Effect of gender and highly active antiretroviral therapy on HIV-related pulmonary arterial hypertension: results of the HIV-HEART Study.
BACKGROUND
Idiopathic pulmonary arterial hypertension (PAH) is a rare disease. HIV-infected patients exhibit a considerably higher rate of development of this condition compared to the general population.


METHODS
This cross-sectional study of 802 (83.4% male; age 44.3+/-10.3 years) HIV-positive patients aimed to evaluate the male-to-female ratio in HIV-related PAH and to elucidate whether PAH is more likely to occur in patients receiving highly active antiretroviral therapy (HAART) than in HIV-treatment-naïve patients. All patients were examined by Doppler echocardiography to estimate systolic pulmonary arterial pressure (sPAP). Manifest PAH was defined as sPAP >35 mmHg at rest in combination with symptoms of dyspnoea.


RESULTS
A total of 38 (4.7%) patients were diagnosed with elevated sPAP >35 mmHg. Fourteen (1.7%; 11 male) of these patients presented with symptoms of dyspnoea, resulting in a male-to-female ratio of manifest HIV-associated PAH of 1:1.4. Patients with symptoms of dyspnoea and sPAP>35 mmHg were more likely to receive HAART (13/14 patients).


CONCLUSIONS
In HIV patients, sPAP occurs more frequently than has been reported previously; the condition is possibly associated with HAART. Furthermore, HIV-positive females exhibit a higher prevalence of HIV-related PAH (HIV-PAH) than HIV-positive males.
Reinsch
N
N
Department of Cardiology, West German Heart Centre, University of Duisburg-Essen, Germany.
Buhr
C
C
Krings
P
P
Kaelsch
H
H
Kahlert
P
P
Konorza
T
T
Neumann
T
T
Erbel
R
R
D000328:Adult; D000368:Aged; D019380:Anti-HIV Agents / Q000009:adverse effects*; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects*; D001794:Blood Pressure / Q000187:drug effects; D003430:Cross-Sectional Studies; D004417:Dyspnea / Q000453:epidemiology; D015150:Echocardiography, Doppler; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy*; D015497:HIV-1; D006801:Humans; D006976:Hypertension, Pulmonary / Q000000981:diagnostic imaging / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D017678:Sex Distribution; D013599:Systole / Q000187:drug effects
D019380:Anti-HIV Agents