Regression of HIV-associated pulmonary arterial hypertension and long-term survival during antiretroviral therapy

Speich, Rudolf; Jenni, Rolf; Opravil, Milos; Jaccard, René

doi:10.4414/smw.2001.09842

Cited by 19 publications

(3 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Antiretroviral therapy remains questionable in the treatment, even though the potential for slowing the progression of pulmonary hypertension or even causing its regression, has been observed. 54,55 The pathogenesis of HIV-related pulmonary hypertension is not well understood. In vivo and in vitro studies show that HIV does not infect lung endothelial cells and HIV DNA, RNA, or p24 antigen could not be detected in the pulmonary vessels of patients with HIV-related pulmonary hypertension.…”

Section: Pulmonary Hypertensionmentioning

confidence: 99%

“…Pulmonary hypertension in HIV infection showed plexogenic pulmonary arteriopathy in 95% of all cases,53 similar to the findings in immunocompetent patients. Antiretroviral therapy remains questionable in the treatment, even though the potential for slowing the progression of pulmonary hypertension or even causing its regression, has been observed 54,55…”

Section: Pulmonary Hypertensionmentioning

confidence: 99%

See 1 more Smart Citation

Current Update on HIV‐associated Vascular Disease and Endothelial Dysfunction

Mu¹,

Chai²,

Lin³

et al. 2007

World j. surg.

View full text Add to dashboard Cite

Highly active antiretroviral therapy (HAART) has greatly reduced the risk of early death from opportunistic infections and extended the lifespan of people infected with the human immunodeficiency virus (HIV). Thus, many complications and organic damage in the HIV-infected population emerge. Cardiovascular disease as coronary artery disease has become a matter of particular concern. Its incidence is greatly increased in the HIV-infected population over that of people of the same age in the absence of general cardiovascular risk factors. Despite several clinical and laboratory studies in the association between HIV infection and cardiovascular disease, the pathogenic mechanisms of this significant clinical problem are largely unknown and are now under active investigation. Endothelial dysfunction is possibly the most plausible link between HIV infection and atherosclerosis. Increased expression of adhesion molecules such as intercellular adhesion molecule (ICAM)-1 and endothelial adhesion molecule (E-selectin) and inflammatory cytokines such as tumor necrosis factor (TNF)-alpha and interleukin (IL-6 has been reported in HIV-positive patients. The effect of HAART on endothelial function in HIV-positive patients is also demonstrated. In this review, we focus on the recent research update of HIV-associated vascular disease and vascular injury. We analyze and discuss the recent clinical and laboratory investigations on the effect of HIV, viral protein, and HAART therapy on endothelial injury and vascular disease; identify the areas of controversy and clinical relevance; and suggest some directions for future research.

show abstract

Section: Pulmonary Hypertensionmentioning

confidence: 99%

Section: Pulmonary Hypertensionmentioning

confidence: 99%

Current Update on HIV‐associated Vascular Disease and Endothelial Dysfunction

Mu¹,

Chai²,

Lin³

et al. 2007

World j. surg.

View full text Add to dashboard Cite

show abstract

“…PH started as a clinical observation in HIV-infected individuals, which quickly populated the scientific literature three decades ago, through numerous case reports [8][9][10][11][12][13]. After almost a decade of observations, HIV was recognized as an independent risk factor for PH, along with commendable efforts using drugs to target either the lungs or the virus to tackle HIV-associated PH [14][15][16][17].…”

Section: Introductionmentioning

confidence: 99%

The Intersection of HIV and Pulmonary Vascular Health: From HIV Evolution to Vascular Cell Types to Disease Mechanisms

Garcia,

Almodovar

2024

JVD

View full text Add to dashboard Cite

People living with HIV (PLWH) face a growing burden of chronic diseases, owing to the combinations of aging, environmental triggers, lifestyle choices, and virus-induced chronic inflammation. The rising incidence of pulmonary vascular diseases represents a major concern for PLWH. The study of HIV-associated pulmonary vascular complications ideally requires a strong understanding of pulmonary vascular cell biology and HIV pathogenesis at the molecular level for effective applications in infectious diseases and vascular medicine. Active HIV infection and/or HIV proteins disturb the delicate balance between vascular tone and constriction, which is pivotal for maintaining pulmonary vascular health. One of the defining features of HIV is its high genetic diversity owing to several factors including its high mutation rate, recombination between viral strains, immune selective pressures, or even geographical factors. The intrinsic HIV genetic diversity has several important implications for pathogenic outcomes of infection and the overall battle to combat HIV. Challenges in the field present themselves from two sides of the same coin: those imposed by the virus itself and those stemming from the host. The field may be advanced by further developing in vivo and in vitro models that are well described for both pulmonary vascular diseases and HIV for mechanistic studies. In essence, the study of HIV-associated pulmonary vascular complications requires a multidisciplinary approach, drawing upon insights from both infectious diseases and vascular medicine. In this review article, we discuss the fundamentals of HIV virology and their impact on pulmonary disease, aiming to enhance the understanding of either area or both simultaneously. Bridging the gap between preclinical research findings and clinical practice is essential for improving patient care. Addressing these knowledge gaps requires interdisciplinary collaborations, innovative research approaches, and dedicated efforts to prioritize HIV-related pulmonary complications on the global research agenda.

show abstract

Therapeutischer Algorithmus bei pulmonal arterieller Hypertonie

Hoeper

2005

Herz

View full text Add to dashboard Cite

During the last decade, we have witnessed substantial improvements in the therapeutic options for pulmonary arterial hypertension (PAH), including true innovations targeting some of the mechanisms involved in the pathogenesis of this devastating disease. Intravenous epoprostenol was the first drug to improve symptoms and survival of patients with PAH. Novel prostanoids including subcutaneous treprostinil and inhaled iloprost also have beneficial effects in many patients, although their long-term efficacy is less well known. Among the newer treatments for PAH, endothelin receptor antagonists and phosphodiesterase type 5 inhibitors have reshaped clinical practice. The endothelin receptor antagonist bosentan has been approved in many parts of the world and most current guidelines recommend this drug as first-line treatment for PAH. Novel endothelin receptor antagonists such as sitaxsentan and ambrisentan are currently being investigated. The phosphodiesterase type 5 inhibitor sildenafil is also being intensively studied in patients with pulmonary hypertension, and most of the available data look promising, although approval for PAH is still pending. Other phosphodiesterase type 5 inhibitors have not yet undergone extensive study in PAH. However, PAH is a complex disorder and targeting a single pathway cannot be expected to be uniformly successful. Thus, combining substances with different modes of action is expected to improve symptoms, hemodynamics and survival in PAH patients, although combination therapy has yet to undergo the scrutiny of large randomized clinical trials.Based on the available data, several guidelines for the diagnostic and therapeutic approach to PAH have been published recently. These guidelines have incorporated treatment algorithms, which, fortunately, are virtually identical. The present review article summarizes the current guidelines to the management of patients with PAH.

show abstract

Regression of HIV-associated pulmonary arterial hypertension and long-term survival during antiretroviral therapy

Cited by 19 publications

References 11 publications

Current Update on HIV‐associated Vascular Disease and Endothelial Dysfunction

Current Update on HIV‐associated Vascular Disease and Endothelial Dysfunction

The Intersection of HIV and Pulmonary Vascular Health: From HIV Evolution to Vascular Cell Types to Disease Mechanisms

Therapeutischer Algorithmus bei pulmonal arterieller Hypertonie

Contact Info

Product

Resources

About