Tuberculosis is an opportunistic infection caused by the bacteria Mycobacterium tuberculosis. The infections occurring in people with weak immunity as compared to the people with a healthy immune system are called as opportunistic infections. As, HIV enters the human body, it replicates and weakens the immune system which in turn increases the risk of contracting Tuberculosis in people already suffering from HIV infection.

An HIV and Tuberculosis co-infection occurs when an individual has both, the HIV infection and an either latent or active TB disease simultaneously.  Each disease acts in speeding up the progress of the other, when HIV and TB infection is present together in the body. HIV infection speeds up the progression from latent to active Tuberculosis, Mycobacterium tuberculosis also accelerates the progression of replication and spread of the HIV infection.

HIV infection and Tuberculosis are totally different type of infectious diseases. HIV is a viral infection and TB is a bacterial one. An HIV infected person will not contract TB unless a contact happens with a TB infected person. TB spreads via droplet infection and is communicable. If a person lives in a country with a high prevalence rate of TB, an HIV patient is highly susceptible to contracting the infection. In the similar manner, a person suffering from TB gets infected with the HIV infection only through the blood and bodily fluids borne route, with unprotected sexual intercourse with an HIV infected individual being the most important cause.

Amongst all the other opportunistic infections, TB occurs at an earlier stage in the course of an HIV infection than most other opportunistic infections. Mortality rate in the co-infected patients is more than twice that of HIV infected individuals without a TB infection. Even if a patient is undergoing anti-retroviral therapy, the death rates remain high in co-infected individuals.The natural history and course of TB gets altered in people with an infected immune system. The damage to immunity due to HIV infection causes a drastic reduction in the pathogen killing capacity of the body. In such patients if there is no anti-retroviral treatment prescribed, then the latency period between the infection and progression of disease gets eliminated. 

An active phase of TB is observed in such individuals progressing within a short span of time, ranging from weeks to months, rather than years as it normally should be spanning. Risk of progression from a latent stage to an active stage of TB is around 10-15 times greater in an HIV infected individual as compared to the non-infected person. Such individuals also communicate the disease more rapidly to others.Pulmonary tuberculosis in an HIV infected person can present similar symptoms like that of a classic TB disease. However, a co-infection can sometimes show less presenting TB symptoms, where even the chest X-ray scans can be observed to be normal. A  subclinical  phase of Tb in co-infected patients can cause delay in the diagnosis of the symptoms and subsequently affect the prognosis due to lack of timely treatment.

Social stigma and discrimination has caused an obstacle in provision of adequate treatment for people with HIV. Proper counseling  and initiatives taken to provide indiscriminate care can aid in identification of co-infection and earlier stages. Anti-retroviral treatment teamed up with anti-tubercular drug regimen is prescribed and a successful treatment for drug sensitive cases of TB can be provided with medications for 6-8 months.

How HIV & TB  Are Related?

Although your body is already in possession of the bacteria leading to tuberculosis, your immune system is able to prevent you from becoming sick. Doctors have made a distinction between latent and active tuberculosis (TB). In case of latent TB, the bacteria in the body in a passive state and it causes no symptoms, and therefore it is not contagious. But, in the case of active TB, you would become sick and may even spread the disease to others. It can take place in the first few weeks or even after several months of being infected with TB bacteria.

What are the symptoms of active TB?

If you are coughing for over three weeks and sometimes even coughing up blood, it can be a sign of TB. 
Chest pain and pain while coughing and breathing along with fatigue, fever, chills and night sweat are the common symptoms of TB along with loss of appetite and unintentional weight loss. TB may even affect other organs of your body, including your brain, spine and kidneys. 
When TB takes place outside the lungs, then the signs of TB can vary as per the organs that are involved. For instance, TB in the spine can cause back pain and that in kidneys may cause blood in the urine.
What are the causes of TB?
TB is caused by a bacteria which spreads from individual to individual via the microscopic droplets that are released into the air. This may happen when an affected person is left untreated and he speaks or sneezes or coughs or laughs. 

Though the disease is contagious, it is not easy to be affected by it. As a result, you are much more likely to get affected with active tuberculosis from a person you live with or come in regular contact with, rather than a stranger. It is important to note here that people who are affected with TB and going through proper medications for over two weeks are no more contagious.

Right from the 1980s, the number of individuals affected with TB has increased dramatically, owing to the spread of HIV, which is the virus known for causing AIDS. A person infected with HIV has a weak immunity system as a result of which it becomes difficult for the body to deal with TB bacteria. So those who have AIDS are more likely to be affected with active TB and sometimes the latent form also progresses to an active one very quickly. Therefore, it is important to seek medical assistance and detect if you have any such health complications concerning TB.

Tuberculosis - Watch Out For These Warning Signs!

Asthma is a condition that severely affects the lungs. The airways become narrow and the lungs become inflamed. Its characteristic features include bronchospasm, reversible airflow obstruction and variable and recurring symptoms such as coughing, wheezing, shortness of breath and chest tightness. This might be caused up to 2 to 3 times a day.
Causes
Causes include:
1. Daily use of paracetamol
2. Vaccines
3. Daily use of antibiotics
4. Caesarean sections
5. Asthma in family

Asthma is usually triggered by:
1. Tobacco smoke
2. Exercise
3. Polluted or poor air
4. Cold air
5. Emotional stress
6. Allergies

Homeopathic treatment
Asthma should be preferably treated using homeopathy. It is safe for most age groups. Asthma is a chronic problem that is best treated by a qualified homeopath. While few cures are found in numerous home use packs since they can treat a number of problems, the effective treatment of asthma usually needs potencies and changes of cures more than the extent of a prescriber and a home kit. For best results, the monitoring of a qualified homeopath should be sought. The homeopathic cures required for asthma change according to the signs of the sufferer. Some of them are listed below:

1. Arsenicum album (ars.): symptoms requiring the use of this medication include wheezing with dry cough and asthma caused due to cold air. Upon application, the person will be anxious and restless and the condition worsens after midnight. Sometimes, it might result in exhaustion. There is a chilling sensation and they will crave for warmth. Patients required ars. Will be critical, anxious and afraid of being alone.

