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Revista chilena de cardiología

On-line version ISSN 0718-8560

Abstract

SILVA, Rafael et al. Hipertensión pulmonar en paciente VIH positiva. Rev Chil Cardiol [online]. 2012, vol.31, n.1, pp.61-71. ISSN 0718-8560.  http://dx.doi.org/10.4067/S0718-85602012000100010.

We report the case of a patient 30 years, diagnosed with human immunodeficiency virus (HIV) since 2000, on antiretroviral therapy since 2004. Since 2007 with progressive dyspnea, which in the past year becomes severe, associated with asthenia, fatigue and edema of lower limbs evening. Echocardiography detects an increase in pulmonary artery pressure, which is confirmed by a right heart catheterization. Pulmonary embolism is ruled out and concludes as a pulmonary arterial hypertension (PAH) secondary to HIV. Pulmonary arterial hypertension is a disease of low frequency and can be associated with infection by HIV, with prevalence 6 to 12 times greater relative to individuals without HIV infection. PAH is independent of CD4 T lymphocyte count and viral proteins involved pathogenesis, such as glycoprotein 120 and Nef and Tat proteins, which stimulate a systemic inflammatory cascade, inducing angiogenesis in the pulmonary vessels. The hemodynamic study through right heart catheteri-zation is the method of choice for diagnostic confirmation.

Keywords : HIV- related pulmonary hypertension; primary pulmonary hypertension; human immunodeficiency virus.

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