<scp>HIV</scp>‐associated pulmonary arterial hypertension: from bedside to the future

Correale, Michele; Palmiotti, Giuseppe Antonio; Storto, Maria Maddalena Lo; Montrone, Deodata; Lacedonia, Donato

doi:10.1111/eci.12427

Cited by 34 publications

(29 citation statements)

References 111 publications

(149 reference statements)

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“…PAH has been a known complication of HIV infection, with HIV-associated PAH having similar clinical presentation and histology to idiopathic PAH [87]. The prevalence of HIV-PAH was estimated to be about 0.5% among PLWH before widespread use of ART, and this prevalence seems to not have changed over time since then [88].…”

Section: Pulmonary Arterial Hypertensionmentioning

confidence: 99%

“…The prevalence of HIV-PAH was estimated to be about 0.5% among PLWH before widespread use of ART, and this prevalence seems to not have changed over time since then [88]. HIV+ individuals are 2500 times more likely to develop PAH than the general population [87]. HIV-PAH is well-studied and the literature is abundant, so we will attempt to discuss it briefly and broadly here.…”

Section: Pulmonary Arterial Hypertensionmentioning

confidence: 99%

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HIV Infection and Risk of Cardiovascular Diseases Beyond Coronary Artery Disease

Barnes

Lacson

Bahrami

2017

Curr Atheroscler Rep

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Purpose of Review Cardiovascular disease (CVD) increasingly afflicts people living with HIV (PLWH) in the contemporary era of antiretroviral therapy (ART). Coronary artery disease (CAD) is the most widely studied cardiovascular problem in PLWH; however, less is known about other clinically relevant subtypes of CVD such as heart failure (HF), cerebrovascular disease, sudden cardiac death, pericardial diseases, and pulmonary hypertension. This paper reviews evidence of other subtypes of CVD as emerging issues in the post-ART era. Recent Findings Recent studies have shown that PLWH have higher risk of HF as well as subclinical impairment of left ventricular (LV) mechanics (systolic and diastolic dysfunction) and myocardial abnormalities (fibrosis and steatosis). The underlying mechanisms, however, are not well-understood. A few studies have also shown higher rates of atrial fibrillation and sudden cardiac death in PLWH. Ischemic stroke is the most common stroke type in the post-ART era, with underlying mechanisms like those identified in CAD: chronic inflammation and associated vasculopathy. Studies of great vessels (carotid artery and aorta) and peripheral arterial disease show heterogeneous results. Small subclinical pericardial effusions are common in PLWH in post-ART era. Pulmonary hypertension continues to be an underdiagnosed and potentially fatal complication of HIV infection. Summary PLWH remain at higher risk for all types of CVD including heart failure, stroke, and arrhythmias in the post-ART era. Chronic inflammation may play an important role in this increased risk. More studies are needed to further elucidate the extent of non-coronary CVD in PLWH and the underlying mechanisms for them.

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Section: Pulmonary Arterial Hypertensionmentioning

confidence: 99%

Section: Pulmonary Arterial Hypertensionmentioning

confidence: 99%

HIV Infection and Risk of Cardiovascular Diseases Beyond Coronary Artery Disease

Barnes

Lacson

Bahrami

2017

Curr Atheroscler Rep

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“…It is estimated that the prevalence of PAH related to HIV is much higher than that in the general population [48]. According to a systematic review, the prevalence of PAH among HIV-infected individuals presenting with cardiovascular symptoms from Africa is as high as 14% [49], but the number of studies included was very small.…”

Section: Hiv Infection and The Lungmentioning

confidence: 99%

Pulmonary Diseases in Refugees and Migrants in Europe

et al. 2018

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More than 2 million people fleeing conflict, persecution, and poverty applied for asylum between 2015 and 2016 in the European Union. Due to this, medical practitioners in recipient countries may be facing a broader spectrum of conditions and unusual presentations not previously encountered, including a wide range of infections with pulmonary involvement. Tuberculosis is known to be more common in migrants and has been covered broadly in other publications. The scope of this review was to provide an overview of exotic infections with pulmonary involvement that could be encountered in refugees and migrants and to briefly describe their epidemiology, diagnosis, and management. As refugees and migrants travel from numerous countries and continents, it is important to be aware of the various organisms that might cause disease according to the country of origin. Some of these diseases are very rare and geographically restricted to certain regions, while others have a more cosmopolitan distribution. Also, the spectrum of severity of these infections can vary from very benign to severe and even life-threatening. We will also describe infectious and noninfectious complications that can be associated with HIV infection as some migrants might originate from high HIV prevalence countries in sub-Saharan Africa. As the diagnosis and treatment of these diseases can be challenging in certain situations, patients with suspected infection might require referral to specialized centers with experience in their management. Additionally, a brief description of noncommunicable pulmonary diseases will be provided.

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“…HIV does appear to be an independent risk factor for PAH, and simian immunodeficiency virus (SIV)-infected macaque studies demonstrate a high frequency of PAH development (76). HIV-PAH shares the histopathological features of hypertrophy and proliferation of the arterial wall and plexiform lesions with idiopathic PAH, despite not directly infecting pulmonary endothelial cells (77), which has led to suggestions that the two have common pathogenic mechanisms, albeit with different triggers (78). Chief among these are the HIV proteins; Nef may contribute to pulmonary vascular remodeling in a primate model and is found in human endothelial cells (79, 80).…”

Section: Pathogenesis Of Hiv-pahmentioning

confidence: 99%

Maintaining lung health with longstanding HIV

Collini

Morris

2016

Current Opinion in Infectious Diseases

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Purpose of review Human immunodeficiency virus (HIV) is now managed as a chronic disease. Non-infectious pulmonary conditions have replaced infection as the biggest threat to lung health, particularly as HIV cohorts age, but there is no consensus on how best to maintain long-term lung health. We review the epidemiology and pathogenesis of chronic obstructive pulmonary disease (COPD), pulmonary arterial hypertension (PAH) and lung cancer in HIV-seropositive individuals. Recent Findings Diagnoses of COPD are now up to 50% more prevalent in HIV-seropositive individuals than HIV-uninfected controls, and prospective pulmonary function studies find significant impairment in 7%–>50% of HIV-seropositive individuals. The prevalence of HIV-PAH is 0.2%–0.5%, and lung cancer is 2–3 times more prevalent in HIV-seropositive individuals. Although host factors such as age and smoking have a role, HIV is an independent contributor to the pathogenesis of COPD, PAH and lung cancer. Chronic inflammation, immune senescence, oxidative stress and direct effects of viral proteins are all potential pathogenetic mechanisms. Despite their prevalence, non-infectious lung diseases remain under-recognized and evidence for effective screening strategies in HIV-seropositive individuals is limited. Summary COPD, PAH and lung cancer are a growing threat to lung health in the HAART era necessitating early recognition.

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

Cited by 34 publications

References 111 publications

HIV Infection and Risk of Cardiovascular Diseases Beyond Coronary Artery Disease

HIV Infection and Risk of Cardiovascular Diseases Beyond Coronary Artery Disease

Pulmonary Diseases in Refugees and Migrants in Europe

Maintaining lung health with longstanding HIV

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