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HIV induced pericarditis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ramyar Ghandriz MD[2]

Synonyms and keywords:

Overview

Overview

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ramyar Ghandriz MD[2]

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Xyz from Other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications, and Prognosis

Diagnosis

Diagnostic Study of Choice

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

X-ray

Echocardiography and Ultrasound

CT scan

MRI

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Interventions

Surgery

Primary Prevention

Secondary Prevention

References


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Historical Perspective

Historical Perspective

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ramyar Ghandriz MD[2]

Overview

Since introduction of HIV induced pericarditis in 1986, although the incidence of disease is not increased, but due to increase in AIDS patients survival, prevalence of the disease increased.

Historical Perspective

Discovery

  • HIV induced pericarditis was first reported as a case report in 1986 by Cohen et al.
  • It was reported in a 32 years old married man with incurative prolonged fever.[1]

Famous Cases

The following are a few famous cases of HIV induced pericardial effusion:

  • Freddie Mercury

References

  1. ↑ Cohen, Ira S.; Anderson, David W.; Virmani, Renu; Reen, Bernard M.; Macher, Abe M.; Sennesh, Joel; DiLorenzo, Paul; Redfield, Robert R. (1986). “Congestive Cardiomyopathy in Association with the Acquired Immunodeficiency Syndrome”. New England Journal of Medicine. 315 (10): 628–630. doi:10.1056/NEJM198609043151007. ISSN 0028-4793.

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Classification

Classification

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ramyar Ghandriz MD[2]

Overview

HIV related pericarditis can be classified by possible complications. since there is always another organism or pathology underlying the disease, it is usually classified by its underlying cause.

Classification

HIV related pericarditis may be classified according to AHA based on possible complications as below[1][2][3]:

  • HIV related pericarditis which present with small effusion
  • HIV related pericarditis which present with large effusion
  • HIV related pericarditis which present with tamponade

Since there are plenty of underlying causes of HIV related pericarditis, these abnormalities and pathologies are usually indicated by the basic cause , like kaposi sarcoma caused pericarditis, streptococcal pericarditis.

References

  1. ↑ “Cardiac Manifestations of HIV”.
  2. ↑ “Pericardial Effusion in AIDS | Circulation”.
  3. ↑ Stotka JL, Good CB, Downer WR, Kapoor WN (1989). “Pericardial effusion and tamponade due to Kaposi’s sarcoma in acquired immunodeficiency syndrome”. Chest. 95 (6): 1359–61. doi:10.1378/chest.95.6.1359. PMID 2721281.

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Pathophysiology

Pathophysiology


Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ramyar Ghandriz MD[2]

Overview

Pericardial effusion is common among asymptomatic HIV positive patients, it may cause large tamponade. Heart involvement is one of the most co-morbidity of HIV patients because. Since the improvement of anti retro viral therapies, other causes of AIDS mortality have decreased, and pericarditis began to be the leading cause.

Pathophysiology

Pathogenesis

a) tuberculoma in the left atrium (black arrow); b numerous small foci of granulomatous inflammation diffusely scattered thorough the liver; c) numerous subcapsular small foci of granulomatous inflammation in the kidney (black arrow), note irregular shape of the organ[10]
Bread and butter appearance upon opening the pericardium. The “bread and butter” appearance seen upon separating the visceral and parietal surfaces of the pericardium during surgery is typical for fibrinous pericarditis.[11]

Microscopic Pathology

  • On microscopic histopathological analysis, acid fast bacilli is a characteristic findings of tuberculous pericarditis.
(A) A pink, amorphous meshwork of threads admixed with degenerated red blood cells and leukocytes (H&E stain, × 400). (B) Numerous acid-fast bacilli (Ziehl-Neelsen stain, × 1,000)[12]
  • Kaposi’s sarcoma induced pericarditis is defined if the pathology exists in organs as described below:(pericarditis may be the first manifestation)
Elongated spindle cells are separated by slits containing red blood cells in lymph node with Kaposi’s sarcoma (hematoxylin and eosin stain, ×200) (a), anti-HHV-8 antibody immunostaining positivity detected in the lymph node (×400) (b).[13]

