PRIMARY PULMONARY-HYPERTENSION AND THE HUMAN-IMMUNODEFICIENCY-VIRUS -REPORT OF 2 CASES AND A REVIEW OF THE LITERATURE

We report two cases of human immunodeficiency virus (HIV) seropositivi ty and pulmonary hypertension seen at our institution and present a co mprehensive literature review and available histopathologic findings o f the association between HIV seropositivity and pulmonary hypertensio n, Studies and reviews pertaining to HIV seropositivity and pulmonary hypertension were identified through a MEDLINE search and reference ci tations, All studies and series found in the MEDLINE search were revie wed and are discussed in this article. Where data were available, comp arisons and analyses were made between groups of reported cases of HIV seropositivity and pulmonary hypertension with regard to the followin g parameters: sex distribution, mode of acquiring HIV infection, prese nce or absence of the acquired immunodeficiency syndrome, CD4 cell cou nts, PO2 or oxygen saturation by pulse oximetry, concurrent lower resp iratory tract infection, and histopathologic features. We conclude tha t there is strong evidence for pulmonary hypertension associated with HIV infection that is histologically indistinguishable from primary pu lmonary hypertension. Consequently, HIV-seropositive patients with une xplained dyspnea should be evaluated for primary pulmonary hypertensio n. Prospective studies in HIV-positive patients are indicated.