Highly active antiretroviral therapy compared with HAART and bosentan in combination in patients with HIV-associated pulmonary hypertension

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Abstract
Previously untreated HIV-infected patients with PAH were elegible for the study. The patients were screened by clinical examination and tranthoracic echocardiography. Patients with an echocardiographic right ventricular systolic pressure > 35 mm Hg underwent right heart catheterisation. PAH was defined on the basis of mean pulmonary artery pressure (mPAP) at rest > 25 mm Hg, pulmonary capillary wedge pressure < 15 mm Hg and pulmonary vascular resistance > 240 dyn·s·cm−5 by right heart catheterisation.4 Exclusion criteria were age < 18 years; history of drug addiction and use of drugs known to have a definite cardiotoxic action (for example, cocaine and amphetamines); recent HIV-associated opportunistic infections; previous treatment with antiretroviral or immunomodulating drugs, or both; history of chronic obstructive pulmonary disease (assessed by analysis of clinical records and by pulmonary function tests); previous congenital or acquired heart disease (assessed by analysis of clinical records …