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Chest infections are common - AIDS

The most common infection is a chest infection. A twenty-three-year-old man walks into his doctor's office with a chest infection not responding to antibiotics. He is flushed and has a high temperature. He has been increasingly short of breath with a dry cough for several weeks. He becomes breathless and has an emergency chest X-ray. The X-ray is strange. No one has seen anything like it before. Could this be AIDS? Samples are taken from the lung. The man is rushed to intensive care and is too ill to ask if he would agree to a blood test. Within two days he is dead. A strange germ is found in his lung: pneumocystis carinii. This is incredibly rare except in AIDS.

He may or may not be reported as a statistic to the centre collecting information on AIDS. This is voluntary and doctors are busy. If he had died a day or two earlier, the cause of death would have been thought to be pneumonia. Yet another silent victim, unnoticed and unrecorded. Our statistics may be incomplete, and remember, no test was done for HIV.

He was unlucky. Average life expectancy if you develop your first pneumocystis pneumonia is just over two years. 78% survive the first episode, only 40% survive the second. You could live for over three years, or you might be dead in three months. Each new chest infection could be your last. Often people seem only an hour or two from death, then pull around, recover completely, and go home for several months until the next crisis.

We know that eighty-five out of a hundred people with these chest infections in Western nations are infected with pneumocystis carinii, but many are infected with several things at once. Worldwide, the commonest HIV-related chest infection is tuberculosis. As HIV spreads, TB is on the increase, with possibly a million extra cases a year at present as a result of HIV. Latent TB infection is common in the general population. HIV damage to CD4 white cells allows reactivation, rapid deterioration and death.