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KMID : 0882420110810060729
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Korean Journal of Medicine
2011 Volume.81 No. 6 p.729 ~ p.739
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Prevalence and Clinical Characteristics of Pulmonary Arterial Hypertension in Human Immunodeficiency Virus-Infected Patients
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Kim Mi-Hyun
Chang Hyuk-Jae
Yang Young-June
Hong Ji-Young
Kang Min-Kyoung
Yang Woo-In
Shim Chi-Young
Ha Jong-Won
Chung Nam-Sik
Shin So-Youn
Han Sang-Hoon
Choi Jun-Yong
Kim June-Myoung
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Abstract
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Background/Aims: Human immunodeficiency virus-associated pulmonary arterial hypertension (HIV-PAH) is a complication of HIV infection. Due to improvements in HIV survival rates following the introduction of highly active antiretroviral therapy, HIV-PAH has become an important cause of HIV-related morbidity. Thus, the objective of this study was to explore the prevalence and characteristics of HIV-PAH.
Methods: Ninety-two patients were enrolled in the study from March to August 2010. We investigated clinical characteristics and performed echocardiography. HIV-PAH was defined as having a mean pulmonary arterial pressure (mPAP) ≥ 25 mmHg based on Mahan’s equation, without lung disease or heart disease. The HIV-PAH-possible group was defined as having a tricuspid regurgitation velocity (TRV) of 2.9-3.4 m/s and a pulmonary arterial systolic pressure (PASP) of 37-50 mmHg.
Results: Fifteen patients (16.3%) met the criteria of HIV-PAH based on mPAP. With respect to TRV, six patients met the criteria of the HIV-PAH-possible group. Based on the criteria of mPAP, the duration of HIV infection was not different with or without HIV-PAH. HIV RNA titers and CD4 T cell counts tended to be higher in HIV-PAH patients (8,607 ± 11 vs. 1,067 ± 64 copies/mL, p = 0.371; 471 ± 148 vs. 499 ± 252 cells/mm3, p = 0.680, respectively). Echocardiographic indices of the right ventricle were significantly deteriorated in the HIV-PAH group as compared with the non-HIV-PAH group (TASPE: 20.52 vs. 23.2, p = 0.001; Tei index: 0.42 vs. 0.39, p = 0.037). In a multivariate regression analysis, HIV activity factors (HIV duration, HIV RNA titer, and CD4 cell count) were not associated with echocardiographic indices of PAH (mPAP, PASP, and pulmonary vascular resistance).
Conclusions: In this study, the prevalence of HIV-PAH was comparable to that of previous studies.
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KEYWORD
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Echocardiography, Human immunodeficiency virus, Pulmonary hypertension
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