systhiperСистемные гипертензииSystemic Hypertension2075-082X2542-2189LLC «ИнтерМедсервис»10.38109/2075-082X-2024-1-21-28systhiper-806Research ArticleОБЗОРНАЯ СТАТЬЯREVIEWОсновные аспекты патофизиологии, диагностики и лечения пациентов с легочной артериальной гипертензией, ассоциированной с инфекцией вируса иммунодефицита человека: что достигнуто и что еще предстоит достичь?Basic aspects of pathophysiology, diagnosis and treatment of patients with pulmonary arterial hypertension associated with human immunodeficiency virus infection: what has been achieved and what remains to be achieved?https://orcid.org/0009-0000-2780-420XЧитанаваВ. Л.ChitanavaV. L.

Читанава Виктория Людвиговна, врач-кардиолог, Институт клинической кардиологии им. А.Л. Мясникова

ул. Академика Чазова, д. 15 а, г. Москва 121552

Viktoria L. Chitanava, cardiologist, A.L. Myasnikov Scientific Research Institute of Cardiology

st. Academician Chazova, 15a, Moscow 121552

chitanava.vika@mail.ruhttps://orcid.org/0000-0002-9041-3604ВалиеваЗ. С.ValievaZ. S.

Валиева Зарина Солтановна, к.м.н., старший научный сотрудник, отдел легочной гипертензии и заболеваний сердца, Институт клинической кардиологии им. А.Л. Мясникова

ул. Академика Чазова, д. 15 а, г. Москва 121552

Zarina S. Valieva, Cand. of Sci. (Med.), Senior Researcher, Department of Pulmonary Hypertension and Heart Diseases, A.L. Myasnikov Scientific Research Institute of Clinical Cardiology

st. Academician Chazova, 15a, Moscow 121552

https://orcid.org/0000-0002-9022-8097МартынюкТ. В.MartynyukT. V.

Мартынюк Тамила Витальевна, д.м.н., руководитель отдела легочной гипертензии и заболеваний сердца, Институт института клинической кардиологии им. А.Л. Мясникова, ФГБУ «НМИЦК им. акад. Е.И. Чазова» Минздрава России; профессор, кафедра кардиологии, факультет дополнительного профессионального образования, РНИМУ им. Н.И. Пирогова

ул. Академика Чазова, д. 15 а, г. Москва 121552, 

ул. Островитянова, д. 1, г. Москва 117997

Tamila V. Martynyuk, Dr. of Sci. (Med.), Head of the Department of pulmonary hypertension and heart diseases, A.L. Myasnikov Scientific Research Institute of Clinical Cardiology, E.I. Chazov National Medical Research Center of cardiology; professor, Department of Cardiology, Faculty of Continuing Professional Education, N.I. Pirogov Russian National Research Medical University

st. Academician Chazova, 15a, Moscow 121552,

Ostrovitianov str. 1, Moscow 117997

trukhiniv@mail.ruФГБУ «Национальный медицинский исследовательский центр кардиологии имени академика Е.И. Чазова» Минздрава РоссииРоссияE.I. Chazov National Medical Research Center of cardiologyRussian FederationФГБУ «Национальный медицинский исследовательский центр кардиологии имени академика Е.И. Чазова» Минздрава России; ФГАОУ ВО «Российский национальный исследовательский медицинский университет им. Н.И. Пирогова» Минздрава РоссииРоссияE.I. Chazov National Medical Research Center of cardiology; Pirogov Russian National Research Medical UniversityRussian Federation2024290320242112128Copyright © Читанава В.Л., Валиева З.С., Мартынюк Т.В., 20242024Читанава В.Л., Валиева З.С., Мартынюк Т.В.Chitanava V.L., Valieva Z.S., Martynyuk T.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.syst-hypertension.ru/jour/article/view/806