References

  1. ↑ Remick, Joshua; Georgiopoulou, Vasiliki; Marti, Catherine; Ofotokun, Igho; Kalogeropoulos, Andreas; Lewis, William; Butler, Javed (2014). “Heart Failure in Patients With Human Immunodeficiency Virus Infection”. Circulation. 129 (17): 1781–1789. doi:10.1161/CIRCULATIONAHA.113.004574. ISSN 0009-7322.
  2. ↑ Moreno, Raùl; Villacastín, Julián P; Bueno, Héctor; López de Sá, Esteban; López-Sendón, José L; Bobadilla, Jaime F; García-Fernández, Miguel A; Delcán, Juan L. (1997). “Clinical and Echocardiographic Findings in HIV Patients with Pericardial Effusion”. Cardiology. 88 (5): 397–400. doi:10.1159/000177367. ISSN 1421-9751.
  3. ↑ Sudano, Isabella; Spieker, Lukas E.; Noll, Georg; Corti, Roberto; Weber, Rainer; Lüscher, Thomas F. (2006). “Cardiovascular disease in HIV infection”. American Heart Journal. 151 (6): 1147–1155. doi:10.1016/j.ahj.2005.07.030. ISSN 0002-8703.
  4. ↑ Maher D, Harries AD (1997). “Tuberculous pericardial effusion: a prospective clinical study in a low-resource setting–Blantyre, Malawi”. The International Journal of Tuberculosis and Lung Disease : the Official Journal of the International Union against Tuberculosis and Lung Disease. 1 (4): 358–64. PMID 9432393. Unknown parameter |month= ignored (help)
  5. ↑ Dronda F, Suzacq C (1997). “[Pericardial tuberculosis complicated with heart tamponade as presentation form of acquired immunodeficiency syndrome]”. Revista Clínica Española (in Spanish; Castilian). 197 (7): 502–6. PMID 9411548. Unknown parameter |month= ignored (help)
  6. ↑ Chen Y, Brennessel D, Walters J, Johnson M, Rosner F, Raza M (1999). “Human immunodeficiency virus-associated pericardial effusion: report of 40 cases and review of the literature”. American Heart Journal. 137 (3): 516–21. PMID 10047635. Unknown parameter |month= ignored (help)
  7. ↑ Flum DR, McGinn JT, Tyras DH (1995). “The role of the ‘pericardial window’ in AIDS”. Chest. 107 (6): 1522–5. PMID 7781340. Unknown parameter |month= ignored (help)
  8. ↑ Gouny P, Lancelin C, Girard PM, Hocquet-Cheynel C, Rozenbaum W, Nussaume O (1998). “Pericardial effusion and AIDS: benefits of surgical drainage”. European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery. 13 (2): 165–9. PMID 9583822. Unknown parameter |month= ignored (help)
  9. ↑ Eisenberg MJ, Gordon AS, Schiller NB (1992). “HIV-associated pericardial effusions”. Chest. 102 (3): 956–8. PMID 1516433. Unknown parameter |month= ignored (help)
  10. ↑ Szaluś-Jordanow, Olga; Augustynowicz-Kopeć, Ewa; Czopowicz, Michał; Olkowski, Arkadiusz; Łobaczewski, Andrzej; Rzewuska, Magdalena; Sapierzyński, Rafał; Wiatr, Elżbieta; Garncarz, Magdalena; Frymus, Tadeusz (2016). “Intracardiac tuberculomas caused by Mycobacterium tuberculosis in a dog”. BMC Veterinary Research. 12 (1). doi:10.1186/s12917-016-0731-7. ISSN 1746-6148.
  11. ↑ Woudstra, Odilia I.; Boink, Gerard J. J.; Winkelman, Jacobus A.; van Stralen, Ron (2016). “A Rare Case of Primary Meningococcal Myopericarditis in a 71-Year-Old Male”. Case Reports in Cardiology. 2016: 1–3. doi:10.1155/2016/1297869. ISSN 2090-6404.
  12. ↑ Yoon, Shin-Ae; Hahn, Youn-Soo; Hong, Jong Myeon; Lee, Ok-Jun; Han, Heon-Seok (2012). “Tuberculous Pericarditis Presenting as Multiple Free Floating Masses in Pericardial Effusion”. Journal of Korean Medical Science. 27 (3): 325. doi:10.3346/jkms.2012.27.3.325. ISSN 1011-8934.
  13. ↑ Aydin, Seniz Ongoren; Eskazan, Ahmet Emre; Aki, Hilal; Ozguroglu, Mustafa; Baslar, Zafer; Soysal, Teoman (2011). “Synchronous Detection of Hairy Cell Leukemia and HIV-Negative Kaposi’s Sarcoma of the Lymph Node: A Diagnostic Challenge and a Rare Coincidence”. Case Reports in Oncology. 4 (3): 439–444. doi:10.1159/000331894. ISSN 1662-6575.

