Role of human immunodeficiency virus in primary pulmonary hypertension--case reports.
Previous cases of pulmonary hypertension (PH) in human immunodeficiency virus (HIV) infection have been reported in the literature. The role of HIV in PH is still debatable. The purpose of this report was to analyze whether HIV plays a direct or indirect role in PH pathogenesis. Between February and November 1997, 56 HIV-infected patients with cardiac symptoms and signs were studied by serial color Doppler echocardiography. In four patients (7.1%), PH not related to other well-known associated conditions, was disclosed. In spite of a low serum HIV RNA viral load and a high-efficacy antiretroviral therapy, including a protease inhibitor in two patients, PH developed and worsened. It could be hypothesized that in some patients with an individual immunogenetic predisposition, a high secretion of cytokines and endothelin-1 stimulated by an unidentified pathogen different from HIV could lead to PH. Antiretroviral therapy seems not to prevent or reduce right ventricle pressure gradient in PH.
Pellicelli
A M
AM
II Department of Infectious Disease, IRCCS Lazzaro Spallanzani Hospital, Rome, Italy.
Palmieri
F
F
D'Ambrosio
C
C
Rianda
A
A
Boumis
E
E
Girardi
E
E
Antonucci
G
G
D'Amato
C
C
Borgia
M C
MC
D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D018618:Echocardiography, Doppler, Color; D017809:Fatal Outcome; D005260:Female; D005500:Follow-Up Studies; D006678:HIV / Q000235:genetics / Q000472:pathogenicity*; D015658:HIV Infections / Q000188:drug therapy / Q000503:physiopathology / Q000821:virology*; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D006976:Hypertension, Pulmonary / Q000188:drug therapy / Q000503:physiopathology / Q000821:virology*; D008297:Male; D008875:Middle Aged; D011669:Pulmonary Wedge Pressure; D012367:RNA, Viral / Q000032:analysis; D012189:Retrospective Studies
D019380:Anti-HIV Agents; D002121:Calcium Channel Blockers; D012367:RNA, Viral