elsevierViewall">Patients were identified for inclusion using the two hospitals&#8217; clinical documentation systems&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Ethics</span><p id="par0055" class="elsevierStylePara elsevierViewall">Ethical approval was granted by the Pontevedra&#47;Vigo&#47;Ourense Research Ethics Committee &#40;code 2015&#47;489&#41;&#46;</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Measurements</span><p id="par0060" class="elsevierStylePara elsevierViewall">Clinical records for each admission were reviewed&#46; We analyzed sociodemographic data &#40;age and sex&#41;&#59; comorbidities &#40;defined according to the Charlson comorbidity index &#8211; CCI&#44; see <a class="elsevierStyleCrossRef" href="#sec0090">Appendix A&#46; Supplementary data</a>&#41;&#59; date of HIV infection diagnosis&#59; most recent CD4 count and viral load &#40;VL&#41; &#40;in the event that these data were unavailable for the six months prior to admission&#44; we used the first post-admission data if determined during the first week of ICU admission&#41;&#59; HAART &#40;active prescription of at least three antiretrovirals from at least two classes&#44; unless there was evidence of therapeutic non-compliance&#41;&#59; nutritional status &#40;cachexia&#44; reported during physical examination&#44; and albumin levels upon ICU admission&#41;&#59; reason for ICU admission&#59; severity at admission &#40;APACHE II score&#41;&#59; organ dysfunction &#40;SOFA score at admission and 72<span class="elsevierStyleHsp" style=""></span>h&#41;&#59; organ support during admission &#40;vasopressors&#44; mechanical ventilation and renal replacement techniques &#91;RRTs&#93;&#41;&#59; ICU&#47;hospital length of stay &#40;LOS&#41; and ICU and in-hospital mortality&#46; We also recorded ART administration during the ICU stay&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">Admission from ED &#40;Emergency Department&#41; was defined as ICU admission right away from ED&#46; Admission form medical or surgical ward was defined as &#8220;admission not from E&#46;D&#46;&#8221;</p><p id="par0070" class="elsevierStylePara elsevierViewall">Patients with new positive tests during hospital admission and before discharge from the ICU were considered newly diagnosed with an HIV infection&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">Co-infection with Hepatitis C Virus &#40;HCV&#41; was defined as positive RNA-HCV and Hepatitis B Virus infection &#40;HBV&#41; was defined as positive surface antigen &#40;HBsAg&#41;&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">To identify changes over time&#44; we established three periods of 5 years &#40;1&#58; 2000&#8211;2004&#44; 2&#58; 2005&#8211;2009&#44; 3&#58; 2010&#8211;2014&#41;&#46;</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Sample size rationale</span><p id="par0085" class="elsevierStylePara elsevierViewall">A total of 283 patients were recruited during the study period&#46; This sample size allows estimating parameters with a precision of &#177;6&#46;5&#37; at a confidence level of 95&#37;&#46; Furthermore&#44; it allows to detect as statistically significant differences in hospital mortality rates of 16&#37; or higher&#44; assuming a mortality rate around 25&#37; and an expected exposure to a risk factor of 50&#37; &#40;confidence level 95&#37;&#44; power level 80&#37;&#41;&#46;</p></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Statistical analysis</span><p id="par0090" class="elsevierStylePara elsevierViewall">Continuous variables are shown as mean<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>standard deviation &#40;SD&#41; or median and p25&#8211;p75&#59; qualitative variables are shown as number and percentage&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">We compared patients who survived hospital admission with those who died during their hospital stay using the Chi-square test for categorical variables and Student&#39;s <span class="elsevierStyleItalic">t</span>-test or the Mann&#8211;Whitney <span class="elsevierStyleItalic">U</span> test for continuous variables&#44; assuming an alpha level<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#46; We compared the three time periods using Kruskal&#8211;Wallis <span class="elsevierStyleItalic">H</span> for quantitative variables&#44; and Chi-square for categorical variables&#46; Trends in mortality during the study period were investigated by a joinpoint regression analysis&#46; We used logistic regression to calculate OR values to evaluate the association with mortality during the hospital stay&#46; Variables associated with hospital mortality &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#41; on univariate analyses were included in the multivariate analysis&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">Statistical analyses were performed using IBM SPSS Statistics&#44; Version 19&#46;0&#46; &#40;IBM Corp&#46;&#44; Armonk&#44; NY&#41;&#46;</p></span></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Results</span><p id="par0105" class="elsevierStylePara elsevierViewall">A total of 297 admissions were recorded&#59; among these&#44; 14 patients were admitted twice&#44; so only the initial 283 episodes were included for final analyses&#46; The patient sample characteristics are shown in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0110" class="elsevierStylePara elsevierViewall">A total of 71 patients &#40;25&#46;1&#37;&#41; died during their admission to the ICU&#44; while another 22 died before hospital discharge&#44; translating to a total hospital mortality of 32&#46;9&#37; &#40;95&#37; CI<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>21&#46;2&#8211;38&#46;5&#37;&#41;&#46; Among these 14 patients who were admitted twice&#44; 11 &#40;78&#46;6&#37;&#41; died during hospital stay&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">Median ICU and hospital LOS were 5<a class="elsevierStyleCrossRefs" href="#bib0205"><span class="elsevierStyleSup">2&#44;13</span></a> and 18<a class="elsevierStyleCrossRefs" href="#bib0240"><span class="elsevierStyleSup">9&#44;37</span></a> days&#44; respectively&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">In this sample&#44; 68&#46;9&#37; fulfilled the AIDS criteria following CDC 1993 criteria&#46;<a class="elsevierStyleCrossRef" href="#bib0365"><span class="elsevierStyleSup">34</span></a> Following new definitions<a class="elsevierStyleCrossRef" href="#bib0370"><span class="elsevierStyleSup">35</span></a> 11&#46;7&#37; patients were in stage 0&#44; 12&#46;0&#37; in stage 1&#44; 14&#46;1&#37; in stage 2&#44; 59&#37; in stage 3 and 3&#46;2 in stage <span class="elsevierStyleItalic">unknown</span>&#46; Among patients with a known HIV infection&#44; 62&#37; were under HAART at the time of admission &#40;54&#46;8&#37; of the total sample&#41;&#46; Their CD4 count was 167&#46;0 &#40;53&#46;5&#44; 414&#46;0&#41;<span class="elsevierStyleHsp" style=""></span>cells&#47;mm<span class="elsevierStyleSup">3</span> and VL was log 2&#46;9 &#40;0&#46;0&#44; 5&#46;3&#41;&#44; with 22&#46;6&#37; having an undetectable VL&#46; Patients who survived their hospital admission&#44; compared with those