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Causes

Causes


Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Varun Kumar, M.B.B.S.; Lakshmi Gopalakrishnan, M.B.B.S. Ramyar Ghandriz MD[2]

Overview

Common causes of HIV induced pericarditis include Mycobacterium tuberculosis, Staphylococcus aureus, Cryptococcus neoformans, and Herpes simplex.

Causes

It is often difficult to identify the etiology of pericardial effusion in HIV-infected patients. The common organisms isolated are:

Supportive Trial Data

  • A retrospective study[7] of 29 patients with AIDS-related pericardial effusion, who underwent fluid cultures and pericardial biopsy, included the following causes:

References

  1. ↑ Mayosi BM, Burgess LJ, Doubell AF (2005). “Tuberculous pericarditis”. Circulation. 112 (23): 3608–16. doi:10.1161/CIRCULATIONAHA.105.543066. PMID 16330703.
  2. ↑ Sudano I, Spieker LE, Noll G, Corti R, Weber R, Lüscher TF (2006). “Cardiovascular disease in HIV infection”. Am Heart J. 151 (6): 1147–55. doi:10.1016/j.ahj.2005.07.030. PMID 16781213.
  3. ↑ Stechel RP, Cooper DJ, Greenspan J, Pizzarello RA, Tenenbaum MJ (1986) Staphylococcal pericarditis in a homosexual patient with AIDS-related complex. N Y State J Med 86 (11):592-3. PMID: 3467225
  4. ↑ Decker CF, Tuazon CU (1994) Staphylococcus aureus pericarditis in HIV-infected patients. Chest 105 (2):615-6. PMID: 8306779
  5. ↑ Schuster M, Valentine F, Holzman R (1985) Cryptococcal pericarditis in an intravenous drug abuser. J Infect Dis 152 (4):842. PMID: 4045235
  6. ↑ Freedberg RS, Gindea AJ, Dieterich DT, Greene JB (1987) Herpes simplex pericarditis in AIDS. N Y State J Med 87 (5):304-6. PMID: 3035442
  7. ↑ Flum DR, McGinn JT, Tyras DH (1995) The role of the ‘pericardial window’ in AIDS. Chest 107 (6):1522-5. PMID: 7781340
  8. ↑ Hsia J, Ross AM (1994) Pericardial effusion and pericardiocentesis in human immunodeficiency virus infection. Am J Cardiol 74 (1):94-6. PMID: 8017317


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Differentiating HIV induced pericarditis from other Diseases

Differentiating HIV induced pericarditis from other Diseases


Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ramyar Ghandriz MD[2]

Overview

HIV pericarditis must be differentiated based on existence of pericarditis and reason of pericarditis, so the below is the differential according to these two different basis.

