1
|
Salvador ML, Rodríguez-Padial L, Soto Abánades C, Cruz Utrilla A, Barberá Mir JA, López-Meseguer M, Segovia Cubero J, Samper GJ, Blanco Vich I, Escribano-Subías P. Management and prognosis of HIV-associated pulmonary arterial hypertension: 20 Years of evidence from the REHAP registry. J Intern Med 2022; 292:116-126. [PMID: 35184348 DOI: 10.1111/joim.13468] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Pulmonary arterial hypertension (PAH) is an independent predictor of death in patients with human immunodeficiency virus (HIV) infection. HIV is the leading cause of PAH (HIV-PAH) worldwide. AIMS We described the characteristics, treatment patterns, and prognosis of a cohort of HIV-PAH patients and compared them with those of an equivalent cohort of patients with idiopathic/familial PAH (IPAH/FPAH). METHODS We retrospectively analysed and compared the demographic, clinical, and treatment data from patients with HIV-PAH and those with IPAH/FPAH in the Spanish PAH registry (REHAP) from 1998 to 2018. The HIV-PAH overall survival (OS) rate up to 5 years was compared to the age- and sex-matched IPAH/FPAH population. Changes in treatment patterns in patients with HIV-PAH after 2010 and their effects on OS were also analysed. RESULTS Compared to those with IPAH/FPAH (n = 739), patients with HIV-PAH (n = 132) were younger, mainly men, and had a better functional status. The clinical presentation, haemodynamics, and respiratory function were similar between the groups. Parenteral drug use was the most common mode of HIV transmission. Approximately 11% of patients with HIV-PAH did not receive PAH-targeted therapy. The age- and sex-adjusted 5-year OS rate from diagnosis was 74.0% for patients with HIV-PAH and 68.7% for those with IPAH (p < 0.159). During/after 2010, 23% of patients with IPAH/FPAH received upfront dual oral combination, while oral monotherapy remained the main first-line treatment in patients with HIV-PAH. The overall OS rate remained stable. CONCLUSIONS Patients with HIV-PAH were predominantly young men. The short-term prognosis is similar to that of age- and sex-matched patients with IPAH/FPAH, despite a better functional status. Oral monotherapy remains the preferred first-line treatment in the current cohorts.
Collapse
Affiliation(s)
| | | | - Clara Soto Abánades
- Department of Internal Medicine, Hospital Universitario La Paz, Madrid, Spain
| | - Alejandro Cruz Utrilla
- Pulmonary Hypertension Unit, Department of Cardiology, Hospital Universitario 12 de Octubre. Instituto de Salud Carlos III, Madrid, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain
| | - Joan Albert Barberá Mir
- Pulmonary Hypertension Unit, Department of Pulmonary Medicine, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | | | - Javier Segovia Cubero
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain.,Department of Cardiology, Hospital Universitario Puerta de Hierro - Majadahonda, Madrid, Spain
| | - Gustavo Juan Samper
- Department of Pneumology, Hospital General Universitario de Valencia, Valencia, Spain
| | - Isabel Blanco Vich
- Pulmonary Hypertension Unit, Department of Pulmonary Medicine, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Madrid, Spain
| | - Pilar Escribano-Subías
- Pulmonary Hypertension Unit, Department of Cardiology, Hospital Universitario 12 de Octubre. Instituto de Salud Carlos III, Madrid, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain
| | | | | |
Collapse
|
2
|
de Miguel-Díez J, López-de-Andrés A, Jiménez-García R, Puente-Maestu L, Jiménez-Trujillo I, Hernández-Barrera V, Resino S, Álvaro-Meca A. Trends in Epidemiology of COPD in HIV-Infected Patients in Spain (1997-2012). PLoS One 2016; 11:e0166421. [PMID: 27846297 PMCID: PMC5112896 DOI: 10.1371/journal.pone.0166421] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Accepted: 10/30/2016] [Indexed: 02/02/2023] Open
Abstract
