[Pulmonary hypertension in HIV-infected patients]

Pulmonary hypertension (PH) appears to be more frequent and more rapidly progressive in HIV+ patients than in the general population. We describe 2 cases of PH in HIV+ patients disclosed by right-side heart failure. The patients were ex-intravenous drug users. On had AIDS and the other was asymptomatic. Both patients had cured hepatitis B and chronic hepatitis C and both died 10 and 11 months after PH diagnosis. Pulmonary hypertension is a likely diagnosis in HIV+ patients with unexplained dyspnea. For primary PH patients, HIV+ serology should be performed. There is probably an indirect mechanism linking PH and HIV. The role of associated chronic hepatitis C is unknown. Treatment of PH is symptomatic using diuretics, calcium-channel inhibitors, and anticoagulation, but with no real efficacy in terms of prognosis. Antiretroviral therapy is recommended. In the future treatment with epoprostenol may perhaps provide improvement in the prognosis of PH in HIV+ patients.