Differentiating HIV induced pericarditis from other Diseases

  • HIV induced pericarditis usually remains sillent and is found during autopsies as a random co-existing condition.
  • If it was symptomatic, we can differentiate underlying cause as below:
Diseases Clinical manifestations Para-clinical findings Gold standard
Symptoms Physical examination
Lab Findings Histopathology and imaging
Chest pain Jugular vein Dry cough with hemoptesis Friction rub Lymph-adenopathy Sputom cuture Histological demonestration
Tuberculosis + elevated If +, increases the risk + +/- + – Active caseating granuloma in lungs Treat all HIV induced pericarditis for tuberclosis. if not clinically improved, search for other diseases.
Congestive cardiomypathy + not elevated – – – – – Causes detectable CXR changes.
pneumocystis + + – + – + – Detectable by unique shape and pathologic features
CMV + + – + + – + Detecting pathologic giant CD8+ T-cell
Kaposi sarcoma + + – + + – + Specific skin and GI manifestations
Lymphoma + + – + + – + Lymph node excision and frozen section manifest unique features

Differential diagnosis of pericarditis

Chest pain or pressure are common symptoms. A small effusion may be asymptomatic. Larger effusions may cause cardiac tamponade, a life-threatening complication and the signs of impending tamponade include dyspnea, low blood pressure, and distant heart sounds. There are several other cardiac insults with similar symptoms that should be considered in differential diagnosis of pericardial effusion.

Differential Diagnosis by Organ System

Cardiovascular Cathether ablation for arrhythmias, coronary artery bypass grafting, dissecting aortic aneurysm, Dresslers syndrome, endocarditis, myocarditis, pacemaker insertion, percutaneous coronary intervention, postpericardiotomy syndrome, TAVI, thoracic surgery, valvuloplasty
Chemical / poisoning Silicosis
Dermatologic Behcet syndrome[1]
Drug Side Effect Dantrolene, doxorubicin, hydralazine, isoniazid, penicillin, phenylbutazone, procainamide
Ear Nose Throat Temporal arteritis[2]
Endocrine Addisonian crisis, Severe hypothyroidism (myxedema)
Environmental No underlying causes
Gastroenterologic Inflammatory bowel disease, Whipple’s
Genetic Gaucher disease, Jacobs arthropathy-camptodactyly syndrome, Mulibrey nanism syndrome, recurrent hereditary polyserositis
Hematologic Leukemia, lymphoma
Iatrogenic Cardiopulmonary resuscitation, postpericardiotomy syndrome, radiation therapy, serum sickness, thoracic duct obstruction secondary to tumor, surgery
Infectious Disease Actinomycosis, adenovirus, alveolar hydatid disease, amebiasis, aspergillus, blastomycosis, borrelia, brucellosis, candida, coccidiomycosis, coxsackie B virus, cytomegalovirus, Ebstein-Barr virus, echinococcus, echovirus, entamoeba histolytica, escherichia coli, francisella, haemophilus influenza, hepatitis B, histoplasmosis, influenza, klebsiella, legionella, Lyme disease, meningococci, mumps, mycoplasma pnuemonia, neisseria, nocardia, pneumococcus, proteus, pseudomonas, rickettsia, salmonella, staphylococcus, streptococcus, toxoplasmosis, tuberculous, tularemia, varicella
Musculoskeletal / Ortho No underlying causes
Neurologic No underlying causes
Nutritional / Metabolic No underlying causes
Obstetric/Gynecologic No underlying causes
Oncologic Breast cancer, carcinoid, fibroma, kaposis sarcoma, leukemia, lipoma, lung cancer, lymphomas, melanoma, mesothelioma, ovarian cancer, sarcoma, Sipple syndrome
Opthalmologic No underlying causes
Overdose / Toxicity No underlying causes
Psychiatric No underlying causes
Pulmonary Sarcoidosis
Renal / Electrolyte Uremia
Rheum / Immune / Allergy Acute rheumatic fever, amyloidosis, ankylosing spondylitis, Behcet syndrome, Kawasaki disease, mixed connective tissue disease, polyarteritis nodosa, polymyositis, Reiter’s Syndrome, rheumatoid arthritis, sarcoidosis, scleroderma, Still’s disease, systemic lupus erythematosus, systemic sclerosis, temporal arteritis, Wegener’s
Sexual Neisseria gonorrhoeae[3], treponema pallidum
Trauma Blunt or penetrating chest trauma, esophageal rupture, esophogeal perforation, gastric perforation, pancreatic-pericardial fistula
Urologic Renal Failure, uremia
Miscellaneous Idiopathic

