The Bottom Line: Pulmonary arterial hypertension is a rare and life-threatening complication of HIV. The course of HIV infection can be complicated by pulmonary arterial hypertension regardless of the route of transmission, the stage of infection, and the degree of immunosuppression. Clinical presentation and underlying pathology of pulmonary arterial hypertension associated with HIV are similar to those encountered in other forms of pulmonary arterial hypertension, although there are data suggesting the HIV related form has a greater inflammatory component.
Degano Pulmonary arterial hypertension and HIV infection. Seminars in respiratory and critical care medicine 2009 vol:30 iss:4 pg:440 -447
In Pulmonary arterial hypertension associated HIV, pulmonary vessel obstruction arises from medial hypertrophy and smooth muscle cell proliferation, endothelial proliferation, and fibrosis. Pathology of the affected vessels share widespread similarities with all other forms of ulmonary arterial hypertension. European and US guidelines list Pulmonary arterial hypertension associated HIV as a special condition and stress that evidence is lacking to support best management.