HIV-associated pulmonary arterial hypertension: survival and prognostic factors in the modern therapeutic era

Abstract

In patients with PAH-HIV, HAART seems unable to improve haemodynamic parameters. Prognosis in PAH-HIV is mainly related to CD4+ lymphocyte count and cardiac function.

Enhanced Pulmonary Arteriopathy in Simian Immunodeficiency Virus–infected Macaques Exposed to Morphine

“…In this regard, one of the most devastating sequelae is the development of pulmonary arterial hypertension (PAH) in HIVinfected individuals (HIV-PAH). HIV-PAH results in early mortality and serves as an independent predictor of survival (1). Despite antiretroviral therapy, 1 in 200 patients with AIDS still develops HIV-PAH (2,3).…”

Pulmonary Manifestations of HIV Disease

“…There was better survival in patients with CD4 T cell count of greater than 200 and a higher cardiac index. Anti-retroviral therapy did not appear to influence hemodynamic parameters 259 .…”

Prevalence and Hospital Discharge Status of Human Immunodeficiency Virus–Associated Pulmonary Arterial Hypertension in the United States

“…9 In 2003, Nunes et al 10 reported that 3-year survival for individuals with HIV-PAH diagnosed at New York Heart Association (NYHA) functional classes I and II (84%) is greater than 3-year survival for patients who received a diagnosis of NYHA functional classes III and IV (28%). More recently, Degano et al 11 reported that the overall survival rate among patients with HIV-PAH was 72% at 3 years, but survival rate varied on the basis of NYHA class, with a 3-year survival rate of just greater than 90% for persons with NYHA class II and just less than 30% for persons with NYHA class IV. This highlights the importance of making a diagnosis and initiating therapy early.…”