Инфекция, вызванная вирусом иммунодефицита человека (ВИЧ), характеризуется высокой заболеваемостью и является значимой угрозой для здоровья человечества, повышая общемировую смертность. Число людей, живущих с ВИЧ-инфекцией, по результатам Объединённой программы Организации Объединённых Наций по вирусу иммунодефицита человека/синдроме приобретенного иммунного дефицита человека (ЮНЭЙДС) в 2022 году составило 39 млн. (33,1-45,7 млн) человек. По мере внедрения в клиническую практику высокоэффективной антиретровирусной терапии (ВАРТ) и, как следствие, увеличения продолжительности жизни у данной когорты пациентов, на передний план стали выходить ВИЧ-ассоциированные осложнения, среди которых наиболее суровым является легочная артериальная гипертензия (ЛАГ), характеризующаяся прогрессирующим увеличением легочного сосудистого сопротивления и давления в легочной артерии, приводящее к развитию правожелудочковой недостаточности. Впоследствии стало очевидным, что данная патология может встречаться на всех стадиях ВИЧ-инфекции и, по всей видимости, не имеет четкой связи со степенью иммунодефицита, а также является независимым предиктором летального исхода у пациентов с ЛАГ-ВИЧ, в связи с чем требует к себе отдельного, пристального внимания.

В статье проведен обзор, охватывающий основные вопросы патофизиологии, клинических проявлений, диагностики и лечения ЛАГ, ассоциированной с ВИЧинфекцией (ЛАГ-ВИЧ), акцентируя внимание на проблемах, встречающихся на каждом из этапов.

Также в данном обзоре рассматриваются современные аспекты, направленные на изучение ЛАГ у пациентов с ВИЧ, включая новые экспериментальные методы медикаментозного лечения, учитывающие взаимодействие различных схем ВАРТ с ЛАГ-специфическими препаратами.

Human immunodeficiency virus (HIV) infection is characterized by high morbidity and is a significant threat to human health, increasing global mortality. The number of people living with HIV infection is estimated by the United Nations Joint Program on Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome (UNAIDS) to be 39 million (33.1-45.7 million) in 2022. With the introduction of highly effective antiretroviral therapy (cART) into clinical practice and the resulting increase in life expectancy in this cohort of patients, HIV-associated complications have come to the forefront, among which the most severe is pulmonary arterial hypertension (PAH), characterized by a progressive increase in pulmonary vascular resistance and pulmonary artery pressure, leading to the development of right ventricular failure. Subsequently, it became evident that this pathology can occur at all stages of HIV infection and, apparently, has no clear relationship with the degree of immunodeficiency, and is an independent predictor of mortality in patients with LAH-HIV, and therefore requires separate, close attention. This article provides an overview covering the basic pathophysiology, clinical manifestations, diagnosis and treatment of HIV-associated LAH (LAHHIV), emphasizing the challenges encountered at each stage. The review also considers current aspects aimed at studying LAH in patients with HIV, including new experimental drug therapies that take into account the interaction of different regimens with LAH-specific drugs.

