Incidence and risk factors of pulmonary hypertension in Chinese people living with human immunodeficiency virus
Objective To evaluate pulmonary hypertension(PH)in Chinese people living with human immunodeficiency virus(HIV)receiving long-term anti-retroviral therapy(ART)and those who had not received ART for HIV infection,and to analyze the risk factors for PH in HIV infected individuals,so as to provide evidence for the monitoring and management of cardiovascular diseases in people living with HIV in China.Methods HIV infected individuals who received long-term ART were from the NCT04463810 study cohort.In addition,using propensity score matching method,gender matched HIV infected individuals who had not received ART were selected as controls from the NCT00872417 and NCT01844297 studies.This study was a retrospective and observational clinical study.Basic data,clinical visit and cardiac Doppler ultrasonography data were collected to analyze the prevalence of PH and risk factors for PH in people living with HIV.Chi-square test and multivariate logistic regression were used for statistical analysis.Results Among the 318 HIV infected individuals,159 underwent long-term ART and 159 did not receive ART,which were divided into long-term ART group and ART-naïve group,respectively.Among 318 HIV infected individuals,30 cases(9.4％)experienced PH,including 23 cases(7.2％)with critical PH,six cases(1.9％)with mild PH,one case(0.3％)with moderate PH,and there was no severe PH.The prevalence of PH in the long-term ART group was 5.0％(8/159),which was lower than that in the ART-naïve group(13.8％,22/159).The difference was statistically significant(x2=7.21,P=0.012).Multivariate analysis showed that older age(odds ratio(OR)=1.064,95％confidence interval(CI)1.019 to 1.111,P=0.016)and unsuppressed HIV status(OR=2.660,95％CI 1.041 to 6.797,P=0.041)were independent risk factors for PH of people living with HIV.Conclusions The prevalence of PH in people living with HIV with long-term ART is lower than that of ART-naïve people living with HIV.Older age and unsuppressed HIV status are independent risk factors for PH in people living with HIV.Cardiac Doppler ultrasonography is helpful for the early screening of PH in people living with HIV.ART should be actively performed to reduce theincidence of PH in people living with HIV.
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