Julián Olalla1, Daniel Urdiales2, Marta Pombo3, Alfonso del Arco2, Javier de la Torre2, José Luis Prada2. 1. Unidad de Medicina Interna, Hospital Costa del Sol, Marbella, Málaga, España. Electronic address: julio.olalla@gmail.com. 2. Unidad de Medicina Interna, Hospital Costa del Sol, Marbella, Málaga, España. 3. Área de Cardiología, Hospital Costa del Sol, Marbella, Málaga, España.
Abstract
BACKGROUND AND OBJECTIVE: Pulmonary arterial hypertension (PAH) is a serious disorder, more prevalent in patients infected with human immunodeficiency virus (HIV). It is not entirely clear what role is played by highly active antiretroviral therapy (HAART) in PAH development or course. Our aim was to describe PAH prevalence in a series of HIV-infected patients and identify possible links with cumulative and current use of different antiretrovirals. PATIENTS AND METHOD: Cross-sectional study of a cohort of HIV-infected patients attending a hospital in southern Spain. Demographic data, data on HIV infection status and on cumulative and recent antiretroviral treatment were recorded. Transthoracic echocardiography was performed in all study participants. PAH was defined as pulmonary artery systolic pressure of 36mmHg or more. RESULTS: A total of 400 patients participated in the study; 178 presented with tricuspid regurgitation and 22 of these presented with PAH (5.5%). No differences were encountered in age, sex, CD4 lymphocytes, proportion of naive patients or patients with AIDS. No differences were encountered in cumulative use of antiretrovirals. However, recent use of lamivudine was associated with a greater presence of PAH, whereas recent use of tenofovir and emtricitabine was associated with a lower presence of PAH. Logistic regression analysis was performed including the use of lamivudine, emtricitabine and tenofovir. Only recent use of tenofovir was associated with a lower presence of PAH (odds ratio 0.31; 95% confidence interval: 0.17-0.84). CONCLUSIONS: PAH prevalence in our study was similar to others series. Current use of tenofovir may be associated with lower PAH prevalence.
BACKGROUND AND OBJECTIVE:Pulmonary arterial hypertension (PAH) is a serious disorder, more prevalent in patients infected with human immunodeficiency virus (HIV). It is not entirely clear what role is played by highly active antiretroviral therapy (HAART) in PAH development or course. Our aim was to describe PAH prevalence in a series of HIV-infectedpatients and identify possible links with cumulative and current use of different antiretrovirals. PATIENTS AND METHOD: Cross-sectional study of a cohort of HIV-infectedpatients attending a hospital in southern Spain. Demographic data, data on HIV infection status and on cumulative and recent antiretroviral treatment were recorded. Transthoracic echocardiography was performed in all study participants. PAH was defined as pulmonary artery systolic pressure of 36mmHg or more. RESULTS: A total of 400 patients participated in the study; 178 presented with tricuspid regurgitation and 22 of these presented with PAH (5.5%). No differences were encountered in age, sex, CD4 lymphocytes, proportion of naive patients or patients with AIDS. No differences were encountered in cumulative use of antiretrovirals. However, recent use of lamivudine was associated with a greater presence of PAH, whereas recent use of tenofovir and emtricitabine was associated with a lower presence of PAH. Logistic regression analysis was performed including the use of lamivudine, emtricitabine and tenofovir. Only recent use of tenofovir was associated with a lower presence of PAH (odds ratio 0.31; 95% confidence interval: 0.17-0.84). CONCLUSIONS: PAH prevalence in our study was similar to others series. Current use of tenofovir may be associated with lower PAH prevalence.
Keywords:
Highly active antiretroviral therapy; Hipertensión pulmonar; Human immunodeficiency virus; Pulmonary hypertension; Tenofovir; Tratamiento antirretroviral de gran actividad; Virus de la inmunodeficiencia humana