title: [Pulmonary hypertension in human immunodeficiency virus-infected patients: the role of antiretroviral therapy].
abstract: OBJECTIVE
  Pulmonary arterial hypertension (PAH) is a serious disorder, more prevalent in patients infected with human immunodeficiency virus (HIV). It is not entirely clear what role is played by highly active antiretroviral therapy (HAART) in PAH development or course. Our aim was to describe PAH prevalence in a series of HIV-infected patients and identify possible links with cumulative and current use of different antiretrovirals.
  
  
  METHODS
  Cross-sectional study of a cohort of HIV-infected patients attending a hospital in southern Spain. Demographic data, data on HIV infection status and on cumulative and recent antiretroviral treatment were recorded. Transthoracic echocardiography was performed in all study participants. PAH was defined as pulmonary artery systolic pressure of 36mmHg or more.
  
  
  RESULTS
  A total of 400 patients participated in the study; 178 presented with tricuspid regurgitation and 22 of these presented with PAH (5.5%). No differences were encountered in age, sex, CD4 lymphocytes, proportion of naive patients or patients with AIDS. No differences were encountered in cumulative use of antiretrovirals. However, recent use of lamivudine was associated with a greater presence of PAH, whereas recent use of tenofovir and emtricitabine was associated with a lower presence of PAH. Logistic regression analysis was performed including the use of lamivudine, emtricitabine and tenofovir. Only recent use of tenofovir was associated with a lower presence of PAH (odds ratio 0.31; 95% confidence interval: 0.17-0.84).
  
  
  CONCLUSIONS
  PAH prevalence in our study was similar to others series. Current use of tenofovir may be associated with lower PAH prevalence.
authors.affiliation: Unidad de Medicina Interna, Hospital Costa del Sol, Marbella, Málaga, España. Electronic address: julio.olalla@gmail.com.
authors.forename: Julián
authors.initials: J
authors.lastname: Olalla
authors.affiliation: Unidad de Medicina Interna, Hospital Costa del Sol, Marbella, Málaga, España.
authors.forename: Daniel
authors.initials: D
authors.lastname: Urdiales
authors.affiliation: Área de Cardiología, Hospital Costa del Sol, Marbella, Málaga, España.
authors.forename: Marta
authors.initials: M
authors.lastname: Pombo
authors.affiliation: Unidad de Medicina Interna, Hospital Costa del Sol, Marbella, Málaga, España.
authors.forename: Alfonso
authors.initials: A
authors.lastname: del Arco
authors.affiliation: Unidad de Medicina Interna, Hospital Costa del Sol, Marbella, Málaga, España.
authors.forename: Javier
authors.initials: J
authors.lastname: de la Torre
authors.affiliation: Unidad de Medicina Interna, Hospital Costa del Sol, Marbella, Málaga, España.
authors.forename: José Luis
authors.initials: JL
authors.lastname: Prada
mesh_terms: D000225:Adenine / Q000008:administration & dosage / Q000031:analogs & derivatives / Q000627:therapeutic use; D000328:Adult; D019380:Anti-HIV Agents / Q000009:adverse effects / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D003430:Cross-Sectional Studies; D004359:Drug Therapy, Combination; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D006976:Hypertension, Pulmonary / Q000139:chemically induced / Q000150:complications* / Q000000981:diagnostic imaging / Q000453:epidemiology; D019259:Lamivudine / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D063065:Organophosphonates / Q000008:administration & dosage / Q000627:therapeutic use; D015995:Prevalence; D012189:Retrospective Studies; D018894:Reverse Transcriptase Inhibitors / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D000068698:Tenofovir; D014262:Tricuspid Valve Insufficiency / Q000150:complications; D014463:Ultrasonography
chemical_list: D019380:Anti-HIV Agents; D063065:Organophosphonates; D018894:Reverse Transcriptase Inhibitors; D019259:Lamivudine; D000068698:Tenofovir; D000225:Adenine
keywords: Highly active antiretroviral therapy; Hipertensión pulmonar; Human immunodeficiency virus; Pulmonary hypertension; Tenofovir; Tratamiento antirretroviral de gran actividad; Virus de la inmunodeficiencia humana