Virtual symposium by the iPVD Consortium: Microbes series (Clinical Aspects) – HIV

Name: Clinical aspects: iPVD Microbes Virtual Symposium series - HIV and pulmonary hypertension
Uploaded: 2025-09-01T03:20:51+00:00

Date: August 28, 2024

HIV and pulmonary hypertension
Dr. Nicola Petrosillo (University Hospital Campus Bio-Medico, Italy)

Moderators: Dr. Navneet Dhillon (University of Kansas, USA)/Dr. Suellen Darc Oliveira (University of Illinois Chicago, USA)

Summary:

HIV-associated pulmonary hypertension (PH) was first recognized in 1987 and remains a significant cardiopulmonary complication in HIV patients. While HIV-associated (Group 1) PH is a distinct entity, it can also co-exist with PH due to left heart or lung disease, especially as HIV patients age and develop comorbidities.
The Veterans Aging Cohort Study showed HIV-infected individuals have a significantly higher risk of developing PH compared to uninfected individuals. HIV viral proteins (like glycoprotein-120 and Nef) contribute to vascular remodeling via inflammation, oxidative stress, and endothelial dysfunction. Direct infection of pulmonary vessels is not observed.
Prevalence estimates of HIV-associated PH vary widely (0.5% to over 10%), influenced by diagnostic methods, population genetics, and HIV-related factors like viral load and co-infections.
Clinical presentation mimics idiopathic PH, with symptoms such as dyspnea, pedal edema, and fatigue; rapid symptom progression often occurs.
Survival is poor but may improve with antiretroviral and PH-specific therapies; prognosis is worse with low CD4 counts and advanced symptoms. HIV-associated PH remains independently predictive of mortality among HIV patients.
PH-specific treatments (phosphodiesterase inhibitors, endothelin receptor antagonists, prostacyclin analogs) have demonstrated benefit but are under-studied specifically in HIV populations.