who died&#44; received ART more frequently &#40;58&#46;9 compared with 46&#46;2&#37;&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;01&#41; and had a better immunovirological profile&#58; higher CD4 count &#40;204&#46;0 &#40;74&#46;0&#44; 493&#46;5&#41;<span class="elsevierStyleHsp" style=""></span>cell&#47;mL compared with 80&#46;0 &#40;29&#46;0&#44; 236&#46;5&#41;&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;01&#41;&#44; and lower VL &#40;2&#46;6 &#40;0&#46;0&#44; 5&#46;0&#41; log compared with 4&#46;5 &#40;1&#46;1&#44; 5&#46;5&#41;&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;02&#41;&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">The most common comorbidity in this sample was liver disease &#40;present in 65&#46;4&#37;&#41;&#44; with 60&#46;1&#37; co-infected with HCV &#40;<a class="elsevierStyleCrossRef" href="#sec0090">Appendix A&#46; Supplementary data</a>&#44; Table e1&#41;&#46; Their CCI &#40;median&#44; IQR&#41; was 6<a class="elsevierStyleCrossRefs" href="#bib0205"><span class="elsevierStyleSup">2&#44;7</span></a> points&#46; Both moderate&#8211;severe liver disease and CCI were statistically higher in patients who died in the hospital&#46; A total of 24&#46;7&#37; of all patients were reported as cachectic upon physical examination&#44; with median albumin 2&#46;6 &#40;2&#46;1&#44; 3&#46;3&#41;<span class="elsevierStyleHsp" style=""></span>g&#47;dL and a statistically high proportion of cachectic patients and lower albumin figures among those who did not survive&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">The most common cause for admission was severe sepsis&#47;septic shock &#40;SS&#47;SS&#41; &#40;49&#46;5&#37;&#41;&#44; followed by admissions with a cardiologic origin &#40;19&#46;4&#37;&#41; &#40;<a class="elsevierStyleCrossRef" href="#sec0090">Appendix A&#46; Supplementary data</a>&#44; Table e2&#41;&#46; 61&#46;3&#37; of patients who died had been admitted due to SS&#47;SS&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">APACHE II scores upon admission and SOFA scores during the first 24<span class="elsevierStyleHsp" style=""></span>h were 18&#46;05<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>9&#46;05 and 6&#44;<a class="elsevierStyleCrossRefs" href="#bib0210"><span class="elsevierStyleSup">3&#44;9</span></a> respectively&#46; A total of 60&#46;8&#37; of patients required respiratory support with invasive mechanical ventilation &#40;MV&#41; &#40;length of MV&#58; 7 days &#91;2&#44; 13&#46;75&#93;&#41;&#59; 40&#46;3&#37; received vasoactive drugs &#40;VADs&#41; &#40;length of VADs&#58; 2 &#91;1&#44; 4&#93; days&#41;&#44; and 11&#37; required RTTs &#40;5 &#91;2&#44; 11&#93; days&#41;&#46; Patients who died in the hospital presented significantly higher severity scores at admission and required more frequent respiratory&#44; haemodynamic and renal support&#46;</p><p id="par0140" class="elsevierStylePara elsevierViewall">Comparison between the three periods is shown in <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#46; During the study period&#44; the figures for hospital mortality did not vary significantly&#44; being 30&#46;3&#37; among patients admitted in 2000&#8211;2004&#44; 31&#46;8&#37; in 2005&#8211;2009 and 36&#46;4&#37; in 2010&#8211;2014 &#40;annual percentage of change<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#46;6&#59; 95&#37; CI -2&#46;3 to 5&#46;8&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;39&#41;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0145" class="elsevierStylePara elsevierViewall">In <a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a> we present differences between patients who were receiving HAART at the moment they were admitted to ICU with whose were not and&#44; on the other hand&#44; between those patients who received HAART during their ICU stay and those who not&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0150" class="elsevierStylePara elsevierViewall">We found HAART-related complications in less than 10&#37; of patients who receive treatment during ICU stay &#40;<a class="elsevierStyleCrossRef" href="#sec0090">Appendix A&#46; Supplementary data</a>&#44; Table e3&#41;&#44; more frequently in patients without previous ART &#40;26&#46;9 vs 3&#46;5&#37;&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;01&#41;&#46;</p><p id="par0155" class="elsevierStylePara elsevierViewall">Factors significantly associated with hospital mortality on univariate analysis were included in the final regression model&#44; and we found that only admission from a site other than the ED &#40;&#40;OR 3&#46;64&#44; 95&#37; CI 1&#46;30&#8211;10&#46;20&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;01&#41;&#44; the existence of moderate&#8211;severe liver disease &#40;OR 5&#46;65&#44; 95&#37; CI 1&#46;11&#8211;28&#46;87&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;04&#41;&#44; APACHE II &#40;OR 1&#46;14&#44; 95&#37; CI 1&#46;04&#8211;1&#46;26&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;01&#41; and SOFA at 72<span class="elsevierStyleHsp" style=""></span>h &#40;OR 1&#46;19&#44; 95&#37; CI 1&#46;02&#8211;1&#46;40&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;03&#41; maintained a statistically significant relationship with hospital mortality &#40;<a class="elsevierStyleCrossRef" href="#tbl0020">Table 4</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia></span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0130">Discussion</span><p id="par0160" class="elsevierStylePara elsevierViewall">Our study describes the HIV-infected patient population that required ICU admission over a relatively long period &#40;15 years&#41;&#44; and during the current period of ART&#46; Consistent with most publications to date&#44; we found that critical patients infected with HIV are young and predominantly male&#46; In our study&#44; we could not prove a relation between immunovirological or nutritional status&#44; reason for admission or need for organ support and hospital mortality&#46; Variables related with higher hospital mortality in our patients were severity scores &#40;APACHE II at admission and SOFA at 72<span class="elsevierStyleHsp" style=""></span>h&#41;&#44; moderate&#8211;severe liver disease and admission form hospital ward&#46; Our data provide important insight regarding the complex management of hospitalised HIV-infected patients&#46; Sepsis remains the leading cause of ICU admission in the current HAART era&#46; Mortality&#44; although higher&#44; increasingly approximates that of non-HIV patients&#46;</p><p id="par0165" class="elsevierStylePara elsevierViewall">Our population has a long-standing history of clinical course of infection &#40;median nine years from diagnosis&#44; increasing up to 12 in last five years of our study&#41; and very few patients were diagnosed during their current admission &#40;less than 12&#37;&#41;&#46; These data are similar to those recently published describing industrialized countries&#46;<a class="elsevierStyleCrossRefs" href="#bib0305"><span class="elsevierStyleSup">22&#44;28&#44;33</span></a> However&#44; in the studies by Chiang et al&#46; and Xiao et al&#46;&#44; the clinical course of the