легочная артериальная гипертензиявирус иммунодефицита человекалегочная артериальная гипертензияассоциированная с вирусом иммунодефицита человекапатогенездиагностикаЛАГ-специфические препаратыантиретровирусные препаратыpulmonary arterial hypertensionhuman immunodeficiency viruspulmonary arterial hypertension associated with human immunodeficiency viruspathogenesisdiagnosisPAH-specific drugsantiretroviral drugsReferencesOldroyd SH, Manek G, Sankari A, et al. Pulmonary Hypertension. StatPearls. [2023. Accessed January 25, 2024]. https://www.ncbi.nlm.nih.gov/books/NBK482463/Oldroyd SH, Manek G, Sankari A, et al. Pulmonary Hypertension. StatPearls. [2023. Accessed January 25, 2024]. https://www.ncbi.nlm.nih.gov/books/NBK482463/Humbert M, Kovacs G, Hoeper MM, et al. ESC/ERS Scientific Document Group. 2022 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension Developed by the task force for the diagnosis and treatment of pulmonary hypertension of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS). Endorsed by the International Society for Heart and Lung Transplantation (ISHLT) and the European Reference Network on rare respiratory diseases (ERN-LUNG). Eur Heart J 2022;43(38):3618–373. https://doi.org/10.1093/eurheartj/ehac237Humbert M, Kovacs G, Hoeper MM, et al. ESC/ERS Scientific Document Group. 2022 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension Developed by the task force for the diagnosis and treatment of pulmonary hypertension of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS). Endorsed by the International Society for Heart and Lung Transplantation (ISHLT) and the European Reference Network on rare respiratory diseases (ERN-LUNG). Eur Heart J 2022;43(38):3618–373. https://doi.org/10.1093/eurheartj/ehac237Butrous G. Human immunodeficiency viruses and their effect on the pulmonary vascular bed. Am J Physiol Lung Cell Mol Physiol. 2021;1;321(6):L1062-L1066. https://doi.org/10.1152/ajplung.00451.2021Butrous G. Human immunodeficiency viruses and their effect on the pulmonary vascular bed. Am J Physiol Lung Cell Mol Physiol. 2021;1;321(6):L1062-L1066. https://doi.org/10.1152/ajplung.00451.2021Palakeel JJ, Ali M, Chaduvula P, et al. An Outlook on the Etiopathogenesis of Pulmonary Hypertension in HIV. Cureus. 2022;14(7):e27390. https://doi.org/10.7759/cureus.27390Palakeel JJ, Ali M, Chaduvula P, et al. An Outlook on the Etiopathogenesis of Pulmonary Hypertension in HIV. Cureus. 2022;14(7):e27390. https://doi.org/10.7759/cureus.27390Hon SM, Alpizar-Rivas RM, Farber HW. Pulmonary Arterial Hypertension in Patients Infected with the Human Immunodeficiency Virus. Cardiol Clin. 2022;40(1):45-54. https://doi.org/10.1016/j.ccl.2021.08.004Hon SM, Alpizar-Rivas RM, Farber HW. Pulmonary Arterial Hypertension in Patients Infected with the Human Immunodeficiency Virus. Cardiol Clin. 2022;40(1):45-54. https://doi.org/10.1016/j.ccl.2021.08.004Wong CM, Bansal G, Pavlickova L, et al. Reactive oxygen species and antioxidants in pulmonary hypertension. Antioxid Redox Signal. 2013;18(14):1789-96. https://doi.org/10.1089/ars.2012.4568Wong CM, Bansal G, Pavlickova L, et al. Reactive oxygen species and antioxidants in pulmonary hypertension. Antioxid Redox Signal. 2013;18(14):1789-96. https://doi.org/10.1089/ars.2012.4568Simenauer A, Nozik-Grayck E, Cota-Gomez A. The DNA Damage Response and HIV-Associated Pulmonary Arterial Hypertension. Int J Mol Sci. 2020;21(9):3305. https://doi.org/10.3390/ijms21093305Simenauer A, Nozik-Grayck E, Cota-Gomez A. The DNA Damage Response and HIV-Associated Pulmonary Arterial Hypertension. Int J Mol Sci. 2020;21(9):3305. https://doi.org/10.3390/ijms21093305Cicalini S, Almodovar S, Grilli E, Flores S. Pulmonary hypertension and human immunodeficiency virus infection: epidemiology, pathogenesis, and clinical approach. Clin Microbiol Infect. 