Role of Human Immunodeficiency Virus in Primary Pulmonary Hypertension

Previous cases of pulmonary hypertension (PH) in human immunodeficiency virus (HIV) infection have been reported in the literature. The role of HIV in PH is still debatable. The purpose of this report was to analyze whether HIV plays a direct or indirect role in PH pathogenesis. Between February and November 1997, 56 HIV-infected patients with cardiac symptoms and signs were studied by serial color Doppler echocardiography. In four patients (7.1%), PH not related to other well-known associated conditions, was disclosed. In spite of a low serum HIV RNA viral load and a high-efficacy antiretroviral therapy, including a protease inhibitor in two patients, PH developed and worsened. It could be hypothesized that in some patients with an individual immunogenetic predis position, a high secretion of cytokines and endothelin-1 stimulated by an unidentified pathogen different from HIV could lead to PH. Antiretroviral therapy seems not to prevent or reduce right ventricle pressure gradient in PH.

[1]  W. Edwards,et al.  Human immunodeficiency virus infection and pulmonary hypertension: two new cases and a review of 86 reported cases. , 1998, Mayo Clinic proceedings.

[2]  R. Speich,et al.  HIV-associated primary pulmonary hypertension. A case control study. Swiss HIV Cohort Study. , 1997, American journal of respiratory and critical care medicine.

[3]  A. Carayon,et al.  Endothelin-1 in the lungs of patients with pulmonary hypertension. , 1997, Cardiovascular research.

[4]  G. Sinha,et al.  Primary pulmonary hypertension in HIV infection: an outcome determined by particular HLA class II alleles. , 1996, American journal of respiratory and critical care medicine.

[5]  S. Scharf,et al.  Primary pulmonary hypertension and the human immunodeficiency virus. Report of two cases and a review of the literature. , 1995, Archives of internal medicine.

[6]  M. Humbert,et al.  Increased interleukin-1 and interleukin-6 serum concentrations in severe primary pulmonary hypertension. , 1995, American journal of respiratory and critical care medicine.

[7]  Y. Bar-dayan,et al.  Autoimmune aspects of primary pulmonary hypertension. , 1995, Pathobiology : journal of immunopathology, molecular and cellular biology.

[8]  J. Guérin.  Hypertension artérielle pulmonaire chez le toxicomane , 1994 .

[9]  J. Coligan,et al.  Potent stimulation of monocytic endothelin-1 production by HIV-1 glycoprotein 120. , 1993, Journal of immunology.

[10]  G. Kane.  Primary pulmonary hypertension in HIV infection. , 1992, Chest.

[11]  H. Palevsky,et al.  Primary pulmonary hypertension in association with human immunodeficiency virus infection. A possible viral etiology for some forms of hypertensive pulmonary arteriopathy. , 1992, The American review of respiratory disease.

[12]  C. Strange,et al.  Pulmonary hypertension and human immunodeficiency virus infection. Two reports and a review of the literature. , 1992, Chest.

[13]  G. Bray,et al.  Idiopathic pulmonary hypertension, hemophilia A, and infection with human immunodeficiency virus (HIV) , 1989, Annals of internal medicine.

[14]  S. Blomqvist,et al.  Pulmonary hypertension in hemophilia. , 1988, Annals of internal medicine.

[15]  T. Driscol,et al.  Primary pulmonary hypertension in patients with classic hemophilia. , 1988, Annals of internal medicine.

[16]  S. Factor,et al.  Membranoproliferative glomerulonephritis and plexogenic pulmonary arteriopathy in a homosexual man with acquired immunodeficiency syndrome. , 1987, Human pathology.

[17]  B. Brundage,et al.  Antinuclear antibodies in primary pulmonary hypertension. , 1986, Journal of the American College of Cardiology.

[18]  L. Rubin,et al.  Primary Pulmonary Hypertension: AN ANALYSIS OF 28 CASES AND A REVIEW OF THE LITERATURE , 1986 .

[19]  J. Tomashefski,et al.  The pulmonary vascular lesions of intravenous drug abuse. , 1980, Human pathology.

[20]  P. Hopewell,et al.  Alteration of pulmonary function in intravenous drug abusers. Prevalence, severity, and characterization of gas exchange abnormalities. , 1980, The American journal of medicine.