disease was much shorter &#40;less than a year&#41;&#44; with a high percentage of diagnoses during admission &#40;approximately 50&#37;&#41;&#46;<a class="elsevierStyleCrossRefs" href="#bib0325"><span class="elsevierStyleSup">26&#44;29</span></a></p><p id="par0170" class="elsevierStylePara elsevierViewall">At present&#44; it is widely currently recommended that HAART be administered to all HIV-infected patients&#44; regardless of immunovirological profile or symptoms&#46; However&#44; despite that proportion of patients receiving HAART is increasing&#44; only 54&#46;8&#37; of our patients were under HAART at admission&#46; These data are comparable to those reported by other countries from our region&#44;<a class="elsevierStyleCrossRefs" href="#bib0285"><span class="elsevierStyleSup">18&#44;28&#44;33</span></a> and the level in Spain is higher than in the studies published from countries such as Australia&#44; Brazil&#44; Taiwan and China &#40;in which less than 40&#37; of patients received ART&#41;&#44;<a class="elsevierStyleCrossRefs" href="#bib0305"><span class="elsevierStyleSup">22&#44;26&#44;27&#44;29</span></a> but far from the 71&#37; reported in the USA by Akg&#252;n et al&#46;<a class="elsevierStyleCrossRef" href="#bib0295"><span class="elsevierStyleSup">20</span></a> This variability in the percentage of patients who receive ART is reflected in their CD4 T-lymphocyte counts at admission&#46; Among our patients&#44; the median was 167<span class="elsevierStyleHsp" style=""></span>cells&#47;mm<span class="elsevierStyleSup">3</span> &#40;53&#46;5&#44; 414&#46;0&#41;&#59; in studies with a lower percentage of patients receiving ART&#44; the CD4 count is lower&#44; even falling below 50<span class="elsevierStyleHsp" style=""></span>cells&#47;mm<span class="elsevierStyleSup">3</span>&#46;<a class="elsevierStyleCrossRefs" href="#bib0325"><span class="elsevierStyleSup">26&#44;29</span></a></p><p id="par0175" class="elsevierStylePara elsevierViewall">As in other recent studies&#44; despite our patients&#8217; relatively good immunovirological conditions&#44; almost half were admitted to the ICU because of infection&#46;<a class="elsevierStyleCrossRefs" href="#bib0305"><span class="elsevierStyleSup">22&#44;23</span></a></p><p id="par0180" class="elsevierStylePara elsevierViewall">Consistent with previous reports&#44;<a class="elsevierStyleCrossRefs" href="#bib0305"><span class="elsevierStyleSup">22&#44;31</span></a> 13&#46;1&#37; of our patients presented with chronic liver disease with cirrhosis or PHT&#46; HCV co-infection is very common in HIV patients and varies between 15&#37; and 60&#37;<a class="elsevierStyleCrossRefs" href="#bib0290"><span class="elsevierStyleSup">19&#44;31</span></a>&#59; in our sample&#44; 60&#46;1&#37; of patients presented with HCV co-infection&#46;</p><p id="par0185" class="elsevierStylePara elsevierViewall">ICU and hospital mortality &#40;25&#46;1&#37; and 32&#46;9&#37;&#44; respectively&#41; observed in our study was comparable to the figures reported for other industrialized countries<a class="elsevierStyleCrossRefs" href="#bib0225"><span class="elsevierStyleSup">6&#8211;23</span></a> and lower than those reported for developing countries &#40;higher than 40&#37;&#41;<a class="elsevierStyleCrossRefs" href="#bib0315"><span class="elsevierStyleSup">24&#8211;30</span></a> and in other Spanish studies&#46;<a class="elsevierStyleCrossRefs" href="#bib0350"><span class="elsevierStyleSup">31&#44;32</span></a> These observed mortality differences are probably of multifactorial origin and impact both factors such as extra-hospital treatment for these patients &#40;follow-up in consultations&#44; HAART&#44; management of comorbidities&#44; etc&#46;&#41; and the care received during hospital admission &#40;ICU admission criteria&#44; organ support provided&#44; etc&#46;&#41;&#46;</p><p id="par0190" class="elsevierStylePara elsevierViewall">We did not find a significant relationship between immunovirological condition&#44; receiving ART&#44; or years of evolution of infection and hospital mortality&#46; These data coincide with those reported in most&#44;<a class="elsevierStyleCrossRefs" href="#bib0235"><span class="elsevierStyleSup">8&#44;10&#44;15&#44;16&#44;18&#44;19&#44;22&#44;26&#44;27&#44;29&#44;33&#44;36&#44;37</span></a> although not all&#44;<a class="elsevierStyleCrossRefs" href="#bib0250"><span class="elsevierStyleSup">11&#44;13&#44;17&#44;22&#44;24&#44;26&#44;28&#44;38</span></a> studies published to date&#46; Probably the difficulty in detecting an independent relationship between mortality and inmunovorological status lies in the fact that patients who receive HAART have not only a higher CD4 count and a lower VL but also a better nutritional status and a different reason for ICU admission&#46; Nevertheless&#44; a larger sample size could&#44; perhaps&#44; give us a statistically significant relation of CD count with mortality&#46;</p><p id="par0195" class="elsevierStylePara elsevierViewall">Furthermore&#44; some studies have related the use of HAART during the ICU stay to lower intra-ICU mortality without impacting long-term survival&#46;<a class="elsevierStyleCrossRefs" href="#bib0290"><span class="elsevierStyleSup">19&#44;25&#44;27&#44;33</span></a> A meta-analysis including 12 retrospectives studies&#44; published in 2017&#44; showed a significant benefit on short-term mortality when HAART is received during ICU stay&#44; but long-term benefit remains unclear&#46;<a class="elsevierStyleCrossRef" href="#bib0390"><span class="elsevierStyleSup">39</span></a> Herein&#44; despite we found a lower hospital mortality in patients having HAART both previously and during ICU stay&#44; we could not prove a significant relationship between receiving HAART and hospital mortality&#46; Although is possible that inclusion of a higher number of patients would change this&#44; there were important differences between these groups&#46; On the one hand&#44; patients under HAART at admission had a better immunovirological and nutritional status&#44; less ICU admissions caused by sepsis and lower severity scores at admission&#46; On the other hand&#44; severity scores were higher in patients who did not receive HAART during ICU stay and patients who receive HAART on ICU were more frequently under treatment at admission &#40;with a consequent better immunovirological status&#41;&#46; It&#39;s remarkable that only 54&#37; patients with chronic HAART treatment receive it during ICU stay&#46; HAART administration in ICU is complicated due to limited availability of parenteral ART and unknown pharmacokinetics of enteral administration through nasogastric tubes in patients receiving mechanical ventilation or in shock&#44; risk of potential drugs interactions and risk of provoking immune reconstitution inflammatory syndrome&#46; The delay in the start of HAART in ICU was 1 &#40;0&#44; 5&#41; day&#44; but was higher in patients with invasive mechanical ventilation &#91;4&#46;5 &#40;1&#44; 7&#41; compared with 0 &#40;0&#44; 1&#41; days in no-ventilated patients&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;01&#93; or in shock &#91;5 &#40;1&#44; 8&#46;5&#41; vs 1 &#40;0&#44; 