Ciao Dr. Pavia; it's Anna from Italy, maybe you remember answering me some time ago. I'm pretty happy at the moment because the winter is passing and I didn't need yet any cortison cure for my platelets because their level remained normal. ITP is actually the only symptom I developed, I'm positive since at least 1997. At the moment the VL is around 1,000 and CD4 count is over 1,300. I'm not taking any anti-viral medication so far. My question is the following; the lymphnodes under my ears are quite often swelling, especially during the winter time and they're usually the first symptom of a pretty strong cold. Sometimes are just swelling, without influencing my health or temperature; I would like to understand why this is happening and if I shold consider a closer examination every time it's happening. We checked them with an echo but they don't seem to be dangerously growing. At the moment I'm testing my blood levels every 3 months and I just would like to keep everything under control. Many thanks for your usual kind attention and keep up the wonderful job. Anna

Ciao Anna,

I am glad to hear you are doing so well. Swollen lymph nodes beneath your ears are a very common finding in colds, sore throats, mouth sores and ear infections. The reason is that lymph nodes represent the local infection fighting resources for a region. Whether you have HIV or not, you will commonly get swollen lymph nodes in the front of the neck ("anterior cervical lymph nodes") with a cold. Intermittent swollen lymph nodes are also very common in people with untreated HIV infection and fairly good CD4 counts. It is likely that this stage represents a battle between the virus and the immune system.

We tend to worry about lymph nodes that keep growing, that are very large (over 1.5 cm is a guideline), are rock hard, or are in funny places, such as behind the collar bone. Lymph nodes that come and go are usually nothing to worry about, but it never hurts to have them checked out by someone who knows HIV take a look at them.

Regards ATP