2011;17(1):25-33. https://doi.org/10.1111/j.1469-0691.2010.03286.xCicalini S, Almodovar S, Grilli E, Flores S. Pulmonary hypertension and human immunodeficiency virus infection: epidemiology, pathogenesis, and clinical approach. Clin Microbiol Infect. 2011;17(1):25-33. https://doi.org/10.1111/j.1469-0691.2010.03286.xGolpe R, Fernandez-Infante B, Fernandez-Rozas S. Primary pulmonary hypertension associated with human immunodeficiency virus infection. Postgrad Med J. 1998;74(873):400-4. https://doi.org/10.1136/pgmj.74.873.400Golpe R, Fernandez-Infante B, Fernandez-Rozas S. Primary pulmonary hypertension associated with human immunodeficiency virus infection. Postgrad Med J. 1998;74(873):400-4. https://doi.org/10.1136/pgmj.74.873.400Mehta NJ, Khan IA, Mehta RN, Sepkowitz DA. HIV-Related pulmonary hypertension: analytic review of 131 cases. Chest. 2000;118(4):1133-41. https://doi.org/10.1378/chest.118.4.1133Mehta NJ, Khan IA, Mehta RN, Sepkowitz DA. HIV-Related pulmonary hypertension: analytic review of 131 cases. Chest. 2000;118(4):1133-41. https://doi.org/10.1378/chest.118.4.1133Kanmogne GD, Primeaux C, Grammas P. Induction of apoptosis and endothelin-1 secretion in primary human lung endothelial cells by HIV-1 gp120 proteins. Biochem Biophys Res Commun. 2005;333(4):1107- 15. https://doi.org/10.1016/j.bbrc.2005.05.198Kanmogne GD, Primeaux C, Grammas P. Induction of apoptosis and endothelin-1 secretion in primary human lung endothelial cells by HIV-1 gp120 proteins. Biochem Biophys Res Commun. 2005;333(4):1107- 15. https://doi.org/10.1016/j.bbrc.2005.05.198Mirrakhimov AE, Ali AM, Barbaryan A, Prueksaritanond S. Human immunodeficiency virus and pulmonary arterial hypertension. ISRN Cardiol. 2013;2013:903454. https://doi.org/10.1155/2013/903454Mirrakhimov AE, Ali AM, Barbaryan A, Prueksaritanond S. Human immunodeficiency virus and pulmonary arterial hypertension. ISRN Cardiol. 2013;2013:903454. https://doi.org/10.1155/2013/903454Suh AJ, Suzuki DI, Gychka SG, et al. gp120 Envelope Glycoproteins of HIV-1 Group M Subtype A and Subtype B Differentially Affect Gene Expression in Human Vascular Endothelial Cells. Int J Mol Sci. 2023;24(4):3536. https://doi.org/10.3390/ijms24043536Suh AJ, Suzuki DI, Gychka SG, et al. gp120 Envelope Glycoproteins of HIV-1 Group M Subtype A and Subtype B Differentially Affect Gene Expression in Human Vascular Endothelial Cells. Int J Mol Sci. 2023;24(4):3536. https://doi.org/10.3390/ijms24043536Авдеев С.Н., Барбараш О.Л., Баутин А.Е., др. Легочная гипертензия, в том числе хроническая тромбоэмболическая легочная гипертензия. Клинические рекомендации 2020. Российский кардиологический журнал 2021; 26(12):46. https://doi.org/10.15829/1560-4071-2021-4683Avdeev S.N., Barbarash O.L., Bautin A.E., et al. 2020. Clinical practice guidelines for Pulmonary hypertension, including chronic thromboembolic pulmonary hypertension. Russian Journal of Cardiology. 