3&#41; days&#93;&#46;</p><p id="par0200" class="elsevierStylePara elsevierViewall">Just as in other studies&#44;<a class="elsevierStyleCrossRefs" href="#bib0300"><span class="elsevierStyleSup">21&#44;27&#8211;30</span></a> delayed ICU admission from patient hospital arrival &#40;here defined as admission not from E&#46;D&#46;&#41; significantly increased the risk of death during the hospital stay&#46; Factors such as initially inadequate treatment&#44; poor response to that treatment&#44; or onset of complications during the hospital stay may justify the relationship between delayed admission and higher mortality&#46;</p><p id="par0205" class="elsevierStylePara elsevierViewall">In the current era&#44; in which HIV infection is controllable with ART&#44; comorbidities play an increasingly important role in patient prognosis&#46; Patients with a history of moderate&#8211;severe liver disease have a higher risk of hospital death in our study and those by Barbier et al&#46;&#44; Turvey et al&#46; and Medrano et al&#46;<a class="elsevierStyleCrossRefs" href="#bib0300"><span class="elsevierStyleSup">21&#44;22&#44;31</span></a> We did not find relation between other comorbidities and mortality&#46;</p><p id="par0210" class="elsevierStylePara elsevierViewall">It has been proposed that&#44; nowadays&#44; the mortality among ICU-admitted HIV patients is related to the severity of their acute event&#46; Higher severity scores among critical patients at admission&#44; such as APACHE II or SAPS II&#44; have been related to higher mortality&#46;<a class="elsevierStyleCrossRefs" href="#bib0290"><span class="elsevierStyleSup">19&#44;21&#44;22&#44;25&#44;27&#44;28&#44;33</span></a> This was observed in our study&#44; in which risk of death increases close to 20&#37; for each point on SOFA score evaluated at 72<span class="elsevierStyleHsp" style=""></span>h and more than 10&#37; for each point on the APACHE II score&#46; However&#44; we did not find a significant relationship between the SOFA at ICU admission and mortality&#44; which probably reflects that in order to establish the prognosis it is more important to assess the response to treatment than the initial organ dysfunction&#46; Regarding the need for organ support&#44; evidence is contradictory&#44; with discrepancies as to the relationship between hospital mortality and the need for respiratory support with invasive MV&#44;<a class="elsevierStyleCrossRefs" href="#bib0290"><span class="elsevierStyleSup">19&#44;21&#44;22&#44;25&#44;27&#44;29</span></a> for VADs<a class="elsevierStyleCrossRefs" href="#bib0290"><span class="elsevierStyleSup">19&#44;21&#44;22</span></a> and for RRTs&#46;<a class="elsevierStyleCrossRefs" href="#bib0300"><span class="elsevierStyleSup">21&#44;22&#44;29</span></a> In our study&#44; the need for support did not predict hospital mortality once we adjusted for severity&#44; reason for admission and comorbidities&#46;</p><p id="par0215" class="elsevierStylePara elsevierViewall">While some studies have reported poorer prognosis in patients admitted to the ICU because of infection&#44;<a class="elsevierStyleCrossRefs" href="#bib0320"><span class="elsevierStyleSup">25&#44;30</span></a> we did not detect any relationship between the reason for ICU admission and prognosis&#46; These differences may be based on patients&#8217; immunovirological profiles at admission&#44; because more immunosuppression increases their risk of admission due to OIs&#44; which then lead to a worse prognosis&#46;</p><p id="par0220" class="elsevierStylePara elsevierViewall">Finally&#44; we found important differences between the three periods &#40;2000&#8211;2004&#44; 2005&#8211;2009 and 2010&#8211;2014&#41;&#46; First&#44; patients were older and with more years living with HIV in most recent periods&#46; Second&#58; proportion of patients receiving HAART also increases significantly&#44; with a consequent decrease in HIV viral load&#46; Third&#44; severity scores were higher in most recent periods&#46; We did not find changes in mortality over time &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#41;&#46;</p><p id="par0225" class="elsevierStylePara elsevierViewall">Our study is not without limitations&#46; First&#44; it was observational and retrospective&#46; Second&#44; although two sites took part&#44; both are in the same geographic setting&#44; limiting the extent to which we can generalize the results&#46; Third&#44; data on ART administration were obtained from clinical records&#59; no drug level tests were performed either at admission or during the ICU stay&#46; Thus&#44; it is possible that patients noncompliant with treatment were not detected&#46; Fourth&#44; only physical examination and albumin levels at admission were used to evaluate nutritional status&#59; we do not have other useful data such as body mass index&#46; Fifth&#44; a recruitment bias cannot be ruled out&#44; because neither of the two units taking part have defined ICU admission criteria for HIV patients&#59; we identified patients retrospectively using the hospital records system&#46; Finally&#44; our study includes patients over 15 years&#44; which may reduce its external validity&#46;</p></span><span id="sec0075" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0135">Conclusions</span><p id="par0230" class="elsevierStylePara elsevierViewall">Delayed ICU admission&#44; comorbidities and severity of critical illness&#44; determine the prognosis of HIV-infected patients admitted to the ICU&#46; We did not detect any impact of immunovirological or nutritional condition&#44; reason for admission&#44; or need for organ support during admission&#46; Based on these data&#44; HIV patients should receive the same level of care as non-HIV-infected patients&#44; regardless of their immunological or nutritional condition&#46; We can not prove a relationship between receiving HAART and prognosis&#44; but we have shown significant differences between patients who receive and do not receive treatment before ICU admission &#40;better nutritional and inmunovirologic status&#44; and less severity&#44; sepsis-related admissions and need for mechanical ventilation in HAART patients&#41; and during their ICU stay &#40;better immunological status&#44; less HCV-infected patients and less severity and more cardiac-related diagnosis in patients who received HAART&#41;&#46;</p></span><span id="sec0095" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0140">Autorship</span><p id="par0255" class="elsevierStylePara elsevierViewall">Pablo Vidal-Cort&#233;s has participated in the conception and design of the study and the acquisition&#44; analysis and interpretation of the data and has made the draft of the article&#46;</p><p id="par0260" class="elsevierStylePara elsevierViewall">Luis Antonio &#193;lvarez-Rocha has participated in the conception and design of the study&#44; and in the critical review of intellectual content&#46; He has approved the version that is presented&#46;</p><p id="par0265" class="elsevierStylePara elsevierViewall">Paula Fern&#225;ndez-Ugidos has participated in the acquisition of data and has approved the version presented&#46;</p><p id="par0270" class="elsevierStylePara