Miyanaga Sunao, Kubota Kayoko, Iwatani Noriko, Akao Mitsumasa, Mitsuyoshi Kokoro, Ohishi Mitsuru
Departments of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan.
J Cardiol Cases. 2023 Jun 1;28(2):72-74. doi: 10.1016/j.jccase.2023.04.008. eCollection 2023 Aug.
Pulmonary artery hypertension associated with human immunodeficiency virus infection (PAH-HIV) is known to be caused by HIV infection. Antiretroviral therapy and PAH-specific drugs improve the prognosis of patients with PAH-HIV, but the pathophysiology of PAH-HIV remains unclear. We report a case of PAH-HIV treated with upfront combination therapy including subcutaneous injection of treprostinil. One year after treatment initiation, the patient's PAH improved significantly. However, it worsened over time due to reduced efficacy of subcutaneous injection of treprostinil.
The etiology and pathophysiology of pulmonary artery hypertension associated with human immunodeficiency virus infection (PAH-HIV) remain unclear, and there are few case reports of PAH-HIV in Japan because the HIV prevalence is low. We encountered a case of PAH-HIV in which the efficacy of subcutaneous treprostinil injection was attenuated. It was unclear whether the reduced efficacy was associated with the pathophysiology of PAH-HIV. When PAH control deteriorates, early alteration of medication choice and administration route is important.
已知人类免疫缺陷病毒感染相关的肺动脉高压（PAH-HIV）由HIV感染引起。抗逆转录病毒疗法和PAH特异性药物可改善PAH-HIV患者的预后，但PAH-HIV的病理生理学仍不清楚。我们报告1例接受包括皮下注射曲前列尼尔在内的初始联合治疗的PAH-HIV患者。治疗开始1年后，患者的PAH显著改善。然而，由于皮下注射曲前列尼尔的疗效降低，病情随时间推移而恶化。
人类免疫缺陷病毒感染相关的肺动脉高压（PAH-HIV）的病因和病理生理学仍不清楚，在日本PAH-HIV的病例报告很少，因为HIV患病率较低。我们遇到1例PAH-HIV患者，皮下注射曲前列尼尔的疗效减弱。尚不清楚疗效降低是否与PAH-HIV的病理生理学有关。当PAH控制恶化时，尽早改变药物选择和给药途径很重要。
