Abstract
Human immunodeficiency virus (HIV) infection is associated with an increased risk for pulmonary arterial hypertension (PAH). Upon the screening of 220 asymptomatic HIV-positive individuals by echocardiography, we detected and confirmed HIV-associated PAH in 0.45 % of cases. Mild elevations of systolic pulmonary arterial pressure most probably owing to left ventricular diastolic dysfunction were found in 7.7 % of cases, without progress after 2 years. We suggest that the screening of asymptomatic HIV-positive patients for PAH should not be performed.
This is a preview of subscription content, log in via an institution to check access.
References
Hoeper MM, Bogaard HJ, Condliffe R, Frantz R, Khanna D, Kurzyna M, et al. Definitions and diagnosis of pulmonary hypertension. J Am Coll Cardiol. 2013;62:D42–50. doi:10.1016/j.jacc.2013.10.032.
D’Alonzo GE, Barst RJ, Ayres SM, Bergofsky EH, Brundage BH, Detre KM, et al. Survival in patients with primary pulmonary hypertension. Results from a national prospective registry. Ann Intern Med. 1991;115:343–9.
Simonneau G, Gatzoulis MA, Adatia I, Celermajer D, Denton C, Ghofrani A, et al. Updated clinical classification of pulmonary hypertension. J Am Coll Cardiol. 2013;62:D34–41. doi:10.1016/j.jacc.2013.10.029.
Mehta NJ, Khan IA, Mehta RN, Sepkowitz DA. HIV-related pulmonary hypertension: analytic review of 131 cases. Chest. 2000;118:1133–41.
Rudski LG, Lai WW, Afilalo J, Hua L, Handschumacher MD, Chandrasekaran K, et al. Guidelines for the echocardiographic assessment of the right heart in adults: a report from the American Society of Echocardiography endorsed by the European Association of Echocardiography, a registered branch of the European Society of Cardiology, and the Canadian Society of Echocardiography. J Am Soc Echocardiogr. 2010;23:685–713; quiz 786–8. doi:10.1016/j.echo.2010.05.010.
Sitbon O, Lascoux-Combe C, Delfraissy JF, Yeni PG, Raffi F, De Zuttere D, et al. Prevalence of HIV-related pulmonary arterial hypertension in the current antiretroviral therapy era. Am J Respir Crit Care Med. 2008;177:108–13. doi:10.1164/rccm.200704-541OC.
Reinsch N, Neuhaus K, Esser S, Potthoff A, Hower M, Brockmeyer NH, et al. Prevalence of cardiac diastolic dysfunction in HIV-infected patients: results of the HIV-HEART study. HIV Clin Trials. 2010;11:156–62. doi:10.1310/hct1103-156.
Schuster I, Thöni GJ, Edérhy S, Walther G, Nottin S, Vinet A, et al. Subclinical cardiac abnormalities in human immunodeficiency virus-infected men receiving antiretroviral therapy. Am J Cardiol. 2008;101:1213–7. doi:10.1016/j.amjcard.2007.11.073.
Seaberg EC, Muñoz A, Lu M, Detels R, Margolick JB, Riddler SA, et al. Association between highly active antiretroviral therapy and hypertension in a large cohort of men followed from 1984 to 2003. AIDS. 2005;19:953–60. doi:10.1097/01.Aids.0000171410.76607.F8.
Helleberg M, Kronborg G, Larsen CS, Pedersen G, Pedersen C, Gerstoft J, et al. Causes of death among Danish HIV patients compared with population controls in the period 1995–2008. Infection. 2012;40:627–34. doi:10.1007/s15010-012-0293-y.
Ehren K, Hertenstein C, Kümmerle T, Vehreschild JJ, Fischer J, Gillor D, et al. Causes of death in HIV-infected patients from the Cologne–Bonn cohort. Infection. 2014;42:135–40. doi:10.1007/s15010-013-0535-7.
Acknowledgments
G. F., C. L., and C. W. have been funded by the German Ministry of Research and Education (BMBF grant 01KI1017). This manuscript contains parts of a doctoral thesis by D. V.
Conflict of interest
The authors state that there is no conflict of interest.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
ten Freyhaus, H., Vogel, D., Lehmann, C. et al. Echocardiographic screening for pulmonary arterial hypertension in HIV-positive patients. Infection 42, 737–741 (2014). https://doi.org/10.1007/s15010-014-0610-8
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s15010-014-0610-8