elsevierViewall">Marcos Antonio P&#233;rez-Veloso has participated in the acquisition of data and has approved the version presented&#46;</p><p id="par0275" class="elsevierStylePara elsevierViewall">Ignacio Mar&#237;a Su&#225;rez-Paul has participated in the acquisition of data and has approved the version presented&#46;</p><p id="par0280" class="elsevierStylePara elsevierViewall">Alejandra Virg&#243;s-Pedreira has participated in the acquisition of data and has approved the version presented&#46;</p><p id="par0285" class="elsevierStylePara elsevierViewall">Sonia P&#233;rtega-D&#237;az has participated in the analysis and interpretation of data&#44; in the critical review of intellectual content&#44; and has approved the version presented&#46;</p><p id="par0290" class="elsevierStylePara elsevierViewall">&#193;ngeles Castro-Iglesias has participated in the conception and design of the study&#44; in the critical review of the intellectual content&#44; and has approved the version presented&#46;</p></span><span id="sec0100" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0145">Conflict of interests</span><p id="par0295" class="elsevierStylePara elsevierViewall">The authors declare no conflict of interest&#46;</p></span></span>"
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    "fechaRecibido" => "2018-12-04"
    "fechaAceptado" => "2019-02-26"
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            2 => "Prognosis"
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          "clase" => "keyword"
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          "palabras" => array:3 [
            0 => "VIH"
            1 => "TARGA"
            2 => "Pron&#243;stico"
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        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Purpose</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">To describe the epidemiology of critical disease in HIV-infected patients during the current highly active antiretroviral therapy &#40;HAART&#41; era and to identify hospital mortality predictors&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">A longitudinal&#44; retrospective observational study was made of HIV-infected adults admitted to the ICU in two Spanish hospitals between 1 January 2000 and 31 December 2014&#46; Demographic and HIV-related variables were analyzed&#44; together with comorbidities&#44; severity scores&#44; reasons for admission and need for organ support&#46; The chi-squared test was used to compare categorical variables&#44; while continuous variables were contrasted with the Student&#39;s <span class="elsevierStyleItalic">t</span>-test&#44; Mann&#8211;Whitney <span class="elsevierStyleItalic">U</span>-test or Kruskal&#8211;Wallis test&#44; assuming an alpha level<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#46; Multivariate logistic regression analysis was used to calculate odds ratios for assessing correlations to mortality during hospital stay&#46; Joinpoint regression analysis was used to study mortality trends over time&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">A total of 283 episodes were included for analyses&#46; Hospital mortality was 32&#46;9&#37; &#40;95&#37;CI&#58; 21&#46;2&#8211;38&#46;5&#41;&#46; Only admission from a site other than the Emergency Care Department &#40;OR 3&#46;64&#44; 95&#37;CI&#58; 1&#46;30&#8211;10&#46;20&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;01&#41;&#44; moderate&#8211;severe liver disease &#40;OR 5&#46;65&#44; 95&#37;CI&#58; 1&#46;11&#8211;28&#46;87&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;04&#41; and the APACHE II score &#40;OR 1&#46;14&#44; 95&#37;CI&#58; 1&#46;04&#8211;1&#46;26&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;01&#41; and SOFA score at 72<span class="elsevierStyleHsp" style=""></span>h &#40;OR 1&#46;19&#44; 95&#37;CI&#58; 1&#46;02&#8211;1&#46;40&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;03&#41; maintained a statistically significant relationship with hospital mortality&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusions</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Delayed ICU admission&#44; comorbidities and the severity of critical illness determine the prognosis of HIV-infected patients admitted to the ICU&#46; Based on these data&#44; HIV-infected patients should receive the same level of care as non-HIV-infected patients&#44; regardless of their immunological or nutritional condition&#46;</p></span>"
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        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Objetivos</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Describir la epidemiolog&#237;a de la patolog&#237;a cr&#237;tica en el paciente infectado por VIH durante la era de tratamiento antirretroviral de gran actividad actual y encontrar predictores de mortalidad hospitalaria&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">M&#233;todos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Estudio observacional&#44; retrospectivo y longitudinal que incluye pacientes infectados por VIH adultos ingresados en las UCI de hospitales de Galicia&#44; entre el 1 de enero de 2000 y el 31 de diciembre de 2014&#46; Analizamos variables demogr&#225;ficas y relacionadas con la infecci&#243;n por el VIH&#44; comorbilidades&#44; puntuaciones de gravedad&#44; motivo de ingreso y necesidad de soporte de &#243;rganos&#46; Empleamos la prueba de la Chi-cuadrado para comparar las variables categ&#243;ricas y las pruebas de la T-Student&#44; U de Mann-Whitney o H de Kruskal-Wallis para las variables continuas&#44; asumiendo un error a<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#46; Utilizamos la regresi&#243;n log&#237;stica multivariante para calcular la OR de la asociaci&#243;n con la mortalidad hospitalaria&#46; Aplicamos an&#225;lisis de regresi&#243;n de <span class="elsevierStyleItalic">joinpoint</span> para estudiar la tendencia temporal de mortalidad&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Incluimos 283 episodios&#46; La mortalidad hospitalaria fue del 32&#44;9&#37; &#40;IC 95&#37;<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>21&#44;2-38&#44;5&#37;&#41;&#46; El ingreso no procedente de Urgencias &#40;OR 3&#44;64&#59; IC 95&#37;<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span> 1&#44;30-10&#44;20&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;01&#41;&#44; la enfermedad hep&#225;tica moderada-grave &#40;OR 5&#44;65&#59; IC 95&#37;<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#44;11-28&#44;87&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;04&#41;&#44; el APACHE II &#40;OR 1&#44;14&#59; IC 95&#37;<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>1&#44;04-1&#44;26&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;01&#41; y el SOFA a las 72<span class="elsevierStyleHsp" style=""></span>h &#40;OR 1&#44;19&#59; IC 95&#37;<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span> 1&#44;02-1&#44;40&#59; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;03&#41; se relacionan con la mortalidad hospitalaria en el an&#225;lisis multivariante&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusiones</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">El retraso en el ingreso en UCI&#44; las comorbilidades y la gravedad del episodio determinan el pron&#243;stico del paciente infectado por VIH ingresado en UCI&#46; Los pacientes con VIH deber&#237;an recibir el mismo nivel de cuidados que los pacientes no infectados por VIH&#44; independientemente de su estado inmunol&#243;gico o nutricional&#46;</p></span>"
