Prevalence and Clinical Characteristics of Pulmonary Arterial Hypertension in Human Immunodeficiency Virus-Infected Patients.
- Author:
Mihyun KIM
1
;
Hyuk Jae CHANG
;
Young June YANG
;
Ji Young HONG
;
Min Kyoung KANG
;
Woo In YANG
;
Chi Young SHIM
;
Jong Won HA
;
Namsik CHUNG
;
So Youn SHIN
;
Sang Hoon HAN
;
Jun Yong CHOI
;
June Myoung KIM
Author Information
1. Division of Cardiology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea. hjchang@yuhs.ac
- Publication Type:Original Article
- Keywords:
Echocardiography;
Human immunodeficiency virus;
Pulmonary hypertension
- MeSH:
Antiretroviral Therapy, Highly Active;
Arterial Pressure;
Blood Pressure;
Cell Count;
Cyclophosphamide;
Echocardiography;
Heart Diseases;
Heart Ventricles;
HIV;
HIV Infections;
Humans;
Hypertension;
Hypertension, Pulmonary;
Lung Diseases;
Prevalence;
RNA;
Survival Rate;
Tricuspid Valve Insufficiency
- From:Korean Journal of Medicine
2011;81(6):729-739
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND/AIMS: Human immunodeficiency virus-associated pulmonary arterial hypertension (HIV-PAH) is a complication of HIV infection. Due to improvements in HIV survival rates following the introduction of highly active antiretroviral therapy, HIV-PAH has become an important cause of HIV-related morbidity. Thus, the objective of this study was to explore the prevalence and characteristics of HIV-PAH. METHODS: Ninety-two patients were enrolled in the study from March to August 2010. We investigated clinical characteristics and performed echocardiography. HIV-PAH was defined as having a mean pulmonary arterial pressure (mPAP) > or = 25 mmHg based on Mahan's equation, without lung disease or heart disease. The HIV-PAH-possible group was defined as having a tricuspid regurgitation velocity (TRV) of 2.9-3.4 m/s and a pulmonary arterial systolic pressure (PASP) of 37-50 mmHg. RESULTS: Fifteen patients (16.3%) met the criteria of HIV-PAH based on mPAP. With respect to TRV, six patients met the criteria of the HIV-PAH-possible group. Based on the criteria of mPAP, the duration of HIV infection was not different with or without HIV-PAH. HIV RNA titers and CD4 T cell counts tended to be higher in HIV-PAH patients (8,607 +/- 11 vs. 1,067 +/- 64 copies/mL, p = 0.371; 471 +/- 148 vs. 499 +/- 252 cells/mm3, p = 0.680, respectively). Echocardiographic indices of the right ventricle were significantly deteriorated in the HIV-PAH group as compared with the non-HIV-PAH group (TASPE: 20.52 vs. 23.2, p = 0.001; Tei index: 0.42 vs. 0.39, p = 0.037). In a multivariate regression analysis, HIV activity factors (HIV duration, HIV RNA titer, and CD4 cell count) were not associated with echocardiographic indices of PAH (mPAP, PASP, and pulmonary vascular resistance). CONCLUSIONS: In this study, the prevalence of HIV-PAH was comparable to that of previous studies.