Purpose The aim of this study was to estimate trends of incidence of hospital admissions and in-hospital mortality (IHM) in HIV-infected patients with COPD in the combination antiretroviral therapy (cART) era in Spain (1997–2012). Methods A retrospective study with data from nationwide population-based COPD diagnoses in the Spanish Minimum Basic Data Set (MBDS) was performed. We established groups according to their HIV and HCV infections: 1) HIV-uninfected patients; 2) HIV-infected patients (with or without HCV coinfection). Results 1,580,207 patients discharge with a COPD diagnosis were included in the study, 8902 of them were HIV-infected patients (5000 HIV-monoinfected patients and 3902 HIV/HCV-coinfected patients). The HIV-infected patients had higher incidence rates of hospital admissions for COPD than the HIV-uninfected patients during the study period. The HIV-monoinfected patients had higher rates of hospitalizations for COPD than the HIV/HCV-coinfected patients in the early-period cART (1997–1999), but these rates decreased in the first group and increased in the second, being even similar in both groups in the late-period cART (2004–2011). On the other hand, the HIV-infected patients with COPD had higher IHM than the HIV-uninfected patients with COPD. The mortality rates were higher in the HIV-monoinfected patients with COPD than in the HIV/HCV-coinfected patients with COPD in the early-period cART; however, in the late-period cART, the mortality rates trends seems higher in the HIV/HCV group. The likelihood of death in HIV/HCV-coinfected patients with COPD was similar to than in HIV-monoinfected patients with COPD. Conclusions Incidence of hospital admissions for COPD and IHM have decreased among HIV-monoinfected individuals but have increased steadily among HIV/HCV-coinfected individuals in the cART era.
Collapse
Affiliation(s)
- Javier de Miguel-Díez
- Pneumology Department, Hospital General Universitario Gregorio Marañón, Facultad de Medicina, Universidad Complutense de Madrid, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
- * E-mail:
| | - Ana López-de-Andrés
- Preventive Medicine and Public Health Teaching and Research Unit, Department of Health Sciences, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
| | - Rodrigo Jiménez-García
- Preventive Medicine and Public Health Teaching and Research Unit, Department of Health Sciences, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
| | - Luis Puente-Maestu
- Pneumology Department, Hospital General Universitario Gregorio Marañón, Facultad de Medicina, Universidad Complutense de Madrid, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
| | - Isabel Jiménez-Trujillo
- Preventive Medicine and Public Health Teaching and Research Unit, Department of Health Sciences, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
| | - Valentín Hernández-Barrera
- Preventive Medicine and Public Health Teaching and Research Unit, Department of Health Sciences, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
| | - Salvador Resino
- National Centre of Microbiology, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain
| | - Alejandro Álvaro-Meca
- Preventive Medicine and Public Health Teaching and Research Unit, Department of Health Sciences, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
| |
Collapse
|
3
|
Montúfar-Andrade FE, Villa-Franco JP, Montúfar-Pantoja MC, Cadavid-Usuga JC, Monsalve MA, Zuluaga M, Díaz L, Vega J, Vélez JD, Zuleta-Tobón JJ, Madrid C. Compromiso pulmonar en pacientes hospitalizados con infección por el virus de inmunodeficiencia humana en el Hospital Pablo Tobón Uribe (Medellín, Colombia). INFECTIO 2016. [DOI: 10.1016/j.infect.2015.10.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
|
4
|
Osorio J, Álvarez D, Barreto-Mora J, Casanova-Bermeo M, Vargas-Plazas H, Giraldo-Bahamon G, Rivera-Sotto F, Falla-Puentes S, López-Guevara Ó, Valderrama SL. Infecciones pulmonares en pacientes con VIH 20 años después de la terapia antirretroviral combinada. ¿Qué ha cambiado? INFECTIO 2016. [DOI: 10.1016/j.infect.2015.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
|
5
|
Sandoval-Gutiérrez JL. [Pulmonary arterial hypertension associated with human immunodeficiency virus. The forgotten topic]. ARCHIVOS DE CARDIOLOGIA DE MEXICO 2014; 84:54-5. [PMID: 24636806 DOI: 10.1016/j.acmx.2013.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2013] [Accepted: 12/19/2013] [Indexed: 10/25/2022] Open
Affiliation(s)
- José Luis Sandoval-Gutiérrez
- Centro de Investigación en Enfermedades Infecciosas, Instituto Nacional de Enfermedades Respiratorias, Ciudad de México, México.
| |
Collapse
|