University of Colorado, Denver – PAH: Inclusion/Exclusion Criteria

Inclusion Criteria

• Infection with HIV greater than 6 months in duration
• Mild to severe pulmonary hypertension as defined by a right heart catheterization with mean PAP > 25 mm Hg at rest or > 30mm Hg with exercise, and pulmonary capillary wedge pressure < 15mm Hg and pulmonary vascular resistance > 3 units
• Stable antiretroviral regimen for the past 6 months or no meds for the past 6 months
• Absence of other potential causes of pulmonary hypertension such as pulmonary parenchymal disease with hypoxia, chronic thromboembolic disease, chronic liver disease, congenital heart defects, or collagen vascular disease
• Willingness to undergo research bronchoscopy once a year
• Willingness to undergo right heart catheterization every other year
• Ability to provide reliable history of HIV medications or has received the majority of medical care from San Francisco General Hospital with available records of medical treatment
• Ability to participate in follow-up for the duration of the study

Exclusion Criteria

• Known significant cardiovascular disease, including clinically significant valvular heart disease, congenital heart disease, current or prior symptomatic coronary disease, or known cardiomyopathy
• Any known pulmonary disease that could potentially cause pulmonary hypertension
• A p02 by pulse oximetry below 90% on room air
• Obstructive sleep apnea
• Known collagen vascular disease
• History of anorexigen use
• Other comorbidities for which the investigators, in conjunction with the primary care provider, believe to render the participate with an expected survival of 6 months or less
• Age less than 18 years old
• Current pregnancy or lactation
• Any of the following medical conditions:  Severe renal insufficiency (on hemodialysis or serum creatinine clearance > 2.5mg/dl) or severe coagulopathy (platelets < 100,000, PT INR > 1.5, PPT > 40 s
• Contraindications to bronchoscopy