Title: Pulmonary Artery Hypertension and HIV; A tertiary care centre based comparative analysis
Authors: Dr Vinay Tuteja, Dr C.L.Nawal, Dr Aradhana Singh, Dr R.S. Chejara, Dr Pradeep Kumar Bansal
DOI: https://dx.doi.org/10.18535/jmscr/v7i6.171
Abstract
Introduction: HIV is a secondary immunodeficiency disease state characterized by fairly raised incidence of multiple systemic and cutaneous conditions, leading to increased morbidity and mortality. Advent of HAART has changed the natural course of the disease and many non-infective diseases have been unfolded in the patients of HIV, with cardiovascular diseases being at the top of the list. Pulmonary artery hypertension is also very frequently encountered in HIV infected patients.
Material and Methods: Total of 200 individuals including 100 patients of HIV and 100 controls were taken, study population was further divided into 3 groups on basis of duration of cART and then on the basis of CD4 count. After clinical assessment, chest x-ray, electrocardiogram and 2-dimensional echocardiography were done. Unpaired ‘t’ test was used for comparison of continuous variable; chi square test was used for qualitative data and ANOVA was used to analyze variance.
Observations and Results: Male to female ratio in cases and control was 3.3:1. Cases divided according to CD4 count and patients having CD4 <200/200-350/>350, the mean CD4 count was 108.47 ± 36.51/277.85 ± 46.73/576.63 ± 195 respectively. Pulmonary artery hypertension (PAH) was found in 10% patients, also 3(30%) patients had moderate grade of PAH.
Conclusion: PAH due to HIV is an infrequent complication of the infection. The pathophysiology of HIV-related PAH is complex and not fully understood. Early diagnosis and timely institution of PAH-specific therapies, can improve the life expectancy as well as quality of life in these patients.
Keywords: Human Immunodeficiency Virus, Pulmonary Artery Hypertension, CD4 count, Echocardiography.
Key Messages: With the advent of HAART, life of HIV infected patients has improved significantly, but with prolonged life comes many non-infective diseases due to various unknown factors, PAH is one such disease and it is very important to early recognize and treat the same. Echocardiography is an excellent non invasive tool for this purpose.
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