[HIV-associated pulmonary hypertension]

The association between pulmonary hypertension and HIV infection is well established. However, the development and progression of pulmonary hypertension has no relationship with the stage of HIV disease and the history of opportunistic infections. Although the pathogenesis of HIV-associated pulmonary hypertension is not clear, several hypotheses have been proposed. Pulmonary arterial pressures are in the moderate-to-severe range. Plexogenic pulmonary arteriopathy is the most common histopathologic finding. Progressive shortness of breath and pedal edema are the two most common presenting features. Responses to pulmonary vasodilator agents, antiretroviral agents, and anticoagulation therapy are variable. The appearance of unexplained cardiopulmonary symptoms in HIV-infected individuals should suggest pulmonary hypertension. Furthermore, HIV testing is recommended in all patients presenting with unexplained pulmonary hypertension, even when they deny HIV risk behaviors.