[Pulmonary hypertension and HIV: implementation of a Regional Registry]

In the era of new, potent antiretroviral therapy, much more attention is being given to non-infectious complications of HIV diseases, such as cardiomyopathy, pericardial effusion and pulmonary hypertension (PH). PH diagnosis is based on a mean pulmonary artery pressure of more than 25 mmHg at rest, or more than 30 mmHg with exercise. The incidence of PH is about 0.1% per year among HIV-positive patients, while in the general population it is 1 to 2 cases per million people. The histopathology of HIV-associated PH (HAPH) is similar to that of idiopathic PH, although its pathogenesis is still unclear. In patients with HAPH secondary causes of PH must be ruled out, such as intravenous drug abuse, valvulopathy, congenital heart disease and previous tricuspid endocarditis. The treatment of HAPH is not substantially different from that of idiopathic PH and is essentially based on the use of vasodilators. The Regional Authority of Lazio (Italy) has instituted a Registry for PH in HIV-positive patients; its aims are to evaluate the real incidence and prevalence of primitive and secondary PH among patients with HIV infection, and optimise the management of patients with suspected PH through the definition of a diagnostic algorithm.