MedStar Heart and Vascular Institute, Washington Hospital Center, Washington, DC, USA.
MedStar Heart and Vascular Institute, Washington Hospital Center, Washington, DC, USA; MedStar Georgetown University Hospital, Washington, DC, USA.
Can J Cardiol. 2019 Mar;35(3):288-298. doi: 10.1016/j.cjca.2019.01.005.
Human immunodeficiency virus-associated pulmonary arterial hypertension (HIV-PAH) is important to recognize given its association with significant morbidity and mortality. With the introduction of antiretroviral therapy, the focus of disease management has largely shifted from treating immunodeficiency-related opportunistic infections to managing chronic cardiopulmonary complications. Symptoms are nonspecific, and a high index of clinical suspicion is needed to avoid significant delay in the diagnosis of HIV-PAH. Although several viral proteins have been implicated in the pathogenesis of HIV-PAH, the exact mechanism remains uncertain. Further studies are needed to elucidate precise pathogenic mechanisms, early diagnostic tools, and novel therapeutic targets to improve prognosis of this severe complication.
人免疫缺陷病毒相关性肺动脉高压（HIV-PAH）很重要，因为它与严重的发病率和死亡率相关。随着抗逆转录病毒疗法的引入，疾病管理的重点已从治疗与免疫缺陷相关的机会性感染，很大程度上转移到管理慢性心肺并发症。症状是非特异性的，需要高度的临床怀疑指数，以避免 HIV-PAH 的诊断出现显著延迟。尽管有几种病毒蛋白被认为与 HIV-PAH 的发病机制有关，但确切的机制仍不确定。需要进一步的研究来阐明精确的发病机制、早期诊断工具和新的治疗靶点，以改善这种严重并发症的预后。
