IntroductionThe combination antiretroviral therapy (cART) has led to decreased opportunistic infections and hospital admissions in human immunodeficiency virus (HIV) infected patients; but the intensive care unit (ICU) admission rate remains constant (or even increased in some instances) during the cART era. Hepatitis C virus (HCV) infection is associated with an increased risk for hospital admission and/or mortality (particularly those related to severe liver disease) compared to the general population. The aim of this study was to assess the mortality among HIV-infected patients in ICU, and to evaluate the impact of HIV/HCV coinfection and severe sepsis on ICU mortality.MethodsWe carried out a retrospective study based on patients admitted to ICU who were recorded in the Minimum Basic Data Set (2005-2010) in Spain. HIV-infected patients (All-HIV-group (n¿=¿1891)) were divided into two groups: HIV-monoinfected patients (HIV-group (n¿=¿1191)) and HIV/HCV-coinfected patients (HIV/HCV-group (n¿=¿700)). A control group (HIV(-)/HCV(-)) was also included (n¿=¿7496).ResultsAll-HIV-group had higher frequencies of severe sepsis (57.7% vs. 39.4%; p¿<¿0.001) than control group. Overall, ICU mortality in patients with severe sepsis was much more frequent than in patients without severe sepsis (other causes) at days 30 and 90 in HIV-infected patients and control group (p¿<¿0.001). Moreover, all-HIV-group in presence or absence of severe sepsis had a higher percentage of death than control group at days 7 (p¿<¿0.001), 30 (p¿<¿0.001) and 90 (p¿<¿0.001). Besides, HIV/HCV-group had a higher percentage of death both in patients with severe sepsis, and in patients without severe sepsis compared to HIV-group at days 7 (p¿<¿0.001) and 30 (p¿<¿0.001); while no differences were found at day 90. In a Bayesian competing risk model, HIV/HCV-group had higher mortality risk (adjusted hazard ratio (aHR)¿=¿1.44 (95%CI¿=¿1.30-1.59) and aHR¿=¿1.57 (95%CI¿=¿1.38-1.78) for patients with and without severe sepsis, respectively).ConclusionsHIV infection was related to higher frequency of severe sepsis and death among patients admitted to the ICU. Besides, HIV/HCV coinfection contributed to an increased risk of death in both presence and absence of severe sepsis.