References

  1. ↑ Scarlett JA, Kistner ML, Yang LC (1979). “Behçet’s syndrome. Report of a case associated with pericardial effusion and cryoglobulinemia treated with indomethacin”. Am J Med. 66 (1): 146–8. PMID 420242.
  2. ↑ Garewal HS, Uhlmann RF, Bennett RM (1981). “Pericardial effusion in association with giant cell arteritis”. West J Med. 134 (1): 71–2. PMC 1272467. PMID 7210667.
  3. ↑ Wilson J, Zaman AG, Simmons AV (1990). “Gonococcal arthritis complicated by acute pericarditis and pericardial effusion”. Br Heart J. 63 (2): 134–5. PMC 1024342. PMID 2317408.

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Epidemiology and Demographics

Epidemiology and Demographics

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [2]; Associate Editor(s)-in-Chief: Varun Kumar, M.B.B.S.; Lakshmi Gopalakrishnan, M.B.B.S. Ramyar Ghandriz MD[3]

Overview

Pericardial disease in HIV positive patients is increasing in prevalence, below is some demographic features of the disease.

Epidemiology and Demographics

Pericardial diseases in the form of pericardial effusion or cardiac tamponade[1][2][3][4] have been recognized as complications since HIV infection was first reported in 1981.

  • In a small autopsy study, 24% of the cases were reported with major cardiac pathology.[5]
  • The incidence of pericardial effusion in patients with asymptomatic AIDS was 11% per year before the introduction of effective highly active antiretroviral therapy(HAART). The 6 month survival rate of AIDS patients with effusion was significantly shorter (36%) than the survival rate without effusions (93%). This shortened survival rate remained statistically significant after adjustment for lead-time bias and was independent of CD4 count and albumin level.[1]
  • The incidence of AIDS-related cardiac disease is very high in Africa in comparison to that seen in the developed countries. In the period from 1993 to 1999 in Burkina Faso, 79% of AIDS patients exhibited cardiac involvement, whereas in an Italian study during the period 1992 to 1995, the incidence of AIDS-related cardiac disease was 6.5%.[8]

References

  1. ↑ 1.0 1.1 1.2 Heidenreich PA, Eisenberg MJ, Kee LL, Somelofski CA, Hollander H, Schiller NB; et al. (1995). “Pericardial effusion in AIDS. Incidence and survival”. Circulation. 92 (11): 3229–34. PMID 7586308.
  2. ↑ Stotka JL, Good CB, Downer WR, Kapoor WN (1989). “Pericardial effusion and tamponade due to Kaposi’s sarcoma in acquired immunodeficiency syndrome”. Chest. 95 (6): 1359–61. PMID 2721281.
  3. ↑ Karve MM, Murali MR, Shah HM, Phelps KR (1992). “Rapid evolution of cardiac tamponade due to bacterial pericarditis in two patients with HIV-1 infection”. Chest. 101 (5): 1461–3. PMID 1582323.
  4. ↑ Chen Y, Brennessel D, Walters J, Johnson M, Rosner F, Raza M (1999) Human immunodeficiency virus-associated pericardial effusion: report of 40 cases and review of the literature. Am Heart J 137 (3):516-21. PMID: 10047635
  5. ↑ Cammarosano C, Lewis W (1985). “Cardiac lesions in acquired immune deficiency syndrome (AIDS)”. J Am Coll Cardiol. 5 (3): 703–6. PMID 3973269.
  6. ↑ Sudano I, Spieker LE, Noll G, Corti R, Weber R, Lüscher TF (2006) Cardiovascular disease in HIV infection. Am Heart J 151 (6):1147-55. [1] PMID: 16781213
  7. ↑ Harmon WG, Dadlani GH, Fisher SD, Lipshultz SE (2002)Myocardial and Pericardial Disease in HIV. Curr Treat Options Cardiovasc Med 4 (6):497-509. PMID: 12408791
  8. ↑ Pugliese A, Gennero L, Vidotto V, Beltramo T, Petrini S, Torre D (2004). “A review of cardiovascular complications accompanying AIDS”. Cell Biochem Funct. 22 (3): 137–41. doi:10.1002/cbf.1095. PMID 15124176.

