title: Prevalence and risk factors associated with pulmonary hypertension in HIV-infected patients on regular follow-up.
abstract: BACKGROUND
  Pulmonary arterial hypertension (PAH) is uncommon among HIV-positive patients. However, it is a potentially life-threatening condition. Transthoracic echocardiography (TTE) is a noninvasive tool validated for PAH screening. The aim of our study was to establish the prevalence and factors associated with PAH in HIV-infected patients.
  
  
  METHODS
  Consecutive HIV-infected individuals attended at one HIV reference clinic in Madrid, Spain, during year 2011 were examined. Demographics and clinical data were recorded and a Doppler echocardiography was performed in all individuals. PAH was considered when right ventricular pressure was more than 35 mmHg (mild if <40 mmHg, moderate if 40-65 mmHg, and severe if >65 mmHg).
  
  
  RESULTS
  Three hundred and ninety-two individuals were examined (83.4% men, median age 47 years, 53% were men who have sex with men and 53% former intravenous drug addicts). Overall, 84% were on HAART, 76% had undetectable HIV viral load and median CD4 cell counts were 577 cells/μl. Cardiovascular risk factors were smoking 50%, arterial hypertension 16% and diabetes mellitus 9%. A total of 28.5 and 4.8% had chronic hepatitis C (CHC) and 4.8% chronic hepatitis B, respectively. PAH was diagnosed in 9.9% of patients (6.4% mild, 2.8% moderate and 0.8% severe). Multivariate logistic regression analysis [odds ratio (OR), 95% confidence interval (CI)] showed that detectable plasma HIV-RNA [OR, 3.3; 95% CI, 1.04-10], CHC [OR, 3.1; 95% CI 1.2-8.2] and female sex [OR, 2.9; 95% CI, 1.04-8.3] were independently associated with PAH.
  
  
  CONCLUSIONS
  The prevalence of PAH HIV-infected patients on regular follow-up approaches 10%, being moderate-severe in nearly 4% of cases. Patients with CHC and/or uncontrolled HIV replication exhibit a higher risk of PAH.
authors.affiliation: Department of Cardiology, Hospital Ramón y Cajal, Madrid, Spain. maribelquezada2000@gmail.com
authors.forename: Maribel
authors.initials: M
authors.lastname: Quezada
authors.forename: Luz
authors.initials: L
authors.lastname: Martin-Carbonero
authors.forename: Vicente
authors.initials: V
authors.lastname: Soriano
authors.forename: Eugenia
authors.initials: E
authors.lastname: Vispo
authors.forename: Eulalia
authors.initials: E
authors.lastname: Valencia
authors.forename: Victoria
authors.initials: V
authors.lastname: Moreno
authors.forename: Leopoldo P
authors.initials: LP
authors.lastname: de Isla
authors.forename: Vera
authors.initials: V
authors.lastname: Lennie
authors.forename: Carlos
authors.initials: C
authors.lastname: Almería
authors.forename: Jose L
authors.initials: JL
authors.lastname: Zamorano
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000188:drug therapy / Q000453:epidemiology* / Q000503:physiopathology; D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D015897:Comorbidity; D003920:Diabetes Mellitus / Q000188:drug therapy / Q000453:epidemiology* / Q000503:physiopathology; D005260:Female; D015497:HIV-1; D019694:Hepatitis B, Chronic / Q000188:drug therapy / Q000453:epidemiology* / Q000503:physiopathology; D019698:Hepatitis C, Chronic / Q000188:drug therapy / Q000453:epidemiology* / Q000503:physiopathology; D006801:Humans; D006976:Hypertension, Pulmonary / Q000188:drug therapy / Q000453:epidemiology* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology* / Q000503:physiopathology; D013030:Spain / Q000453:epidemiology; D019562:Viral Load