[Pulmonary artery hypertension in HIV seropositive drug addicts. Apropos of 10 cases].
Pulmonary hypertension (PH) is a classic complication associated with intravenous drug addiction. Various pathogenic mechanisms may be involved but HIV infection now appears to be the main etiologic factor. We report herein 10 case of PH occurred in HIV+ intravenous drug abusers. Each patient had several pathogenic factors: HIV infection, pills crushed and intravenously injected (6 cases), heavy and repeated consumption of amphetamines and cocaine (6 cases), cirrhosis with portal hypertension (2 cases), anticardiolipid antibodies (2 cases). The clinical findings were similar to those reported for PH in HIV seronegative patients; however, in 5 cases, opiates could have alleviated dyspnea, which became perceptible only at the time of drug withdrawal. Because drug addicts usually exhibit a weak support for medical prescriptions, long term therapy needing regular follow-up such as anticoagulation appears to be hazardous and even dangerous. The prognosis remains poor, since the progression of PH led to the death of one third patients within the year following the diagnosis.
Pétureau
F
F
Service de Pneumo-Allergologie, CHU de Toulouse, Hôpital de Purpan.
Escamilla
R
R
Hermant
C
C
Mourlanette
P
P
Berjaud
J
J
Krempf
M
M
D000328:Adult; D019969:Amphetamine-Related Disorders / Q000150:complications; D017153:Antibodies, Anticardiolipin / Q000097:blood; D000925:Anticoagulants; D002423:Cause of Death; D019970:Cocaine-Related Disorders / Q000150:complications; D000075202:Contraindications; D018450:Disease Progression; D011307:Drug Prescriptions; D004417:Dyspnea / Q000188:drug therapy; D005260:Female; D005500:Follow-Up Studies; D018023:HIV Seronegativity; D006679:HIV Seropositivity / Q000150:complications*; D006801:Humans; D006976:Hypertension, Pulmonary / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D009294:Narcotics / Q000627:therapeutic use; D011379:Prognosis; D011651:Pulmonary Artery; D019141:Respiratory System Agents / Q000627:therapeutic use; D015819:Substance Abuse, Intravenous / Q000150:complications*; D013375:Substance Withdrawal Syndrome / Q000188:drug therapy; D015996:Survival Rate
D017153:Antibodies, Anticardiolipin; D000925:Anticoagulants; D009294:Narcotics; D019141:Respiratory System Agents