To estimate prevalence of pulmonary arterial hypertension in HIV patients and its association with CD4 cell count

Abstract

Introduction: HIV infection is considered as one of the leading infectious cause of pulmonary arterial hypertension (PAH) and it exhibits higher rate of development of this condition than general population. The prevalence of HIV associated PAH has not been established accurately and varies based on factors such as geographical distribution, gender, duration of HIV and ART etc. This study aims to estimate the prevalence of PAH in HIV infected patients who are on first line ART and to study the association of PAH with CD4 count and viral load. Methods: This cross-sectional study was conducted on 150 HIV positive patients who visited medical OPD and ART centre, JLN medical college and hospital, Ajmer and were above 18 years of age and were on first line ART. PAH was identified through transthoracic doppler echocardiographic screening and systolic pulmonary artery pressure (sPAP) estimation of more than 35 mmHg was used to diagnose PAH. Result: In this study, out of 150 patients, PAH was diagnosed in 12 patients and hence the prevalence of PAH came out to be 8 % (95 % CI: 3.65; 12.34). Significant association of PAH has been observed with viral load (p value = 0.04). While no significant association has been found between PAH and CD4 count. Conclusion: PAH in HIV patients was found to be 8% which is considerably higher than the already established global prevalence. Hence, PAH should be an important consideration for clinicians in differential diagnosis of dyspnea in HIV patients.

Keywords

• PAH
• HIV
• CD4
• sPAP