A patient infected with HIV may develop pulmonary arterial hypertension (PAH). The prevalence of PAH varies in HIV populations and depends on the frequency of other risk factors.
Factors that may contribute to development of PAH in a patient with HIV disease:
(1) plexogenic lesions
(2) persistent inflammation
(3) impact of HIV viral proteins on endothelial cells
Clinical findings:
(1) HIV-infected
(2) often an older adult male
(3) elevated pulmonary artery pressure
The risk of developing PAH equires consideration of comorbid conditions that can also cause PAH:
(1) hereditary hemolytic anemia
(2) abuse of cocaine or methamphetamines, intravenous drug use
(3) COPD
(4) chronic liver disease
(5) thromboembolic disease
Therapy with HAART (highly active antiretroviral therapy) and with drugs for PAH may improve outcomes. Control of comorbid conditions also benefits the patient.
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