2021;26(12):4683. (In Russ.) https://doi.org/10.15829/1560-4071-2021-4683Peng Y, Dai J, Zhao YY. Egln1Tie2Cre Mice Exhibit Similar Therapeutic Responses to Sildenafil, Ambrisentan, and Treprostinil as Pulmonary Arterial Hypertension (PAH) Patients, Supporting Egln1Tie2Cre Mice as a Useful PAH Model. Int J Mol Sci. 2023;24(3):2391. https://doi.org/10.3390/ijms24032391Peng Y, Dai J, Zhao YY. Egln1Tie2Cre Mice Exhibit Similar Therapeutic Responses to Sildenafil, Ambrisentan, and Treprostinil as Pulmonary Arterial Hypertension (PAH) Patients, Supporting Egln1Tie2Cre Mice as a Useful PAH Model. Int J Mol Sci. 2023;24(3):2391. https://doi.org/10.3390/ijms24032391Rodriguez-Irizarry VJ, Schneider AC, Ahle D, et al. Mice with humanized immune system as novel models to study HIV-associated pulmonary hypertension. Front Immunol. 2022;13:936164. https://doi.org/10.3389/fimmu.2022.936164Rodriguez-Irizarry VJ, Schneider AC, Ahle D, et al. Mice with humanized immune system as novel models to study HIV-associated pulmonary hypertension. Front Immunol. 2022;13:936164. https://doi.org/10.3389/fimmu.2022.936164DeJesus E, Saleh S, Cheng S, et al. Pharmacokinetic interaction of riociguat and antiretroviral combination regimens in HIV-1-infected adults. Pulm Circ. 2019;9(2):2045894019848644. https://doi.org/10.1177/2045894019848644DeJesus E, Saleh S, Cheng S, et al. Pharmacokinetic interaction of riociguat and antiretroviral combination regimens in HIV-1-infected adults. Pulm Circ. 2019;9(2):2045894019848644. https://doi.org/10.1177/2045894019848644Jungmann NA, Lang D, Saleh S, et al. In vitro-in vivo correlation of the drug-drug interaction potential of antiretroviral HIV treatment regimens on CYP1A1 substrate riociguat. Expert Opin Drug Metab Toxicol. 2019;15(11):975-984. https://doi.org/10.1080/17425255.2019.1681968Jungmann NA, Lang D, Saleh S, et al. In vitro-in vivo correlation of the drug-drug interaction potential of antiretroviral HIV treatment regimens on CYP1A1 substrate riociguat. Expert Opin Drug Metab Toxicol. 2019;15(11):975-984. https://doi.org/10.1080/17425255.2019.1681968Opravil M, Pechère M, Speich R, et al. HIV-associated primary pulmonary hypertension. A case control study. Swiss HIV Cohort Study. Am J Respir Crit Care Med. 1997;155(3):990-5. https://doi.org/10.1164/ajrccm.155.3.9117037Opravil M, Pechère M, Speich R, et al. HIV-associated primary pulmonary hypertension. A case control study. Swiss HIV Cohort Study. Am J Respir Crit Care Med. 1997;155(3):990-5. https://doi.org/10.1164/ajrccm.155.3.9117037Henriques-Forsythe M, Annangi S, Farber HW. Prevalence and hospital discharge status of human immunodeficiency virus-associated pulmonary arterial hypertension in the United States. Pulm Circ. 2015;5(3):506-12. https://doi.org/10.1086/682222Henriques-Forsythe M, Annangi S, Farber HW. Prevalence and hospital discharge status of human immunodeficiency virus-associated pulmonary arterial hypertension in the United States. Pulm Circ. 2015;5(3):506-12. https://doi.org/10.1086/682222Чазова И.Е., Архипова О.А., Мартынюк Т.В. Легочная артериальная гипертензия в России: анализ шестилетнего наблюдения по данным Национального регистра. Терапевтический архив 2019;91(1):10–31. https://doi.org/10.26442/00403660.2019.01.000024Chazova I.E., Arkhipova O.A., Martynyuk T.V. Pulmonary arterial hypertension in Russia: six-year observation analysis of the National Registry. Therapeutic Archive. 2019;91(1):10–31. https://doi.org/10.26442/00403660.2019.01.000024Reinsch N, Buhr C, Krings P, et al. Competence Network of Heart Failure. Effect of gender and highly active antiretroviral therapy on HIV-related pulmonary arterial hypertension: results of the HIV-HEART Study. HIV Med. 2008;9(7):550-6. https://doi.org/10.1111/j.1468-1293.2008.00602.xReinsch N, Buhr C, Krings P, et al. Competence Network of Heart Failure. Effect of gender and highly active antiretroviral therapy on HIV-related pulmonary arterial hypertension: results of the HIV-HEART Study. HIV Med. 2008;9(7):550-6. https://doi.org/10.1111/j.1468-1293.2008.00602.xЧазова И.