Role of HIV and human herpesvirus-8 infection in pulmonary arterial hypertension

Abstract

HIV-infected persons have a high prevalence of elevated PASP, which is independent of other risk factors for PAH. This suggests a causal role of HIV in PAH and emphasizes the need to understand the natural history of PAH in this setting. A role for HHV-8 infection in PAH remains much less definitive.

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

“…Despite antiretroviral therapy, 1 in 200 patients with AIDS still develops HIV-PAH (2,3). However, the disease may be even more underrecognized than previously described, as recent estimates indicate that 35% of patients with asymptomatic HIV have elevated pulmonary artery pressures (4)(5)(6). Intravenous drug use (IVDU), commonly involving opioids such as heroin and morphine, accounts for one-third of all new cases of AIDS in the United States (7) and has been identified as the most common risk factor in individuals diagnosed with HIV-PAH (2,3,8).…”

Human Immunodeficiency VirusnefSignature Sequences Are Associated with Pulmonary Hypertension

“…1 PH is a significant noninfectious complication affecting individuals infected with the human immunodeficiency virus (HIV) at a higher frequency (1/200), compared to 1/200,000 in the HIV-negative population. [2][3][4][5][6] An echocardiography-based study reported increased pulmonary artery systolic pressures ( > 30 mm Hg) in 35% of HIV pulmonary asymptomatic individuals, compared with only 7.7% of HIV-negative individuals, 7 suggesting a higher risk of HIV-associated PH (HIV-PH) in this population. Whether the prevalence is higher in developing countries with limited access to screening tools remains unknown.…”

“…The frequency of Nef amino acid residues at each position was determined for each subject by counting in an MS Excel spreadsheet and then compared by group (HIV-PH vs. control). The HIV-1 subtype B Nef sequences compiled by O'Neill et al 7 were used to determine the most frequent amino acid at each position of the full-length Nef polypeptide.…”

Pulmonary Hypertension Is a Probable NO/ONOO−Cycle Disease: A Review

“…Several viral infections, including HIV, HHV-8, and hepatitis B and C, are implicated in producing increased PAH incidence and prevalence [109][110][111][112][113][114]. It is estimated that HIV infection increases the prevalence of PAH approximately 2500-fold [110].…”