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Swollen Glands/ Lyphnoids
Jan 4, 2002

Hi, I am finding it difficult to get any information about swollen glands. I was diagnosed positive in June 2001, in the very early stages. My CD count is 600+ and my viral load just dropped down to 6000 so I am feeling great and in general good health. However, since diagnosed I have had swollen glands and lymphnoids in my neck, throat, behind my ears and back of my neck. My neck becomes very sore and achy and the swelling never disappears. Is this a symptom that will always be with me or can I treat it??

Response from Dr. Frascino


Swollen glands are common with almost all infections, including HIV. The lymph glands are an integral part of your body's immune system. The fact that they are swollen indicates that your immune system is activated and fighting for you. It's not a bad sign and doesn't need to be specifically treated. In most cases, they will subside, although perhaps not completely resolve, over time as your body's immune system and the virus reach a sort of equilibrium. They may also go down if you are on effective antiretroviral medication. These medications can effectively turn off most of the HIV virus replication. With less virus around, there is less for your immune system to flight and interact with; therefore, the lymph nodes ("glands") shrink back toward their normal size. The reason they may never go back to completely "normal" is that we can't yet cure HIV. Therefore, there is always some virus present for the immune system to fight.

Your CD4 count is quite good and your viral load is dropping down, which is great. Perhaps you are on medications (HAART), in which case, look for further improvements with your viral load - hopefully becoming non-detectable - and further increases in your CD4 count. As this occurs, your lymph nodes may decrease in size. If you are not on medications, your immune system is handling the HIV infection quite well at the moment, i.e. high CD4 count and low viral load. The consequence of the immune system's fight to maintain control is hypertrophy (swelling) of the lymph nodes.

Hope that addresses your concerns.

Stay well.

Dr. Bob

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