HIV-associated pulmonary arterial hypertension: improving survival despite persistent treatment gaps – a systematic review and meta-analysis

HIV-associated pulmonary arterial hypertension (HIV-PAH) is rare and understudied. We pooled 12 right heart catheterization–confirmed cohorts ( n  = 537, 1986–2021) and found that HIV-PAH presents with severe hemodynamics and advanced functional limitation, with only 64% receiving PAH-targeted therapy at diagnosis. Survival improved progressively over three decades alongside increasing therapy use. These findings highlight persistent treatment gaps and support consideration of contemporary combination PAH therapy in people with HIV-PAH.