Background:
Echocardiography is a practical, non-invasive tool for estimating pulmonary artery pressures and assessing right-heart structure and function. Pulmonary hypertension (PH) occurs more frequently among people living with HIV than in the general population, yet data from African populations remain limited. The development of HIV-associated PH is likely multifactorial, involving recurrent respiratory infections, thromboembolic disease, chronic inflammation, and intrinsic right-heart pathology. In view of these considerations, this study aimed to determine the prevalence of echocardiographically defined pulmonary hypertension among HAART-naïve adults living with HIV and to evaluate the relationship between estimated pulmonary artery pressures and right-heart structural and functional parameters

Methods

This prospective, descriptive cross-sectional case–control study was performed at the University of Port Harcourt Teaching Hospital from July 2011 to July 2014. The trial comprised two hundred HAART-naïve HIV-positive persons and one hundred HIV-negative controls, all matched for age and sex, and devoid of hypertension, diabetes, or known cardiac illness. Everyone who took part got an echocardiogram. The modified Bernoulli equation was used to figure out the pulmonary artery systolic pressure (PASP). We used SPSS to look at the data, and we set the significance level at p<0.05.

Results:
Among 200 HAART-naïve HIV participants (mean age 33.13 ± 8.4 years), pulmonary regurgitation was more frequent than tricuspid regurgitation (35% vs 27.5%), both occurring more often than in controls. Estimated PASP and PADP were higher in the HIV group (19.31 ± 10.3 vs 13.60 ± 5.3 mmHg; 17.92 ± 8.1 vs 14.41 ± 6.0 mmHg). Pulmonary hypertension was present in 7.5%. Tricuspid regurgitation was associated with right atrial and ventricular dilatation. PASP correlated positively with tricuspid E/A (r = 0.68), while PADP correlated inversely with right ventricular ejection fraction (r = −0.80).

Conclusion:
HAART-naïve adults with HIV demonstrated higher pulmonary artery pressures and a 7.5% prevalence of pulmonary hypertension. Right-heart remodeling and the inverse PADP–RVEF relationship suggest early right-sided cardiac involvement in untreated HIV.