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Lymph nodes and HIV

Symptom seen in early infection and more at a late stage of the disease

One of the most common symptoms of HIV is lymphadenopathy, a swelling of the lymph nodes in the armpits (axillary lymph nodes), groin (inguinal lymph nodes), neck (cervical lymph nodes), chest (mediastinal nodes), and abdomen (abdominal nodes) 0,1 While the swelling can be directly related to HIV, particularly in the early stages, it can also be the result of HIV-associated and non-HIV-associated infections in later illnesses.

Anatomy of Lymph nodes

Lymph nodes are small bean-sized organs distributed throughout the body that are part of the immune system.

Lymph, a clear white liquid that contains immune cells that fight infections, is filtered through the lymph nodes through a network of tiny capillaries. It is in the lymph nodes that the lymph is cleaned before returning to the circulation.

The lymphatic system comprises not only the lymph nodes, but also the spleen, the thyroid, the tonsils, the adenoids and the lymphoid tissues.

Causes of lymphadenopathy

A linfadenopathy is a characteristic sign of HIV and a characteristic of many opportunistic infections (OIs) at a later stage. Lymphadenopathy is not usually a symptom of malignancy, but Hodgkin's lymphomas can present in people with advanced HIV. During early acute infection, as the lymph passes through the lymph nodes, a large number of immune cells and other microbes begin to accumulate in the glands. This can cause the system to effectively back up, causing the nodes to swell, sometimes in unpleasant proportions. Lymphadenopathy can occur in one or more parts of the body, the pattern of which can tell us a lot about what is happening.

  • Localized lymphadenopathy it is the swelling of the lymph nodes in a specific part of the body, probably due to an infection. Examples include an infection in the throat that causes swelling of the cervical nodes or a chlamydia infection that causes swelling of the inguinal nodes.
  • Generalized lymphadenopathy is the generalized swelling of lymph nodes throughout the body, suggesting a systemic infection of the whole body, like flu, infectious mononucleosis, tuberculosis, toxoplasmosis, leukemia and HIV.
  • Persistent generalized lymphadenopathy (PGL) it is a type that persists, usually with no apparent cause. It is usually an indication of an untreated chronic infection, such as hepatitis and HIV. PGL can persist for months or even years.

Sometimes, the lymph nodes themselves can become inflamed and infected. This is often called lymphadenitis.

Symptoms of lymphadenopathy

An illustration that seeks to show the lymphatic system

The swollen lymph nodes may or may not be visible. In fact, discomfort and pain are often the first signs of lymphadenopathy before the actual swelling starts.

Even though they are not easily apparent, you can usually feel the enlarged knots under an armpit, around the neck, behind the ears or in the groin.

In some cases, you may feel a single enlarged node. Other times, there may be a set of swollen glands located in various parts of the body.

Although the lymph nodes are usually painful, at theSometimes they can be completely painless.

The skin covering the nodes can also be red and warm to the touch.

Fever can accompany, especially during acute infection.

Treatment of lymphadenopathy due to HIV and Lymph Nodes

To the people with HIV and lymph nodes, the first and main means of treating lymphadenopathy is antiretroviral therapy.

By completely suppressing HIV to undetectable levels, the stress on the lymph nodes can be greatly reduced. Lymphadenopathy usually resolves within a few weeks or months after starting treatment.

Even if lymphadenopathy is caused by a opportunistic infection, antiretroviral therapy is still considered a must. When treating opportunistic infection while suppressing HIV with antiretroviral drugs, a person has a much greater chance of restoring immune function and prevent future infections. If lymphadenopathy is especially painful, a non-steroidal anti-inflammatory drug (NSAID) like ibuprofen can help.  This, with a hot compress, can help reduce any inflammation or swelling.  

Translated by Cláudio Souza de  HIV and Swollen Lymph Nodes by Mark Cichocki, RN Medically reviewed by Latasha Elope, MD, MSPH Updated May 21, 2020 HIV / AIDS

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