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reviews: Nirav J. Mehta, Ijaz A. Khan, Rajal N. Mehta, and Douglas A. Sepkowitz HIV-Related Pulmonary Hypertension : Analytic Review of 131 Cases Chest 2000; 118: 1133-1141 [Abstract] [Full text] [PDF]

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HIV related pulmonary hypertension

Adriano M Pellicelli, Nicola Petrosillo   (2 November 2000)

HIV related pulmonary hypertension 2 November 2000
Adriano M Pellicelli, Physician Lazzaro Spallanzani Hospital Rome-Italy, Nicola Petrosillo Send letter to journal: Re: HIV related pulmonary hypertension adriapel{at}tin.it Adriano M Pellicelli, et al.	Dear Sir The relation between grade of pulmonary hypertension and factors associated with human immunodeficiency virus infection (HIV) among HIV related pulmonary hypertension patients is poorly documented in this review article.Our unpublished study has determined whether a relationship exists between degree of pulmonary hypertension and the following conditions: HIV risk factor, degree of immunosuppression, presence or absence of AIDS, presence or absence of liver cirrhosis. We have analyzed seventy-six patients judged to have HIV related pulmonary hypertension. While no correlation was found between pulmonary artery systolic pressure level (PAPS) and CD4+ cell counts, a statistically significant difference was found between AIDS patients respect to symptomatic and asymptomatic HIV infected with regard to the degree of pulmonary hypertension, expressed as PAPS level (85.4+17 mmHg AIDS patients vs 71.8+15 mmHg HIV infected patients p<0.013). Although a higher PAPS was present in HIV cirrhotic patients, a statistically significant difference wasn’t found between degree of pulmonary hypertension and evidence of hepatic cirrhosis (85+21 mmHg vs 73.1+15 mmHg p<0.062). In conclusion in our study AIDS patients with HIV related pulmonary hypertension present a higher degree of pulmonary hypertension than symptomatic and asymptomatic HIV infected patients. Pulmonary hypertension associated with HIV seems to be related to a cytokine-related stimulation and proliferation of endothelium. High levels of cytokines present in AIDS patients can favour pulmonary hypertension, but the role of a host response to HIV, determined by one or more HLA subtypes, is suspected to enhance high cytokine production levels. References 1.Pellicelli A.M., Palmieri F., D’ambrosio C. et al. Role of human immunodeficiency virus in primary pulmonary hypertension. Case reports. Angiology. 1998; 49: 1005-1011. 2.Adriano M. Pellicelli,Giuseppe Barbaro,Fabrizio Palmieri et al.Primary pulmonary hypertension in HIV patients: a systematic review Angiology.2000 (in press)