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            "etiqueta" => "Appendix A"
            "titulo" => "Supplementary data"
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          "leyenda" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Numbers reported as <span class="elsevierStyleItalic">n</span> &#40;&#37;&#41; and mean<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>standard deviation or median &#40;p25&#8211;p75&#41;&#46;</p><p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">ED&#58; Emergency Department&#59; HAART&#58; high-activity antiretroviral therapy&#59; OI&#58; opportunistic infection&#59; DM&#58; diabetes mellitus&#59; M&#8211;S liver disease&#58; moderate&#8211;severe liver disease&#46;</p>"
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                  \t\t\t\t"><span class="elsevierStyleItalic">Age &#40;years&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#46;73&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Male sex</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">132 &#40;69&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">74 &#40;79&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Admission from ED</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">160 &#40;56&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">128 &#40;67&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">32 &#40;34&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleBold">&#60;0&#46;01</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t  " colspan="5" align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">HIV infection</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Diagnosis at this admission&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">33 &#40;11&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">16 &#40;8&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">17 &#40;18&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Diagnosis in the ICU&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">23 &#40;8&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">13 &#40;6&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">10 &#40;10&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#46;26&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>HAART&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">155 &#40;54&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">112 &#40;58&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">43 &#40;46&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleBold">0&#46;04</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>HAART in the ICU&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">111 &#40;39&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">87 &#40;45&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">24 &#40;25&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleBold">&#60;0&#46;01</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>OI prophylaxis&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">41 &#40;14&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">23 &#40;12&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">18 &#40;19&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">0&#46;10&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>AIDS&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">195 &#40;68&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">124 &#40;65&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">71 &#40;76&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">0&#46;06&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Years of infection&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">9 &#40;3&#44; 16&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">10 &#40;5&#44; 16&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">8 &#40;1&#44; 16&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#46;10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>CD4 count &#40;cell&#47;mL&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">167&#46;0 &#40;53&#46;5&#44; 414&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">204&#46;0 &#40;74&#46;0&#44; 493&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">80&#46;0 &#40;29&#46;0&#44; 236&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleBold">&#60;0&#46;01</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Viral load &#40;log&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">2&#46;9 &#40;0&#46;0&#44; 5&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">2&#46;6 &#40;0&#46;0&#44; 5&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">4&#46;5 &#40;1&#46;1&#44; 5&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleBold">0&#46;02</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Viral load suppressed&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">64 &#40;22&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">47 &#40;29&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">17 &#40;24&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Comorbidities and nutritional status &#40;see</span><span class="elsevierStyleItalic">Appendix A&#46; Supplementary data&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>DM free of complications&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>DM with complications&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0 &#40;0&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#46;32&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Cardiac disease&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">13 &#40;4&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">3 &#40;3&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#46;44&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Lung disease&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">25 &#40;8&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">20 &#40;10&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">5 &#40;5&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#46;15&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Liver disease&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">185 &#40;65&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">122 &#40;64&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">63 &#40;67&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#46;56&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>M-S liver disease&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">37 &#40;13&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">18 &#40;9&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">19 &#40;20&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleBold">0&#46;01</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Renal disease&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">5 &#40;1&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">2 &#40;1&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">3 &#40;3&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#46;19&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Hepatitis C Virus &#40;HCV&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">170 &#40;60&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">114 &#40;60&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">56 &#40;60&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#46;97&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Hepatitis B Virus &#40;HBV&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">36 &#40;12&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">27 &#40;14&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">9 &#40;9&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#46;28&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>HCV<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>HBV&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">24 &#40;8&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">20 &#40;10&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">4 &#40;4&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#46;08&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Charlson Comorbidity Index&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">7 &#40;3&#44; 7&#46;25&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">6 &#40;2&#44; 7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">7 &#40;6&#44; 8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t"><span class="elsevierStyleBold">&#60;0&#46;01</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Cachexia&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">70 &#40;24&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">35 &#40;18&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">35 &#40;37&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleBold">&#60;0&#46;01</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Albumin &#40;g&#47;dL&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">2&#46;6 &#40;2&#46;1&#44; 3&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">2&#46;7 &#40;2&#46;2&#44; 3&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">2&#46;3 &#40;1&#46;8&#44; 3&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Diagnosis at admission &#40;see Appendix A&#46; Supplementary data&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Severe sepsis&#47;septic shock&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">83 &#40;43&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Cardiac&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">48 &#40;25&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">7 &#40;7&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Trauma&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">19 &#40;6&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">15 &#40;7&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">4 &#40;4&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#46;26&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Neurological&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">11 &#40;3&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">4 &#40;2&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">7 &#40;7&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Organ support during admission</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Mechanical ventilation&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">172 &#40;60&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">91 &#40;47&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">81 &#40;87&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Vasoactive drugs&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">59 &#40;63&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Renal replacement therapy&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">31 &#40;11&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">9 &#40;4&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Complications</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Superinfection&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">41 &#40;14&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Severity scores</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>APACHE II&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">6 &#40;3&#44; 9&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">4 &#40;2&#44; 8&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">9 &#40;5&#44; 12&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>SOFA score 72<span class="elsevierStyleHsp" style=""></span>h&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">5 &#40;2&#44; 8&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">3 &#40;2&#44; 7&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">7 &#40;4&#44; 11&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>SOFA 0&#8211;72<span class="elsevierStyleHsp" style=""></span>h&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">-1 &#40;-3&#44; 1&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">-1 &#40;-3&#44; 0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>AIDS&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">102 &#40;79&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>CD4 count &#40;cell&#47;mL&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">1&#46;61 &#40;0&#44; 4&#46;97&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t">5 &#40;10&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">27 &#40;26&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">32 &#40;42&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>HAART&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>M&#8211;S liver disease&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">14 &#40;15&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Charlson Comorbidity Index&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Diagnosis at admission</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Cardiac&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Neurological&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Renal replacement therapy&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>APACHE II&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>SOFA score 72<span class="elsevierStyleHsp" style=""></span>h&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t">0&#46;73&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">16 &#40;8&#44; 42&#46;25&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#46;78&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>ICU mortality&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">17 &#40;25&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Hospital mortality&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">42&#46;1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>8&#46;6&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">45&#46;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>10&#46;7&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">0&#46;75&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">130 &#40;75&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">76 &#40;68&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;19&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Admission from ED</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">73 &#40;57&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">87 &#40;56&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;88&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">96 &#40;55&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">64 &#40;57&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">0&#46;76&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="7" align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="7" align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">HIV infection</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>HAART pre-ICU admission&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Years of infection&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Viral load suppressed&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Days until start of HAART&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Comorbidities and nutritional status &#40;see</span><a class="elsevierStyleCrossRef" href="#sec0090"><span class="elsevierStyleItalic">Appendix A&#46; Supplementary data</span></a><span class="elsevierStyleItalic">&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>M-S liver disease&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Hepatitis C Virus &#40;HCV&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">79 &#40;61&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Diagnosis at admission &#40;see</span><a class="elsevierStyleCrossRef" href="#sec0090"><span class="elsevierStyleItalic">Appendix A&#46; Supplementary data</span></a><span class="elsevierStyleItalic">&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Renal replacement therapy&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Complications &#40;see</span><a class="elsevierStyleCrossRef" href="#sec0090"><span class="elsevierStyleItalic">Appendix A&#46; Supplementary data</span></a><span class="elsevierStyleItalic">&#41;</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t  " colspan="7" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">HIV infection</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Years of infection&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">0&#46;98&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">0&#46;94&#8211;1&#46;01&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;16&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Diagnosis during actual admission&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">2&#46;43&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;17&#8211;5&#46;07&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleBold">0&#46;02</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;55&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;32&#8211;7&#46;56&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;59&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Not receiving HAART&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;67&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;01&#8211;2&#46;75&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">0&#46;04</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;49&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;44&#8211;5&#46;11&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;52&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>HAART during ICU stay&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;41&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;24&#8211;0&#46;71&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">&#60;0&#46;01</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">0&#46;37&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">0&#46;12&#8211;1&#46;17&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;09&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>AIDS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">1&#46;72&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">0&#46;98&#8211;3&#46;02&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;06&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>CD4 count&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;99&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;99&#8211;0&#46;99&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">&#60;0&#46;01</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;99&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">0&#46;99&#8211;1&#46;00&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">0&#46;09&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Viral load&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">1&#46;16&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">1&#46;02&#8211;1&#46;31&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleBold">0&#46;02</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;11&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;83&#8211;1&#46;49&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">0&#46;48&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Viral load suppressed&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;76&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">0&#46;40&#8211;1&#46;44&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;40&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="7" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="7" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Diagnosis at admission</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Severe sepsis&#47;septic shock&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">2&#46;04&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1&#46;23&#8211;3&#46;39&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleBold">&#60;0&#46;01</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#46;65&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#46;18&#8211;2&#46;37&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">0&#46;52&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Cardiological&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">0&#46;28&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#46;12&#8211;0&#46;65&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleBold">&#60;0&#46;01</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">0&#46;66&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Neurological&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Trauma&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Organ support during admission</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Mechanical ventilation&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Vasoactive drugs&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Renal replacement therapy&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Superinfection&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Severity scores</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>APACHE II&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>SOFA score&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1&#46;24&nbs