HIV induced pericarditis medical therapy

• Asymptomatic with mild to moderate pericardial effusion:

• 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]

• Large pericardial effusions with unknown etiology:

• Empiric antituberculous therapy for M.tuberculosis have shown some benefit in patients with AIDS.^[4][5][6]

• Other causes of pericarditis, including bacterial and fungal infections, should be identified and treated accordingly.

• Pericarditis due to lymphoma:

• Radiation and chemotherapy have been tried.^[7][8] However, the response has been transient,^[9] and the associated chemotherapy has significantly increased the risk of death secondary to opportunistic infections.^[7]

• 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.^[10]

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