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Pulmonary Arterial Hypertension in HIV

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Cardiovascular Care in Patients With HIV

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Abstract

Pulmonary arterial hypertension (PAH) is a debilitating condition that occurs more frequently in HIV-infected patients compared to the general population and is associated with increased morbidity and mortality. There is no clear relationship with CD4 counts or HIV viral load, and the mechanisms that lead to PAH in this population are not well defined. A high index of suspicion is essential and should prompt referral to a specialized center for further evaluation and management. There are notable drug-drug interactions between certain antiretroviral therapies and medications like sildenafil and bosentan. Despite the absence of carefully controlled trials of PAH in the HIV population, the approach to management mirrors the therapeutic strategy for patients with other causes of group 1 PAH. It prioritizes the early and aggressive implementation of PAH-specific therapies, often with combinations from different classes, similar to the current treatment paradigm for HIV in the era of antiretroviral therapy.

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Authors and Affiliations

  1. Division of Cardiology/Department of Internal Medicine, Weill Cornell Medical College/New York Presbyterian Hospital, New York, NY, USA

    Udhay Krishnan & Evelyn M. Horn

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  1. Udhay Krishnan
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  2. Evelyn M. Horn
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Correspondence to Udhay Krishnan .

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Editors and Affiliations

  1. Bassett Research Institute, Bassett Medical Center, Cooperstown, NY, USA

    Merle Myerson

  2. Division of Infectious Diseases, Weill Cornell Medical College, New York, NY, USA

    Marshall J. Glesby

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Krishnan, U., Horn, E.M. (2019). Pulmonary Arterial Hypertension in HIV. In: Myerson, M., Glesby, M. (eds) Cardiovascular Care in Patients With HIV. Springer, Cham. https://doi.org/10.1007/978-3-030-10451-1_12

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  • DOI: https://doi.org/10.1007/978-3-030-10451-1_12

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-10450-4

  • Online ISBN: 978-3-030-10451-1

  • eBook Packages: MedicineMedicine (R0)

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