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Relationship between endothelin-1 levels and pulmonary arterial hypertension in HIV-infected patients

2014; Lippincott Williams & Wilkins; Volume: 28; Issue: 18 Linguagem: Inglês

10.1097/qad.0000000000000470

1473-5571

Maribel Q. Feijoo, Rocío Toro, Mariola López Vazquez de la Torre, Vera Lennie, Cristina Arce, V. Moreno, Eulalia Valencia, Eugenia Vispo, Carlos Almerı́a, Alipio Mangas, Luz Martín‐Carbonero,

HIV-related health complications and treatments

Objective: Pulmonary arterial hypertension (PAH) is a progressive, fatal disease with average survival of less than 3 years if left untreated. It is most common in patients infected with HIV. Although the pathogenesis in this population is not fully understood, it is thought that HIV infection, through the immune response and release of different inflammatory mediators such as endothelin-1, may contribute directly to endothelial damage. Our objective was to quantify endothelin-1 levels in HIV-infected patients and determine whether or not there is an association between this marker and PAH. Design: A case-control study in patients attending an infectious diseases clinic. Methods: The sample was composed of 79 patients divided into three groups: 23 HIV patients with PAH (HIV+/PAH+), 45 HIV patients without PAH (HIV+/PAH−) and a control group of 11 healthy individuals. The ratio between the HIV+/PAH− and HIV+/PAH+ groups was 2 : 1. Patients were matched by age, sex, risk group and viral load; the control group by age and sex. All patients had blood taken for endothelin-1 plasma quantification. Results: We found lower endothelin-1 levels in the controls than in the HIV+/PAH− group [0.71 pg/ml (interquartile range, IQR 0.54–0.94) vs. 1.13 pg/ml (IQR 0.87–1.38); P = 0.005] and the HIV+/PAH+ cohort [1.16 pg/ml (IQR 0.86–2.37); P = 0.003]. Patients with severe PAH had higher endothelin-1 levels [2.94 pg/ml (IQR 1.81–6.33)] than patients with mild and moderate PAH. Conclusion: Plasma endothelin-1 levels are higher in HIV patients with PAH than in the HIV-noninfected population and levels increase with the severity of the PAH.