Pulmonary hypertension associated with HIV infection

Pulmonary hypertension occurs with increased frequency among patients with human immunodeficiency virus (HIV) infection. Although the pathogenesis of HIV-associated pulmonary hypertension remains unknown, it appears to occur independently of other risk factors associated with pulmonary vasculopathy, such as chronic hepatitis C infection and intravenous drug use. Signs and symptoms are typical of those immunocompetent patients with primary pulmona ry hypertension, but because many HIV-infected patients are receiving inten sive medical supervision, the diagnosis of pulmonary hypertension is often made at an earlier stage. Acute responses to epoprostenol are similar to th ose among non-HIV-infected individuals, but the benefits of long-term, intr avenous treatment with epoprostenol in HIV-infected patients is unknown. Fu ture investigations should define the true incidence of pulmonary hypertens ion and the long-term effects of epoprostenol on survival among HIV-infecte d individuals. Physicians should be alert to possible pulmonary hypertensio n in persons infected with HIV.