Effect of gender and highly active antiretroviral therapy on HIV-related pulmonary arterial hypertension: results of the HIV-HEART Study

HIV Med. 2008 Aug;9(7):550-6. doi: 10.1111/j.1468-1293.2008.00602.x. Epub 2008 Jun 28.


Background: Idiopathic pulmonary arterial hypertension (PAH) is a rare disease. HIV-infected patients exhibit a considerably higher rate of development of this condition compared to the general population.

Methods: This cross-sectional study of 802 (83.4% male; age 44.3+/-10.3 years) HIV-positive patients aimed to evaluate the male-to-female ratio in HIV-related PAH and to elucidate whether PAH is more likely to occur in patients receiving highly active antiretroviral therapy (HAART) than in HIV-treatment-naïve patients. All patients were examined by Doppler echocardiography to estimate systolic pulmonary arterial pressure (sPAP). Manifest PAH was defined as sPAP >35 mmHg at rest in combination with symptoms of dyspnoea.

Results: A total of 38 (4.7%) patients were diagnosed with elevated sPAP >35 mmHg. Fourteen (1.7%; 11 male) of these patients presented with symptoms of dyspnoea, resulting in a male-to-female ratio of manifest HIV-associated PAH of 1:1.4. Patients with symptoms of dyspnoea and sPAP>35 mmHg were more likely to receive HAART (13/14 patients).

Conclusions: In HIV patients, sPAP occurs more frequently than has been reported previously; the condition is possibly associated with HAART. Furthermore, HIV-positive females exhibit a higher prevalence of HIV-related PAH (HIV-PAH) than HIV-positive males.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Anti-HIV Agents / adverse effects*
  • Antiretroviral Therapy, Highly Active / adverse effects*
  • Blood Pressure / drug effects
  • Cross-Sectional Studies
  • Dyspnea / epidemiology
  • Echocardiography, Doppler
  • Female
  • HIV Infections / complications
  • HIV Infections / drug therapy*
  • HIV-1
  • Humans
  • Hypertension, Pulmonary / diagnostic imaging
  • Hypertension, Pulmonary / epidemiology*
  • Male
  • Middle Aged
  • Prevalence
  • Sex Distribution
  • Systole / drug effects


  • Anti-HIV Agents