Improvement of HIV-related pulmonary hypertension after the introduction of an antiretroviral therapy

To the Editors: The potential impact of combination antiretroviral therapy (CART) on HIV-related pulmonary arterial hypertension (PAH) remains controversial 1–4. We herein report the case of a dramatic improvement in PAH at the time of the inception of CART in a 19-yr-old female with HIV-1 infection due to mother-to-child transmission. HIV-related PAH was diagnosed in January 2006, when she was stable in stage A2 of the US Centers for Disease Control and Prevention classification without any antiretroviral therapy (table 1⇓). Specific PAH therapy with bosentan was started in January 2006, in combination with oral anticoagulant and diuretic therapy. CART was indicated at that time, but not prescribed owing to patient …