HIV and pulmonary hypertension: a review

We describe two unique cases of pulmonary hypertension in association with the human immunodeficiency virus (HIV) and review the 28 previously reported cases in the world literature. Our first patient has coexistent chronic active hepatitis, which has previously been associated with the development of plexogenic pulmonary hypertension; however, our second case clearly demonstrates a closer link between HIV infection and pulmonary hypertension. Unlike previously reported cases, our latter case was devoid of all other coexistent factors including intravenous drug abuse, hepatitis B antigenemia, coexisting immunologic lung parenchymal injury, and hepatitis. Additionally, this is the first case documenting the presence of asymptomatic type II cryoglobulins in an HIV-positive patient with plexogenic pulmonary hypertension.