[Pulmonary hypertension in HIV patients].
Symptomatic HIV-associated pulmonary artery hypertension (PHT) is a thousand times more frequent than idiopathic PHT and has a clearly worse prognosis. Using echocardiographic criteria the prevalence of PHT in HIV-positive patients, including all degrees of clinical severity, is about 7.5 %, half of those affected being asymptomatic (NYHA class I). The only available data are from just one controlled trial of drug treatment of HIV-associated PHT (BREATH-4-Trial), in which the endothelin-receptor antagonist bosentan was found to bring significant improvement in clinical parameters (NYHA functional class, walking distance). Further trials are required to test other therapeutic options such as prostanoids and phosphodiesterase-5-inhibitors.
ten Freyhaus
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Klinik III für Innere Medizin, Universität zu Köln, Joseph-Stelzmann-Strasse 9, 50924 Köln. Henrik.ten-Freyhaus@uk-koeln.de
Neumann
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D015106:3',5'-Cyclic-GMP Phosphodiesterases / Q000037:antagonists & inhibitors; D000959:Antihypertensive Agents / Q000627:therapeutic use; D000077300:Bosentan; D054706:Cyclic Nucleotide Phosphodiesterases, Type 5; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology; D006801:Humans; D006976:Hypertension, Pulmonary / Q000150:complications* / Q000188:drug therapy* / Q000453:epidemiology; D010726:Phosphodiesterase Inhibitors / Q000627:therapeutic use; D015995:Prevalence; D011379:Prognosis; D011453:Prostaglandins / Q000627:therapeutic use; D013449:Sulfonamides / Q000627:therapeutic use
D000959:Antihypertensive Agents; D010726:Phosphodiesterase Inhibitors; D011453:Prostaglandins; D013449:Sulfonamides; D015106:3',5'-Cyclic-GMP Phosphodiesterases; D054706:Cyclic Nucleotide Phosphodiesterases, Type 5; C517381:PDE5A protein, human; D000077300:Bosentan