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November 27, 1995

Primary Pulmonary Hypertension and the Human Immunodeficiency Virus: Report of Two Cases and a Review of the Literature

Author Affiliations

From the Pulmonary and Critical Care Division, Long Island Jewish Medical Center, Campus of the Albert Einstein College of Medicine, New Hyde Park, NY (Drs Weiss and Scharf); and the Department of Pathology and Laboratory Medicine, University of Pennsylvania Medical Center, Philadelphia (Dr Pietra).

Arch Intern Med. 1995;155(21):2350-2354. doi:10.1001/archinte.1995.00430210100016

We report two cases of human immunodeficiency virus (HIV) seropositivity and pulmonary hypertension seen at our institution and present a comprehensive literature review and available histopathologic findings of the association between HIV seropositivity and pulmonary hypertension. Studies and reviews pertaining to HIV seropositivity and pulmonary hypertension were identified through a MEDLINE search and reference citations. All studies and series found in the MEDLINE search were reviewed and are discussed in this article. Where data were available, comparisons and analyses were made between groups of reported cases of HIV seropositivity and pulmonary hypertension with regard to the following parameters: sex distribution, mode of acquiring HIV infection, presence or absence of the acquired immunodeficiency syndrome, CD4 cell counts, Po2 or oxygen saturation by pulse oximetry, concurrent lower respiratory tract infection, and histopathologic features. We conclude that there is strong evidence for pulmonary hypertension associated with HIV infection that is histologically indistinguishable from primary pulmonary hypertension. Consequently, HIV-seropositive patients with unexplained dyspnea should be evaluated for primary pulmonary hypertension. Prospective studies in HIV-positive patients are indicated.

(Arch Intern Med. 1995;155:2350-2354)