[Treatment of HIV-associated pulmonary hypertension with treprostinil].
OBJECTIVE
The treatment of pulmonary hypertension associated with infection by human immunodeficiency virus has not been well defined. Treprostinil is a prostacyclin analogue that has recently been shown to be useful for the treatment of pulmonary hypertension, whether primary, secondary to congenital heart disease, or associated with collagen disease, in a 12-week, double-blind study. We report the results of a one-year follow-up of three patients with pulmonary hypertension associated with human immunodeficiency virus infection who are being treated with treprostinil at our center.


METHODS
After secondary causes of pulmonary hypertension were excluded by a routine work-up, patients started treatment with subcutaneous prostacyclin (treprostinil) with progressive up-titration of the dose. Functional status and effort capacity were assessed every three months and an echocardiographic study was performed every six months.


RESULTS
All patients showed improvement in clinical status, as shown by the NYHA functional class and the results of the six-minute walking test (increase of at least 75 meters). All the patients remain alive after one year of follow-up. Echocardiographic systolic pulmonary pressure decreased in two patients. No serious adverse events were observed.


CONCLUSIONS
Subcutaneous prostacyclin (treprostinil) seems to be an effective and safe therapeutic option for the treatment of pulmonary hypertension associated with human immunodeficiency virus infection.
Cea-Calvo
Luis
L
Servicio de Cardiología. Unidad de Hipertensión Pulmonar, Insuficiencia Cardíaca y Trasplante Cardíaco. Hospital Universitario 12 de Octubre. Madrid. España.
Escribano Subías
Pilar
P
Tello de Menesses
Rocío
R
Lázaro Salvador
María
M
Gómez Sánchez
Miguel A
MA
Delgado Jiménez
Juan F
JF
Pindado Rodríguez
Carlos
C
Ruiz Cano
María J
MJ
Sáenz de la Calzada
Carlos
C
D000328:Adult; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D011464:Epoprostenol / Q000031:analogs & derivatives / Q000627:therapeutic use*; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006439:Hemodynamics / Q000187:drug effects / Q000502:physiology; D006801:Humans; D006976:Hypertension, Pulmonary / Q000188:drug therapy* / Q000209:etiology; D007260:Infusion Pumps; D007262:Infusions, Intravenous; D008297:Male; D016896:Treatment Outcome; D014665:Vasodilator Agents / Q000627:therapeutic use
D000959:Antihypertensive Agents; D014665:Vasodilator Agents; D011464:Epoprostenol; C427248:treprostinil
Tratamiento de la hipertensión pulmonar asociada a la infección por VIH con treprostinil.