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Risk Factors

Risk Factors

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ramyar Ghandriz MD[2]

Overview

Risk factors include those associated with HIV like viral load, CD4 count, duration of HIV infection, and those that are traditionally associated with cardiovascular diseases like dyslipidemia, smoking, obesity.

Risk Factors

Risk factors associated with increased incidence of cardiovascular diseases in AIDS include:

References

  1. ↑ Currie PF, Sutherland GR, Jacob AJ, Bell JE, Brettle RP, Boon NA (1995). “A review of endocarditis in acquired immunodeficiency syndrome and human immunodeficiency virus infection”. European Heart Journal. 16 Suppl B: 15–8. PMID 7671917. Unknown parameter |month= ignored (help)
  2. ↑ Lichtenstein KA, Armon C, Buchacz K; et al. (2013). “Provider compliance with guidelines for management of cardiovascular risk in HIV-infected patients”. Preventing Chronic Disease. 10: E10. doi:10.5888/pcd10.120083. PMC 3557014. PMID 23347705. Unknown parameter |month= ignored (help)
  3. ↑ Savès M, Chêne G, Ducimetière P; et al. (2003). “Risk factors for coronary heart disease in patients treated for human immunodeficiency virus infection compared with the general population”. Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America. 37 (2): 292–8. doi:10.1086/375844. PMID 12856222. Unknown parameter |month= ignored (help)
  4. ↑ Kaplan RC, Kingsley LA, Sharrett AR; et al. (2007). “Ten-year predicted coronary heart disease risk in HIV-infected men and women”. Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America. 45 (8): 1074–81. doi:10.1086/521935. PMID 17879928. Unknown parameter |month= ignored (help)


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Screening

Screening

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ramyar Ghandriz MD[2]

Overview

There is insufficient evidence to recommend routine screening for HIV induced pericarditis.

Screening

There is insufficient evidence to recommend routine screening for HIV induced pericarditis.

References

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Natural History, Complications and Prognosis

Natural History, Complications and Prognosis

Diagnosis

Diagnosis

Diagnostic study of choice | History and Symptoms | Physical Examination | Laboratory Findings | Electrocardiogram | X-Ray Findings | Echocardiography and Ultrasound | CT-Scan Findings | MRI Findings | Other Imaging Findings | Other Diagnostic Studies

Treatment

Treatment

Medical Therapy | Interventions | Surgery | Primary Prevention | Secondary Prevention | Cost-Effectiveness of Therapy | Future or Investigational Therapies

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Varun Kumar, M.B.B.S.; Lakshmi Gopalakrishnan, M.B.B.S.

Treatment

  • Mostly idiopathic and resolves spontaneously.
  • However, asymptomatic effusions in HIV occur in advanced stages of the disease or they signal the onset of full-blown AIDS. These asymptomatic effusions require treatment to improve survival.[1] HAART therapy has significantly reduced the incidence and severity of cardiac complications associated with HIV.[2][3]
  • Requires pericardiocentesis for both therapeutic and diagnostic purposes, to identify possible etiology.
  • Occurs in 33-40% of patients.[4]
  • Warrants immediate pericardiocentesis and a catheter is placed in the pericardial sac for the next 48 hours to continuously drain fluid by underwater-seal suction.
  • Other causes of pericarditis, including bacterial and fungal infections, should be identified and treated accordingly.

