HIV- RELATED PULMONARY ARTERIAL HYPERTENSION: A CASE REPORT

Abstract

The use of highly active antiretroviral therapy (HAART) has increased the life expectancy of HIV-infected patients. With prolonged survival and improved control of infectious susceptibility, vascular complications have emerged as a signicant source of morbidity and mortality in HIV-infected patients [1]. HIV-associated pulmonary arterial hypertension (HIV-PAH) is an important lung disease in HIV-infected persons who live longer with antiretrovirals. HIV-PAH may be detected via chest radiographs, CT scans, or electrocardiograms, but Doppler echocardiography is the most useful screening test to identify candidates for right heart catheterization. Because the survival for HIV-infected individuals with PAH with advanced symptoms (New York Heart Association, NYHA class III-IV) is worse compared with less symptomatic individuals (NYHA class I-II) (2), identication of asymptomatic individuals is of critical importance. Histologically, THE lesions in HIV-infected patients with PAH include concentric laminar intimal brosis, medial hypertrophy, recanalized thrombi, and plexiform lesions (3). According to a more recent study by Sitbon et al [4] in 2008, the prevalence has remained at 0.5% even in the modern era of HIV therapy, suggesting that HAART has not made a dramatic impact on the prevention of HIV-PAH. We present a case of HIVPAH to highlight the importance of the non-infectious pulmonary complications associated with HIV disease.