Е., Мартынюк Т.В., Валиева З.С. и соавт. Евразийские клинические рекомендации по диагностике и лечению легочной гипертензии. Евразийский Кардиологический Журнал. 2020;1:78-122. https://doi.org/10.38109/2225-1685-2020-1-78-122Chazova I.E., Martynyuk T.V., Valieva Z.S. et al. Eurasian Guidelines for the diagnosis and treatment of pulmonary hypertension. Eurasian Нeart Journal 2020;1:78-122. (In Russ.) https://doi.org/10.38109/2225-1685-2020-1-78-122Niakara A, Drabo YJ, Kambire Y, et al. Atteintes cardio-vasculaires et infection par le VIH: étude de 79 cas au CHN de Ouagadougou (Burkina Faso) [Cardiovascular diseases and HIV infection: study of 79 cases at the National Hospital of Ouagadougou (Burkina Faso)]. Bull Soc Pathol Exot. 2002;95(1):23-6. (in French). PMID: 12012958Niakara A, Drabo YJ, Kambire Y, et al. Atteintes cardio-vasculaires et infection par le VIH: étude de 79 cas au CHN de Ouagadougou (Burkina Faso) [Cardiovascular diseases and HIV infection: study of 79 cases at the National Hospital of Ouagadougou (Burkina Faso)]. Bull Soc Pathol Exot. 2002;95(1):23-6. (in French). PMID: 12012958Galiè N, Olschewski H, Oudiz RJ, et al. Ambrisentan in Pulmonary Arterial Hypertension, Randomized, Double-Blind, Placebo-Controlled, Multicenter, Efficacy Studies (ARIES) Group. Ambrisentan for the treatment of pulmonary arterial hypertension: results of the ambrisentan in pulmonary arterial hypertension, randomized, double-blind, placebo-controlled, multicenter, efficacy (ARIES) study 1 and 2. Circulation. 2008;117(23):3010-9. https://doi.org/10.1161/CIRCULATIONAHA.107.742510Galiè N, Olschewski H, Oudiz RJ, et al. Ambrisentan in Pulmonary Arterial Hypertension, Randomized, Double-Blind, Placebo-Controlled, Multicenter, Efficacy Studies (ARIES) Group. Ambrisentan for the treatment of pulmonary arterial hypertension: results of the ambrisentan in pulmonary arterial hypertension, randomized, double-blind, placebo-controlled, multicenter, efficacy (ARIES) study 1 and 2. Circulation. 2008;117(23):3010-9. https://doi.org/10.1161/CIRCULATIONAHA.107.742510Rivera-Lebron BN, Risbano MG. Ambrisentan: a review of its use in pulmonary arterial hypertension. Ther Adv Respir Dis. 2017;11(6):233-244. https://doi.org/10.1177/1753465817696040Rivera-Lebron BN, Risbano MG. Ambrisentan: a review of its use in pulmonary arterial hypertension. Ther Adv Respir Dis. 2017;11(6):233-244. https://doi.org/10.1177/1753465817696040Channick RN, Delcroix M, Ghofrani HA, et al. Effect of macitentan on hospitalizations: results from the SERAPHIN trial. JACC Heart Fail. 2015;3(1):1-8. https://doi.org/10.1016/j.jchf.2014.07.013Channick RN, Delcroix M, Ghofrani HA, et al. Effect of macitentan on hospitalizations: results from the SERAPHIN trial. JACC Heart Fail. 2015;3(1):1-8. https://doi.org/10.1016/j.jchf.2014.07.013Souza R, Delcroix M, Galié N, et al. Long-Term Safety, Tolerability and Survival in Patients with Pulmonary Arterial Hypertension Treated with Macitentan: Results from the SERAPHIN Open-Label Extension. Adv Ther. 2022;39(9):4374-4390. https://doi.org/10.1007/s12325-022-02199-xSouza R, Delcroix M, Galié N, et al. Long-Term Safety, Tolerability and Survival in Patients with Pulmonary Arterial Hypertension Treated with Macitentan: Results from the SERAPHIN Open-Label Extension. Adv Ther. 2022;39(9):4374-4390. https://doi.org/10.1007/s12325-022-02199-xМартынюк Т.