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COPD lymph node

Jan 16, 2007

Dear Dr. Young, I'm poz for 2,5 years with CD-4 700 - 750, VL 1300-1360. I'm 27 yo and have been very healthy. Smoking - yes for 8 years but I quited smoking once I tested positive Sep 06. Since that time I started developing very strange half-dry cough and consulted a pulmonologist. She suspected COPD after several pulmonary function tests and X-ray etc. Surfing in the I-net I found some info about accelerated emphysema/COPD in HIV+, however it was all about people after 40 with longer smoking history. (I've been tested for TB - negative). COuld it really be COPD in 27? Are there any other HIV-associated health complication s with similar symptoms: chronical cough, shortness in breathing, the feeling of lack of oxygen? One more thing: with low viral load I have just one swollen lymph node for 3 months (I know it's possibly swollen for some other reason)in the triangle under my right ear, painless and around 1 cm. Is it normal that only 1 LN non-symmetrically swollen becuase of HIV? Thank you so much and regards from rainy Moscow, Russia.

Response from Dr. Young

Dobry dien, from frigid, snowy Colorado.

Thank you for your post and questions.

Chronic obstructive pulmonary disease (COPD, emphasema) appears to be more common among persons with HIV than HIV negatives. The reasons for this are unclear, but tobacco smoking seems to certainly be a contributor. Even though you've quit smoking, the earlier use may have contributed as can the second-hand exposure in Russia's notoriously smoke filled restaurants and clubs. It's certainly disheartening to hear about your medical findings at such a young age- but multiple pulmonary function tests can't be wrong. Chronic cough can certainly be caused by multiple conditions, though the shortness of breath is more likely associated with COPD than simple bronchitis. Early onset COPD can be associated with other medical conditions, including one called alpha-1 antrypsin deficiency, or other immune deficiencies (but these are usually manifest by sinus and lung infections from childhood). What's not clear is whether starting HAART (even with your high CD4 count) would offset any progression in the COPD, though it's tempting to speculate about this.

As for your small, solitary lymph node- this is not a uncommon finding among many patients, though deserves medical follow up. Should the node enlarge in size, or should more develop, I'd make sure that your doctors are aware of the changes.

I hope this helps, best of health to you. BY

To all the wonderful Dr.'s
Risk of tuberculosis/MAC infection to HIV negative caregivers.

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