Pulmonary arterial hypertension associated to HIV. Our experience

Introduction: The prevalence of PAH-HIV (pulmonary arterial hypertension associated with HIV) is estimated to be at 0.5% and this has not changed despite the introduction of HAART(highly active antiretroviral therapy), being a risk factor for mortality in these patients. Objective: To describe the PAH-HIV diagnosed patients9 population in Alicante General Hospital9s Pneumology department between the years 2004-2014. Methods: a descriptive and retrospective study; the demographic, clinical, hemodynamic and survival status of PAH-HIV diagnosed patients were analyzed. Results: between the years 2004-2014 a total of 1132 HIV patients were in follow-up, 5 of them were PAH-HIV diagnosed representing 0.44%. 3 of these 5 patients were men, with a mean age of 38 years. All patients were coinfected with hepatitis C virus and all had used intravenous drugs. At diagnosis HIV stages were: 1- A1, 2- A2, 1-B3 and 1- C3; only 3 were on HAART; NYHA stages were: 2 - IV,1 - III y 2 - II.On the first right heart catheterization the mean pulmonary arterial pressure was 65.6 and the mean cardiac index was 2.46; specific treatment of PAH was initiated in all patients (4 with prostacyclin and sildenafil; 1 with bosentan). After a mean follow-up of 6 years, improvement in NYHA functional stage was evidenced (3 in class I, 1 class II and 1 dead), with an average of 539,75m in the 6-minute walk test. 1 patient carried a pregnancy to term without complications during her second year of follow-up and the deceased patient had poor adherence to treatment. Conclusion: The PAH is a problem of low prevalence in patients with HIV but affects their quality of life. In our experience specific treatment leads to symptomatic improvement.