| Title | Pulmonary arterial hypertension in human immunodeficiency virus infection. | | Author(s) | Talwar A, Sarkar P, Rosen MJ | | Institution | Division of Pulmonary, Critical Care, and Sleep Medicine, North Shore University Hospital and Long Island Jewish Medical Center, New Hyde Park, NY 11040, USA. arunabh@nshs.edu | | Source | Postgrad Med 2009 Sep; 121(5):56-67. | | MeSH | Anti-Retroviral Agents
Causality
Comorbidity
Dobutamine
Drug Therapy, Combination
HIV Infections
Humans
Hypertension, Pulmonary
Lung Transplantation
Milrinone
Phosphodiesterase Inhibitors
Prevalence
Prognosis
Prostaglandins
Receptors, Endothelin
Respiration, Artificial
Survival Rate
Vasoconstrictor Agents
| | Abstract | Because of the improvement in survival rates of human immunodeficiency virus (HIV)-infected patients after the introduction of combined antiretroviral therapy, pulmonary arterial hypertension (PAH) has become an important cause of morbidity. As the awareness of PAH has increased, it is more likely that this condition will be diagnosed more frequently and earlier in the course of the disease and HIV infection. The etiopathogenesis is not clear; no evidence of direct infection of the pulmonary vascular tree has been found and the current evidence seems to favor a role of dysregulated cytokine response to HIV infection. The pathological changes of plexiform arteriopathy are indistinguishable from the pathological changes of idiopathic pulmonary arterial hypertension (IPAH). Dyspnea is the most common presenting symptom. Echocardiography, though always not accurate in diagnosing PAH and estimating its severity, remains the main screening tool. Right heart catheterization is the gold standard investigation for diagnosis. New therapies like prostanoids, endothelin receptor antagonists, and phosphodiesterase inhibitors have improved the outcome of patients with HIV-associated PAH. However, the overall prognosis of HIV-infected patients who develop PAH still remains poor. | | Language | eng | | Pub Type(s) | Journal Article
Review
| | PubMed ID | 19820275 |
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