Antiretroviral Therapy at the End of Life: The Experience of an Academic HIV Clinic. (August 2014)

• Record Type: Journal Article
• Authors: Ruiz, Marco; Armstrong, Megan; Reske, Tom; Cefalu, Charles; Anwar, Dominique
• Is Part Of: American journal of hospice & palliative care. Volume 31:Number 5(2014)
• Page Start: 475
• Page End: 479
• Publication Date: 2014-08
• Subjects: end of life -- discontinuation -- HIV -- antiretrovirals; Hospice care -- Periodicals; Palliative treatment -- Periodicals; 362.175
• DOI: 10.1177/1049909113494459
• Languages: English
• ISSNs: 1049-9091

Abstract

Introduction: There are no guidelines regarding the discontinuation of antiretroviral therapy at the end of life. Methods: We retrospectively reviewed our databases and identified patients with HIV/AIDS who died over the last 12 months in our HIV clinic. Results: A total of 41 patients from our HIV clinic died in a period of 12 months. Seventy-three percent of the patients were on antiretroviral therapy during the last clinic visit. During the last 3 months of life, 32% (13 of 41) were off antiretroviral therapy, with 77% (10 of 13) of them having intermittent therapy due to noncompliance. The remaining 23% (3 of 13) decided to stop antiretroviral therapy after discussion among families, patients, and providers. Conclusion: Discussions among providers, patients, and families are encouraged to establish goals of care and role of antiretrovirals during the last months of life.