International AIDS Society

Detectable HIV Triples Odds of Pulmonary Hypertension With HIV

Author: Mark Mascolini

16 July 2012

Having a detectable viral load tripled the odds of pulmonary arterial hypertension in a study of 392 Spanish patients with HIV infection. Women had a 3 times higher risk of pulmonary hypertension than men.

Pulmonary arterial hypertension is not common in HIV-positive people, but it can be life-threatening. To determine prevalence of pulmonary hypertension and risk factors, researchers tested 392 consecutive patients at a Madrid HIV clinic.

The investigators defined pulmonary hypertension as right ventricular pressure above 35 mm Hg. They classified pulmonary hypertension as mild if right ventricular pressure lay from 35 to 40 mm Hg, moderate at 40 to 65 mm Hg, and severe if above 65 mm Hg.

Most study participants (83.4%) were men, 53% were men who have sex with men, and 53% were former injection drug users. Most patients (84%) were taking combination antiretroviral therapy, and 76% had an undetectable viral load. Median age stood at 47 years and median CD4 count at 577 cells/μL.

Half of the study group smoked, 16% had arterial hypertension, 9% had diabetes mellitus, 28.5% had chronic hepatitis C virus infection, and 4.8% had chronic hepatitis B virus infection.

Study clinicians diagnosed pulmonary arterial hypertension in 39 people (9.9%), classifying hypertension as mild in 6.4%, moderate in 2.8%, and severe in 0.8%.

Multivariate logistic regression analysis determined that a detectable viral load more than tripled the odds of pulmonary hypertension (odds ratio [OR] 3.3, 95% confidence interval [CI] 1.04 to 10), chronic hepatitis C tripled the odds (OR 3.1, 95% CI 1.2 to 8.2), and female gender tripled the odds (OR 2.9, 95% CI 1.04 to 8.3).

Source: Maribel Quezada, Luz Martin-Carbonero, Vicente Soriano, Eugenia Vispo, Eulalia Valencia, Victoria Moreno, Leopoldo P. de Isla, Vera Lennie, Carlos Almería, Jose L. Zamorano. Prevalence and risk factors associated with pulmonary hypertension in HIV-infected patients on regular follow-up. AIDS. 2012; 26: 1387-1392.

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