Role of human immunodeficiency virus in primary pulmonary hypertension - Case reports

Previous cases of pulmonary hypertension (PH) in human immunodeficiency vir us (HIV) infection have been reported in the literature. The role of HIV in PH is still debatable. The purpose of this report was to analyze whether H IV plays a direct or indirect role in PH pathogenesis. Between February and November 1997 56 HIV-infected patients with cardiac symptoms and signs wer e studied by serial color Doppler echocardiography. In four patients (7.1%) , PH not related to other well-known associated conditions, was disclosed. In spite of a low serum HIV RNA viral load and a high-efficacy antiretrovir al therapy, including a protease inhibitor in two patients, PH developed an d worsened. It could be hypothesized that in some patients with an individu al immunogenetic predisposition, a high secretion of cytokines and endothel in-l stimulated by an unidentified pathogen different from HIV could lead t o PH. Antiretroviral therapy seems not to prevent or reduce right ventricle pressure gradient in PH.