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It is true that pulmonary blood hypertension is a haemodynamic diagnosis established through a right-sided catheterisation with measurement of mean pulmonary blood pressure and ruling out its postcapillary origin through a measurement of pulmonary capillary pressure. In our series<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a>, as in all other studies in populations infected with human immunodeficiency virus (HIV)<a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">2–4</span></a>, we chose to screen patients using transthoracic echocardiography (TTE) and, based on this technique, we established a prevalence of 5.5%, similar to the other published series, both in our context and in other countries. In our case, patients with pulmonary systolic pressure (PSP) measured by TTE above 36<span class="elsevierStyleHsp" style=""></span>mmHg were referred to the Pulmonary Hypertension (PHT) unit of our Cardiology Service, where a clinical assessment, a further TTE to confirm this, and an aetiological study were performed in search of other potential causes of PHT, such as: pulmonary disease and/or hypoxaemia, thromboembolic disease, connective tissue disease, portal hypertension, haematological, metabolic or systemic disorders, or veno-occlusive disease. The TTE would also allow us to identify findings consistent with left-sided heart disease as a potential aetiological factor in PHT. For this study we followed the standard PHT consultation protocol of our Cardiology Service. A clinical and echocardiographic follow-up was performed in patients with PSP from 37 to 50<span class="elsevierStyleHsp" style=""></span>mmHg, and catheterisation was performed on patients with PSP ><span class="elsevierStyleHsp" style=""></span>50<span class="elsevierStyleHsp" style=""></span>mmHg on TTE confirmation or on patients with PSP ><span class="elsevierStyleHsp" style=""></span>36<span class="elsevierStyleHsp" style=""></span>mmHg and symptoms. This happened in 2 cases. One of the patients rejected catheterisation, and the second received it. The catheterisation confirmed diagnosis of severe PHT of precapillary origin, with absence of vasoreactivity in the acute vasodilator test, and the patient is currently under treatment with bosentan and increasing doses of sildenafil. The patient receives tenofovir, emtricitabine and raltegravir as antiretrovirals, and is in a good viroimmunological situation.</p><p id="par0010" class="elsevierStylePara elsevierViewall">Consequently, we can confidently say that we undertook a complete assessment of patients who, using the screening technique, obtained positive results, and followed the standard procedure in the rest of the series, in accordance with the agreed European and US echocardiographic criteria<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">5</span></a> in force at the time our study was carried out. The cases reported as of global prevalence came from an extensive joint study by the HIV Infection Unit and the PHT clinic at our hospital and, therefore, to be strictly accurate, we should change the title of our study to “Pulmonary hypertension in human immunodeficiency virus-infected patients: the role of antiretroviral therapy” (“<span class="elsevierStyleItalic">Hipertensión arterial pulmonar en pacientes con infección por el virus de la inmunodeficiencia humana: papel del tratamiento antirretroviral</span>”). The message that we are trying to communicate through this type of study is none other than to raise awareness among clinicians attending patients infected with HIV that there are very serious conditions which may require specific proactive diagnosis, and that our patients may benefit from this, as in the case of autoimmune disease.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Olalla Sierra J, Pombo Jiménez M, de la Torre Lima J, del Arco Jiménez A. Respuesta. Med Clin (Barc). 2015;144:137–138.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:5 [ 0 => array:3 [ "identificador" => "bib0030" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Hipertensión pulmonar en pacientes con infección por el virus de la inmunodeficiencia humana: papel del tratamiento antirretroviral" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "J. Olalla" 1 => "D. Urdiales" 2 => "M. Pombo" 3 => "A. del Arco" 4 => "J. de la Torre" 5 => "J.L. 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Baptista" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Arq Bras Cardiol" "fecha" => "2008" "volumen" => "90" "paginaInicial" => "11" "paginaFinal" => "17" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18317635" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0050" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Guidelines for the diagnosis and treatment of pulmonary hypertension: 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 of Heart and Lung Transplantation (ISHLT)" "autores" => array:1 [ 0 => array:3 [ "colaboracion" => "ESC Committee for Practice Guidelines (CPG)" "etal" => true "autores" => array:6 [ 0 => "N. Galiè" 1 => "M.M. Hoeper" 2 => "M. Humbert" 3 => "A. Torbicki" 4 => "J.L. Vachiery" 5 => "J.A. Barbera" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1093/eurheartj/ehp297" "Revista" => array:6 [ "tituloSerie" => "Eur Heart J" "fecha" => "2009" "volumen" => "30" "paginaInicial" => "2493" "paginaFinal" => "2537" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19713419" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/23870206/0000014400000003/v1_201510132016/S238702061500056X/v1_201510132016/en/main.assets" "Apartado" => array:4 [ "identificador" => "43309" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Letters to the Editor" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/23870206/0000014400000003/v1_201510132016/S238702061500056X/v1_201510132016/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S238702061500056X?idApp=UINPBA00004N" ]
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