Antiretroviral therapy at the end of life: the experience of an academic HIV clinic.

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.