Pulmonary Hypertension Associated with Human Immunodeficiency Virus Infection: A Review of 4 Cases

It is well-known that pulmonary hypertension can complicate infection by the human immunodeficiency virus (HIV). The incidence of primary pulmonary hypertension in HIV positive patients is unknown, but could be higher than 0.5%, in comparison with an 0.02% incidence in the general population. Since 1987, 131 cases of pulmonary hypertension associated with HIV infection have been published.1 A total of 76 patients presented with primary pulmonary hypertension.2 Among the 76 cases, 61.8% were men, while there was a slight predominance of women among the cases of primary pulmonary hypertension not associated with HIV infection (approximately 1.7 to 1). The clinical and histopathological findings of primary pulmonary hypertension in HIV infection do not differ from those of classic primary pulmonary hypertension. The diagnosis should be highly suspected, and a careful evaluation to should be performed to exclude secondary pulmonary hypertension in patients infected with HIV. Some risk factors for the development of pulmonary hypertension associated with HIV infection are known, including the use of intravenous (IV) drugs, chronic liver disease, and coagulation changes with embolic phenomena. The pathogenesis of primary pulmonary hypertension in patients positive for HIV is unknown. It is speculated that the virus may act via the liberation of mediators. We describe 4 cases of primary pulmonary hypertension in patients with HIV infection who were admitted to our center during the last 3 years.