Pulmonary hypertension in patients infected with the human inmodeficiency virus

pp 635-643

Abstract

Primary pulmonary hypertension is a rare disease in the general population (1 or 2 cases every million in habitants) . Several reports have shown an increased incidence of pulmonary hypertension in patients infected with the human immunodeficiency virus. Our study was comprised of 7 patients who were diagnosed with infection by the said virus and pulmonary hypertension. The patients infected with the human immunodeficiency virus were classified and diagnosed according to the criteria of the Disease Control Centre . Pulmonary hypertension was confirmed by Doppler echocardiogram in all patients and with cardiac catheterization in two. A through clinical examination as well as additional studies did not show secondary causes of pulmonary hypertension. The patients were aged between 24 and 45 years old, five women and two men. Five had antecedents of cocaine-addiction. The predominant symptoms were dyspnea, syncope, edematose-ascitic syndrome and palpitations . At time of the diagnosed two patients were in functional class I, one in functional class III and four in functional class III-IV. Two patients infected with the human immunodeficiency virus were asymptomatic, one had oropharyngeal candida infection and four presented definite disease . They were treated with diuretics, calcium blockers and oral anticoagulants . Three patients died, two because of heart failure and one due to a probable sepsis . In conclusions, pulmonary hypertension is one of the cardiac manifestations found in patients infected with the human immunodeficiency virus . It does not seem to correlate with infection state and can be present even without an addiction background. The pulmonary hypertension may be the first manifestation suggesting infection by retrovirus and its presence may bring about a band prognosis and a short survival.