HIV and respiratory problems

HIV (human immune deficiency virus) infection is known to increase susceptibility to infections and malignancies in the body. The affected person is known to suffer from many different kinds of infectious diseases and tends to remain chronically sick. Along with the other health related problems, most common and troublesome are the problems related to the respiratory system. Two thirds of the HIV affected persons suffer from problems related to the respiratory system at any point or phase of their illness. In early stages of HIV infection, one becomes more prone to develop repeated respiratory tract infections. Thus frequently or chronically he suffers from cold, sneezing, cough, throat pain, ear pain and ear discharge. There can be either one of these problems or many of these problems, may co exist. As the CD4 count (an indicator of the immune status of the individual) goes down further, the immunity reduces proportionately. Thus the individual becomes more prone to develop severe and serious respiratory system infections like acute bronchitis and pneumonia. These patients are also at risk of developing atypical pneumonias. The probability of having pulmonary T.B. is increased manifold in these patients. In fact T.B. is one of the most common opportunistic infection (infections which occur when body’s immunity is reduced) in HIV/AIDS patients. When they develop tuberculosis, it is atypical in presentation and occurs in more severe form as compared to people with a healthy immune system. These patients are also at risk of developing atypical pneumonias. Along with fungal infections of the skin, they are also prone to develop fungal infections of the lungs. These pulmonary fungal infections are difficult to diagnose because they mimic pulmonary T.B. clinically as well as radiologically. One has to suspect their presence then confirm by means of sputum examination which may show the fungal hyphae. In severe immune depressed states, patients can have pneumocystis carinni pneumonia, in spite of taking drugs to prevent it. This is a fungal infection of the lungs which manifests as high fever and breathlessness. It again needs suspicion on part of the treating physician to detect it. Apart from infections these people are also prone to develop tumors of the lung like Kaposi’s sarcoma, e.t.c. Due to these various affections of the respiratory system, these individuals often suffer from cough, chest pain, hyperventilation, breathlessness in variable amounts. Along with cough they may be having bloody sputum, loss of appetite, fever and sweating. Thus the quality of life is affected and they are not able to do any productive work. Due to loss of appetite, their food intake is also reduced. Due to this problem they tend to suffer from chronic malnutrition. Chronic anemia if present augments problem of breathlessness. Protein deficiency can result in generalized swelling over the body. There can be associated fluid collection in the lungs which also causes breathlessness even on lying down. Chronic smoking or alcoholism damages the lungs further thus augmenting the sickness. HIV positive people working in fields or construction sites, where there is much exposure to dust or in case of women who are exposed chronically to smoke while cooking, are more prone to have more severe respiratory problems due to chronic damage to lungs. Considering the big spectrum of respiratory problems HIV affected persons can face, it is best to prevent them. Healthy life style, good adherence with antiretroviral drugs and avoiding alcohol and smoking will certainly help in maintaining the physical strength of the individuals and improving immunity. Thus the chances of these troublesome opportunistic infections will be reduced and one can have a good quality of life in spite of HIV infection. rachna212002@yahoo.co.uk