Supportive Trial Data

  • The incidence of pericardial effusion in patients with asymptomatic AIDS was 11% per year before the introduction of effective highly active antiretroviral therapy (HAART). The 6 month survival rate of AIDS patients with effusion was significantly shorter (36%) than the survival rate without effusions (93%). This shortened survival rate remained statistically significant after adjustment for lead-time bias and was independent of CD4 count and albumin levels.[15]

References

  1. ↑ Barbaro G (2003) Pathogenesis of HIV-associated cardiovascular disease. Adv Cardiol 40 ():49-70. PMID: 14533546
  2. ↑ Ntsekhe M, Hakim J (2005) Impact of human immunodeficiency virus infection on cardiovascular disease in Africa. Circulation 112 (23):3602-7. DOI:10.1161/CIRCULATIONAHA.105.549220 PMID: 16330702
  3. ↑ Sudano I, Spieker LE, Noll G, Corti R, Weber R, Lüscher TF (2006) Cardiovascular disease in HIV infection. Am Heart J 151 (6):1147-55. DOI:10.1016/j.ahj.2005.07.030 PMID: 16781213
  4. ↑ Chen Y, Brennessel D, Walters J, Johnson M, Rosner F, Raza M (1999) Human immunodeficiency virus-associated pericardial effusion: report of 40 cases and review of the literature. Am Heart J 137 (3):516-21. PMID: 10047635
  5. ↑ Flum DR, McGinn JT, Tyras DH (1995) The role of the ‘pericardial window’ in AIDS. Chest 107 (6):1522-5. PMID: 7781340
  6. ↑ Gouny P, Lancelin C, Girard PM, Hocquet-Cheynel C, Rozenbaum W, Nussaume O (1998) Pericardial effusion and AIDS: benefits of surgical drainage. Eur J Cardiothorac Surg 13 (2):165-9. PMID: 9583822
  7. ↑ Ziskind AA, Pearce AC, Lemmon CC, Burstein S, Gimple LW, Herrmann HC et al. (1993) Percutaneous balloon pericardiotomy for the treatment of cardiac tamponade and large pericardial effusions: description of technique and report of the first 50 cases. J Am Coll Cardiol 21 (1):1-5. PMID: 8417048
  8. ↑ Marcy PY, Bondiau PY, Brunner P (2005) Percutaneous treatment in patients presenting with malignant cardiac tamponade. Eur Radiol 15 (9):2000-9. DOI:10.1007/s00330-004-2611-y PMID: 15662494
  9. ↑ Small PM, Schecter GF, Goodman PC, Sande MA, Chaisson RE, Hopewell PC (1991) Treatment of tuberculosis in patients with advanced human immunodeficiency virus infection. N Engl J Med 324 (5):289-94. DOI:10.1056/NEJM199101313240503 PMID: 1898769
  10. ↑ Sunderam G, McDonald RJ, Maniatis T, Oleske J, Kapila R, Reichman LB (1986) Tuberculosis as a manifestation of the acquired immunodeficiency syndrome (AIDS). JAMA 256 (3):362-6. PMID: 3723722
  11. ↑ Syed FF, Mayosi BM (2007) A modern approach to tuberculous pericarditis. Prog Cardiovasc Dis 50 (3):218-36. DOI:10.1016/j.pcad.2007.03.002 PMID: 17976506
  12. ↑ 12.0 12.1 Levine AM (1992) AIDS-associated malignant lymphoma. Med Clin North Am 76 (1):253-68. PMID: 1727539
  13. ↑ Licci S, Narciso P, Morelli L, Brenna A, Cione A, Abbate I et al. (2007) Primary effusion lymphoma in pleural and pericardial cavities with multiple solid nodal and extra-nodal involvement in a human immunodeficiency virus-positive patient. Leuk Lymphoma 48 (1):209-11. DOI:10.1080/10428190601019880 PMID: 17325873
  14. ↑ Sanna P, Bertoni F, Zucca E, Roggero E, Passega Sidler E, Fiori G et al. (1998) Cardiac involvement in HIV-related non-Hodgkin’s lymphoma: a case report and short review of the literature. Ann Hematol 77 (1-2):75-8. PMID: 9760158
  15. ↑ Heidenreich PA, Eisenberg MJ, Kee LL, Somelofski CA, Hollander H, Schiller NB; et al. (1995). “Pericardial effusion in AIDS. Incidence and survival”. Circulation. 92 (11): 3229–34. PMID 7586308.

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