Key result
Pharmacological treatment of HIV-associated pulmonary hypertension should follow established guidelines for idiopathic PAH and antiretroviral therapy, utilizing classes like riociguat.
HIV-associated pulmonary arterial hypertension should be treated using established therapies for idiopathic PAH in conjunction with antiretroviral therapy.
May support idiopathic PAH therapies plus ART in HIV-PAH; leaves open dedicated randomized trials.
Pulmonary arterial hypertension (PAH) is a rare but severe disease that results from chronic obstruction of small pulmonary arteries, leading to right ventricular failure and, ultimately, death. One established risk factor for the development of PAH is HIV infection. The presence of PAH is an independent risk factor for mortality in HIV-infected patients. This article will focus on HIV-associated PAH (HIV-PAH) with special considerations to the available treatments. With the approval of the soluble guanylate cyclase stimulator riociguat, a new drug class has become available in addition to the already existing prostanoids, endothelin receptor antagonists, and phosphodiesterase type 5 inhibitors. Guidelines for the treatment of idiopathic PAH and guidelines for antiretroviral therapy should be followed for the treatment of HIV-PAH.
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Chinello et al. (2016) conducted a review in HIV-associated pulmonary arterial hypertension. Pharmacological treatments (e.g., riociguat, prostanoids, ERAs, PDE5 inhibitors) was evaluated. Pharmacological treatment of HIV-associated pulmonary hypertension should follow established guidelines for idiopathic PAH and antiretroviral therapy, utilizing classes like riociguat.
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