Pulmonary arterial hypertension related to human immunodeficiency virus infection: A case series

Araújo, Inês; Enjuanes-Grau, Cristina; Lopez-Guarch, Carmen Jimenez; Narankiewicz, Dariusz; Ruiz-Cano, María J.; Velazquez-Martin, Teresa; Delgado, Juan; Escribano, Pilar

doi:10.4330/wjc.v6.i6.495

Cited by 18 publications

(8 citation statements)

References 29 publications

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“…However, recently, Araújo et al . reported a case series with eighteen HIV‐PAH subjects, where three patients were in treatment with tadalafil. Instead, most of patients in this case series were in treatment with sildenafil.…”

Section: Pulmonary Hypertension Specific Therapymentioning

confidence: 99%

HIV‐associated pulmonary arterial hypertension: from bedside to the future

Correale

Palmiotti

Storto

et al. 2015

Eur J Clin Investigation

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Pulmonary arterial hypertension (PAH) is a life-threatening complication of HIV infection. The prevalence of HIVassociated PAH (HIV-PAH) seems not to be changed over time, regardless of the introduction of highly active antiretroviral therapy (HAART). In comparison with the incidence of idiopathic PAH in the general population (1-2 per million), HIV-infected patients have a 2500-fold increased risk of developing PAH. HIV-PAH treatment is similar to that for all PAH conditions and includes lifestyle changes, general treatments and specific treatments.

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Section: Pulmonary Hypertension Specific Therapymentioning

confidence: 99%

HIV‐associated pulmonary arterial hypertension: from bedside to the future

Correale

Palmiotti

Storto

et al. 2015

Eur J Clin Investigation

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“…This could be explained by a more prevalent and severe ventricular systolic dysfunction among HIV-PAH patients compared to patients with PAH of other etiologies ( 69 ). More recent studies have shown a slightly improved median survival with 66–86% at 3 years ( 17 , 70 , 71 ). As many deaths in these recent studies were unrelated to PAH, one may suppose a decrease in HIV-PAH-related death ( 71 ).…”

Section: Reviewmentioning

confidence: 98%

Pulmonary Arterial Hypertension among HIV-Infected Children: Results of a National Survey and Review of the Literature

et al. 2015

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Since the advent of highly active anti-retroviral therapy, HIV-related mortality has decreased dramatically. As a consequence, patients are living longer, and HIV infection is becoming a chronic disease. Patients and caretakers have to deal with chronic complications of infection and treatment, such as cardiovascular diseases, which now represent an important health issue, even in the pediatric population. Prevalence of pulmonary arterial hypertension (PAH) in the adult HIV population is around 0.4–0.6%, which is around 1000- to 2500-fold more prevalent than in the general population. In recent adult PAH registries, HIV has been identified as the fourth cause of PAH, accounting for approximately 6–7% of cases. Therefore, regular screening is recommended in HIV-infected adults by many experts. If HIV-associated PAH is mainly reported in HIV-infected adults, pediatric cases have also been, albeit rarely, described. This scarcity may be due to a very low PAH prevalence, or due to the lack of systematic cardiovascular screening in pediatric patients. As PAH may manifest only years or decades after infection, a systematic screening should perhaps also be recommended to HIV-infected children. In this context, we retrospectively looked for PAH screening in children included in our national Swiss Mother and Child HIV cohort study. A questionnaire was sent to all pediatric infectious disease specialists taking care of HIV-infected children in the cohort. The questions tried to identify symptoms suggestive of cardiovascular risk factors and asked which screening test was performed. In the 71 HIV-infected children for which we obtained an answer, no child was known for PAH. However, only two had been screened for PAH, and the diagnosis was not confirmed. In conclusion, PAH in HIV-infected children is possibly underestimated due to lack of screening. Systematic echocardiographic evaluation should be performed in HIV-infected children.

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“…Araujo et al in 2014 reported IVDU as a major risk factor (77.8%) for infection in HIV-PAH patients presenting with NYHA functional classes II-IV [72]. Furthermore, the study by Rasoulinejad et al in the same year reported a greater than 35 mmHg PASP in 3% of HIV-infected patients in a cohort that had 50.5% IVDUs [44].…”

Section: Epidemiology Of Pah In Hiv-infected and Intravenous Drug Usersmentioning

confidence: 99%

“…According to the recent systematic review of HIV-PAH case studies by Janda et al, 59% of all the reported HIV-PAH cases were males [65]. In addition, a recent study by Araujo et al that reported PAH in HIV-infected IVDUs, had 11 males of total 18 HIV-PAH patients [72]. One factor may be that males are more likely to partake in risky behavior such as IVDU, thus increasing their chances for HIV infection and subsequently exposure to known risk factors for PAH.…”

Section: Epidemiology Of Pah In Hiv-infected and Intravenous Drug Usersmentioning

confidence: 99%

Drug abuse and HIV-related pulmonary hypertension

Harter

Agarwal

Dalvi

et al. 2018

Aids

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Improved survival among HIV-1 infected individuals with the advent of antiretroviral therapy has clearly led to a greater prevalence of non-infectious complications. One of the most devastating sequelae in these individuals is the development of pulmonary arterial hypertension (PAH). Various epidemiological studies suggest a worse survival of HIV-PAH patients when compared to other forms of PAH. Given that only a subset and not all HIV-infected individuals develop HIV-PAH, suggests that an additional second hit of genetic or environmental triggers is needed for the development of PAH. In this context, it has been well documented that HIV patients who abuse illicit drugs such as stimulants, opioids etc. are more susceptible to develop PAH. In this review, we highlight the studies that support the significance of a double hit of HIV and drug abuse in the incidence of PAH and focus on the research that has been undertaken to unravel the pathobiology and vascular remodeling mechanisms underlying the deleterious synergy between HIV infection and drugs of abuse in orchestrating the development of PAH.

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Pulmonary arterial hypertension related to human immunodeficiency virus infection: A case series

Abstract: The survival rates of HIV-related PAH patients were higher, most likely due to new aggressive specific therapy. The majority of patients were on oral specific therapy and clinically stable. Moreover, sildenafil appears to be a safe therapy for less severe HIV-related PAH.

Cited by 18 publications

References 29 publications

HIV‐associated pulmonary arterial hypertension: from bedside to the future

HIV‐associated pulmonary arterial hypertension: from bedside to the future

Pulmonary Arterial Hypertension among HIV-Infected Children: Results of a National Survey and Review of the Literature

Drug abuse and HIV-related pulmonary hypertension

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