Natural history of HIV-associated pulmonary arterial hypertension: trends in the HAART era
Natural history of HIV-associated pulmonary arterial hypertension: trends in the HAART era
复制标题
DOI：
10.1097/01.aids.0000327514.60879.47
复制
发表时间：
2008-09-01
期刊：
影响因子：
3.8
通讯作者：
Sereni, Daniel
中科院分区：
文献类型：
--
作者：
Opravil, Milos;Sereni, Daniel
肺动脉高压（PAH）是一种罕见的，但仍然严重危及生命的严重并发症的艾滋病毒感染。由于其非特异性表现，PAH倾向于在疾病晚期被识别，并且患者在诊断时通常处于纽约心脏协会功能III或IV级。HAART的广泛使用改善了HIV感染者的总体生存率，但其对PAH发病率和严重程度的影响尤其存在争议。在这种情况下，HAART对PAH病程和患者生存率的长期影响的数据一直缺乏。本文介绍了最近两项主要欧洲研究（瑞士HIV队列研究和法国前瞻性国家研究）的关键数据，这些研究调查了HIV感染人群中PAH的患病率以及HAART对疾病长期病程的影响。这些大型研究的数据并未表明HAART对PAH的病程或这些患者的生存率有重大影响。尽管有证据表明PAH新发病例正在下降，但目前总体患病率与HAART前相似，仍有相当数量的HIV感染者患有PAH或存在PAH风险。考虑到PAH治疗的最新进展，早期识别这些个体至关重要。(c)2008年威科健康垂直酒吧Lippincott威廉姆斯&威尔金斯
Pulmonary arterial hypertension (PAH) is an infrequent but nevertheless serious life-threatening severe complication of HIV infection. As a result of its non-specific presentation, PAH tends to be recognized at a late stage of the disease, and patients have generally been in New York Heart Association functional class III or IV by the time of diagnosis. The widespread use of HAART has improved overall survival in HIV infected individuals, but its effect on the incidence and severity of PAH in particular has been controversial. Data on the long-term impact of HAART on the course of PAH and patient survival in this context have been lacking. This article presents key data from two recent major European studies (the Swiss HIV Cohort Study and a prospective French national study) investigating the prevalence of PAH in the HIV-infected population and the effect of HAART on the long-term course of the disease. Data from these large studies do not suggest that HAART has a major effect on the course of PAH or on survival in these patients. Although there is evidence that new cases of PAH are declining, the overall prevalence is currently similar to the pre-HAART era, and there is still a significant number of HIV-infected individuals who have or are at risk of PAH. Given recent improvements in the treatment of PAH, the early recognition of these individuals is essential. (c) 2008 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins