Severe pulmonary hypertension and cor pulmonale in the acquired immunodeficiency syndrome

Hipertensão pulmonar associada à síndrome da imunodeficiência adquirida: apresentação de cinco casos e revisão da literatura

“…Posteriormente, diversos casos têm sido descritos em pacientes sem outro fator além da infecção pelo HIV para explicar a presença de hipertensão pulmonar 11 . Em recente estudo, a sobrevida média em três anos de pacientes com HAP associado ao HIV em classe funcional III e IV da NYHA foi de 28% enquanto em classe funcional I e II foi de 84% 26 .…”

Human Immunodeficiency Virus–Associated Pulmonary Arterial Hypertension

“…These early observations suggested the following clinical and pathological features for HIV-associated PAH [4][5][6][7]9 : Human Immunodeficiency Virus-Associated Pulmonary Arterial Hypertension …”

“…Shortly thereafter, Goldsmith and associates 5 described 5 patients with classic hemophilia, HIV infection, and pulmonary hypertension, indicating that the original description of pulmonary hypertension associated with HIV was not an isolated phenomenon. Around the same time, others 6 described a cohort of 6 patients with AIDS and moderate or severe pulmonary hypertension, right ventricular hypertrophy, and right heart failure. All 6 patients in that series presented with rapid clinical deterioration: 2 patients died, and their autopsies revealed medial hypertrophy of the small pulmonary arteries and arterioles (ie, endarteritis obliterans), intimal fibrosis of the pulmonary veins, and lymphohistiocytic infiltration of the interstitium, but no plexogenic lesions.…”

“…The symptoms are nonspecific, may not differ from other cases of PAH, such as progressive dyspnea, chest discomfort, dizziness, and syncope, and may not differ from those attributable to respiratory infections in the absence of fever. [4][5][6][7]9 According to the current guidelines, the clinical diagnosis and approach to an HIV patient with suspected pulmonary hypertension is similar to that used to diagnose PAH in the absence of HIV infection. 91 However, in developing countries where cardiac catheterization laboratories are often unavailable, clinicians should consider the possibility of PAH when HIV patients present with suggestive symptoms.…”

Occult lymphadenopathic Kaposi's sarcoma associated with severe pulmonary hypertension: A clinical hint about the potential role of HHV-8 in HIV-related pulmonary hypertension?

“…PH is an increasingly recognized complication of HIV infection (Himelman et al, 1989;Mehta et al, 2000;Mette et al, 1992;Opravil et al, 1997;Petitpretz et al, 1994;Rosenkranz et al, 2005). The mechanism for the development of PH in HIV disease is unknown.…”