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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 AIDS+Res+Ther
2015 ; 12
(ä): 36
Nephropedia Template TP
gab.com Text
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English Wikipedia
HIV related pulmonary arterial hypertension: epidemiology in Africa,
physiopathology, and role of antiretroviral treatment
#MMPMID26566389
Bigna JJ
; Sime PS
; Koulla-Shiro S
AIDS Res Ther
2015[]; 12
(ä): 36
PMID26566389
show ga
The development of HIV related pulmonary arterial hypertension (PAH) reduces the
probability of survival by half as compared with HIV-infected individuals without
HIV related PAH. HIV infected patients have a greater incidence of PAH compared
to general population and have a 2500-fold increased risk of developing PAH. It
is therefore important to have a recent overview of the problem in Africa, the
most HIV affected part of the world (70 % of all HIV infection in the world).
First, we discussed the epidemiology of HIV-related PAH in Africa. Second, the
current understanding of the HIV-related PAH pathogenesis has been covered.
Third, role of highly active antiretroviral therapy on HIV-related PAH has been
revisited. There are few data concerning epidemiology of HIV related pulmonary
hypertension in Africa leading to necessity to conduct further prospective large
studies. The prevalence of PAH among HIV infected people in Africa varies from 5
to 13 %. The prevalence of HIV-related PAH in Africa is notably high compared to
those in developed countries and in general population. The pathogenesis of PAH
is clearly complex, and probably results from the interaction of multiple
modulating genes with environmental factors. The physiopathology includes
cytokines secretion increase which induces dysregulation of endothelial and
vascular smooth muscle cell growth and imbalance of endogenous vasodilators and
constrictors; HIV viral proteins which induces vascular oxidative stress, smooth
myocyte proliferation and migration, and endothelial injury and genetic
predisposition due to some major histocompatibility complex alleles, particularly
HDL-DR6 and HLA-DR5. Histologically, HIV related PAH has the same characteristics
with other types PAH. Antiretroviral therapy have a beneficial effect on the
outcome of HIV related pulmonary hypertension, but it lacks evidence from large
prospective studies.