Highly active antiretroviral therapy compared with HAART and bosentan in combination in patients with HIV-associated pulmonary hypertension

Bárbaro, Giuseppe; Lucchini, A; Pellicelli, A.; Grisorio, Benvenuto; Giancaspro, Giuseppe; Barbarini, Giorgio

doi:10.1136/hrt.2005.076794

Cited by 63 publications

(51 citation statements)

References 7 publications

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“…The use of highly active antiretroviral therapy (HAART) and aggressive management of opportunistic infections has contributed to increased life expectancy in HIV-infected patients [366,367]. Consequently, the spectrum of complications has shifted towards other long-term conditions, including PAH.…”

Section: Pulmonary Arterial Hypertension Associated With Human Immunomentioning

confidence: 99%

2015 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension

et al. 2015

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Guidelines summarize and evaluate all available evidence on a particular issue at the time of the writing process, with the aim of assisting health professionals in selecting the best management strategies for an individual patient with a given condition, taking into account the impact on outcome, as well as the risk–benefit ratio of particular diagnostic or therapeutic means. Guidelines and recommendations should help health professionals to make decisions in their daily practice. However, the final decisions concerning an individual patient must be made by the responsible health professional(s) in consultation with the patient and caregiver as appropriate.

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Section: Pulmonary Arterial Hypertension Associated With Human Immunomentioning

confidence: 99%

2015 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension

et al. 2015

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“…ZWIąZANE Z ZAKAŻENIEm HIV Zastosowanie wysoce aktywnej terapii antyretrowirusowej (HAART) i agresywnego leczenia zakażeń oportunistycznych przyczyniło się do wydłużenia oczekiwanego okresu przeżycia u pacjentów zakażonych HIV [366,367]. W związku z tym spektrum powikłań przesunęło się w kierunku schorzeń występujących później, w tym PAH.…”

Section: Tętnicze Nadciśnienie Płucneunclassified

2015 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension

Galiè¹,

Humbert²,

Vachiéry³

et al. 2015

Kardiol Pol

389

528

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“…Highly active antiretroviral therapy was associated with improved hemodynamics and survival in some studies 5,6 and with improved exercise tolerance but unchanged pulmonary hemodynamics in oth-ers. 7,8 The effect of highly active antiretroviral therapy in these studies showed considerable interindividual variability, with some patients achieving near-normal pulmonary artery pressures and others experiencing either no change or a further pressure increase. [7][8][9] Thus, an important and still unresolved question is whether antiretroviral therapy, more specifically HIV protease inhibitors (HPIs), interfere with pathophysiological processes underlying the pulmonary vascular remodeling that occurs during PH progression.…”

Section: Clinical Perspective On P 1947mentioning

confidence: 99%

Effects of HIV Protease Inhibitors on Progression of Monocrotaline- and Hypoxia-Induced Pulmonary Hypertension in Rats

et al. 2010

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Background-Pulmonary hypertension (PH) is among the complications of HIV infection. Combination antiretroviraltherapy may influence the progression of HIV-related PH. Because Akt signaling is a potential molecular target of HIV protease inhibitors (HPIs), we hypothesized that these drugs altered monocrotaline-and hypoxia-induced PH in rats by downregulating the Akt pathway, thereby inhibiting pulmonary artery smooth muscle cell proliferation. Methods and Results-Daily treatment with each of 3 first-generation HPIs (ritonavir 30 mg/kg, amprenavir 100 mg/kg, and nelfinavir 500 mg/kg) started 3 weeks after a subcutaneous monocrotaline injection (60 mg/kg) substantially diminished pulmonary artery pressure, right ventricular hypertrophy, number of muscularized pulmonary vessels, pulmonary arterial wall thickness, and proliferating pulmonary vascular Ki67-labeled cells without affecting vessel caspase 3 staining. HPI treatment partially prevented the development of hypoxia-and monocrotaline-induced PH. Monocrotaline-induced PH was associated with marked activation of Akt signaling in the lungs and proximal pulmonary arteries, with increases in phosphorylated Akt, phosphorylated glycogen-synthase-kinase-3␤ (GSK3), and phosphorylated endothelial nitric oxide synthase, all of which decreased markedly after treatment with each HPI. In contrast, PH-associated increases in phosphorylated extracellular signal-related kinase 1/2 and myosin light-chain phosphatase were unaltered by the HPIs. The 3 HPIs and the phosphatidylinositol 3-kinase inhibitor LY294002 inhibited platelet-derived growth factor-induced phosphorylation of Akt and GSK3 in cultured pulmonary artery smooth muscle cells and blocked cell proliferation; this last effect was abolished by the GSK3 inhibitor SB216763. Conclusion-These

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Highly active antiretroviral therapy compared with HAART and bosentan in combination in patients with HIV-associated pulmonary hypertension

Cited by 63 publications

References 7 publications

2015 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension

2015 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension

2015 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension

Effects of HIV Protease Inhibitors on Progression of Monocrotaline- and Hypoxia-Induced Pulmonary Hypertension in Rats

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