В., Наконечников С.Н., Чазова И.Е. Новые горизонты применения антагониста рецепторов эндотелина второго поколения мацитентана у пациентов с легочной гипертензией. Терапевтический архив. 2018;4(90):72-80.Martynyuk T.V., Nakonechnikov S.N., Chazova I.Y. New horizons for the use of the second generation of endothelin receptor antagonist macitentan in patients with pulmonary hypertension. Terapevticheskii arkhiv. 2018;4(90):72-80 (in Russ.).Duggan ST, Keam SJ, Burness CB. Selexipag: A Review in Pulmonary Arterial Hypertension. Am J Cardiovasc Drugs. 2017;17(1):73-80. https://doi.org/10.1007/s40256-016-0209-9Duggan ST, Keam SJ, Burness CB. Selexipag: A Review in Pulmonary Arterial Hypertension. Am J Cardiovasc Drugs. 2017;17(1):73-80. https://doi.org/10.1007/s40256-016-0209-9Isasti G, Moreno T, Pérez I, et al. High prevalence of pulmonary arterial hypertension in a cohort of asymptomatic HIV-infected patients. AIDS Res Hum Retroviruses. 2013;29(2):231-4. https://doi.org/10.1089/AID.2012.0166Isasti G, Moreno T, Pérez I, et al. High prevalence of pulmonary arterial hypertension in a cohort of asymptomatic HIV-infected patients. AIDS Res Hum Retroviruses. 2013;29(2):231-4. https://doi.org/10.1089/AID.2012.0166Isasti G, Pérez I, Moreno T, et al. Echocardiographic abnormalities and associated factors in a cohort of asymptomatic HIV-infected patients. AIDS Res Hum Retroviruses. 2013 Jan;29(1):20-4. https://doi.org/10.1089/AID.2012.0096Isasti G, Pérez I, Moreno T, et al. Echocardiographic abnormalities and associated factors in a cohort of asymptomatic HIV-infected patients. AIDS Res Hum Retroviruses. 2013 Jan;29(1):20-4. https://doi.org/10.1089/AID.2012.0096Ильин Н.В., Иванов К.И., Мартынюк Т.В. Новые возможности терапии легочной артериальной гипертензии — первый селективный агонист IP-рецепторов простациклина селексипаг. Кардиоваскулярная терапия и профилактика. 2019;18(6):80-87. https://doi.org/10.15829/1728-8800-2019-6-80-87Ilyin N.V., Ivanov K.I., Martynyuk T.V. New treatment options for pulmonary arterial hypertension — the first selective IP-receptor agonist selexipag. Cardiovascular Therapy and Prevention. 2019;18(6):80–87. (In Russ.). https://doi.org/10.15829/1728-8800-2019-6-80-87Kumar A, Mahajan A, Salazar EA et al. Impact of human immunodeficiency virus on pulmonary vascular disease. Glob Cardiol Sci Pract. https://doi.org/10.21542/gcsp.2021.12Kumar A, Mahajan A, Salazar EA et al. Impact of human immunodeficiency virus on pulmonary vascular disease. Glob Cardiol Sci Pract. https://doi.org/10.21542/gcsp.2021.12Krowka MJ, Miller DP, Barst RJ, et al. Portopulmonary hypertension: a report from the US-based REVEAL Registry. Chest. 2012;141(4):906-915. https://doi.org/10.1378/chest.11-0160Krowka MJ, Miller DP, Barst RJ, et al. Portopulmonary hypertension: a report from the US-based REVEAL Registry. Chest. 2012;141(4):906-915. https://doi.org/10.1378/chest.11-0160Чазова И.Е., Мартынюк Т.В. Легочная гипертензия. Москва. Практика. 2015; 928с.Chazova I.E., Martynyuk T.V. Pulmonary hypertension. - Moscow. Praktika. 2015; 928p. (In Russ.).Dupuis J, Hoeper MM. Endothelin receptor antagonists in pulmonary arterial hypertension. European Respiratory Journal. 2008;31(2):407-15. https://doi.org/10.1183/09031936.00078207Dupuis J, Hoeper MM. Endothelin receptor antagonists in pulmonary arterial hypertension. European Respiratory Journal. 2008;31(2):407-15. https://doi.org/10.1183/09031936.00078207

The authors declare that there are no conflicts of interest present.