2. Kali bichromicum (kali-bi.): symptoms that require kali-bi include asthma with stringy and sticky mucus. The patients feel chilly and after a while they get sick. The respiratory tract often is infected with mucous membrane infections. Ulcers are an additional infection.

3. Antimoniumtartaricum (ant-t.): uncomfortable breathing and wet cough with mucus require this medication. It solves many issues that accompany difficult breathing. In severe cases, heart failure is possible.

4. Grindelia (grin.): key symptoms are dry cough and possibility of wheezing. It may be accompanied by rattling respiration, chronic bronchitis and suffocation during sleep.

5. Phosphorus (phos.): upper respiratory tract infections cause asthma that ends in the chest. This causes coughing and wheezing.

Other homeopathic medicines for treating asthma are nux vomica (nux-v.) and pulsatilla pratensis (puls.).

Homeopathic Treatment for Asthma

The symptoms of tuberculosis (tb), which is active might vary and depend on which part of the body is infected. Diagnosing tb just from its symptoms can be a difficult, as the symptoms are not for tb alone meaning the symptoms can be of other diseases as well. For the confirmation and diagnosis of tb one must get a test done for tb. However, the general symptoms of tb are tiredness, weakness, weight loss, loss of appetite, fever, chills and night sweats.

Symptoms of pulmonary tb
Pulmonary tb is the tb of lungs. The symptoms of this are bad cough, which might have lasted for more than 3 weeks, chest pain, blood or phlegm might occur on coughing.

Extrapulmonary tb
The tb of any body part other than pulmonary is called extrapulmonary tb. This type of tb does not affect the lungs with the exception being the extrapulmonary tb also known as pleural tb. General symptoms of extrapulmonary tb are same as general symptoms of pulmonary tb.

Symptoms of lymph node tb
Lymph node tb also known as lymphadenitis is basically the enlargement and the inflammation of the lymph nodes. This is a response to the infections especially in children. The symptoms of this might be painless slow growing lymph nodes. These swollen lymph nodes can be in the neck area, though they might also be present in the groin. Lymph node tb of the neck is also called as scrofula or tb adenitis.

Symptoms of skeletal (bone and joint) tb
The common and the first symptoms are pain and depend on the area of the joint or the bone affected. Often it is marked with the loss of movement and curving of the affected bones and joints. The affected area also weakens and is prone to fractures.

Spinal tb is also called as pott disease or tb spondylitis
The symptoms of this depend on the affected site and the stage of the disease. However, back pain is one of the earliest symptoms.

Symptoms of meningitis tb
The meningitis tb starts with classical symptoms of meningitis. It usually starts with symptoms of pains and aches, fever and vague and unwell feeling. These might last for 2-8 weeks and then the evident symptoms like headaches, seizures, vomiting and stiffness might occur.

Symptoms of gastrointestinal or abdominal tb
This is marked with diarrhea, abdominal pain and bleeding from rectum and anus, though the symptoms depend on the exact site.

Symptoms of tb in children
The symptoms depend on the type and site, though the common ones being weight loss, fever and cough.

Symptoms of Tuberculosis

Pulmonary hypertension mainly occurs due to narrowing of the arteries of the lungs as a result of which the flow of blood is restricted. In this kind of condition, blood fails to carry oxygen to your heart and thus your heart gets adversely affected. The blood pressure of your body will get increased to a great extent if this situation remains untreated, thus leading to bdreadful consequenses, specifically situation like heart failure, serious pulmonary diseases, blood clots in lungs and congenial heart defects, etc.

There are certain forms of pulmonary hypertension, which are serious in nature and worsen with time, so much so that they are even fatal at times. It also includes forms which are non curable in nature, however, in order to improve the quality of life, symptoms can be reduced with proper treatment. The treatment for pulmonary hypertension is often complex and it takes some time to find the most appropriate treatment and requires extensive follow-up care. Your doctor might also need to change your treatment if it's no longer effective. However, when pulmonary hypertension is caused by another condition, your doctor will treat the underlying cause whenever possible.

Common treatments for pulmonary hypertension:

Medications

1. Blood vessel dilators (vasodilators): vasodilators open narrowed blood vessels. They are one of the most commonly prescribed vasodilators for pulmonary hypertension is epoprostenol (flolan, veletri). The drawback to epoprostenol is that the effect lasts only for few minutes. This drug is continuously injected through an intravenous (iv) catheter via a small pump that you wear in a pack on your belt or shoulder.

2. Ventavis: another form of the drug, iloprost (ventavis), can be inhaled six to nine times a day through a nebulizer, a machine that vaporizes your medication. Because it's inhaled, it goes directly to the lungs.

3. Treprostinil (tyvaso, remodulin, orenitram): it is another form of the drug, which can be given four times a day and can be inhaled or can be taken as an oral medication and can also be administered through injection.

4. Endothelin receptor antagonists: these medications reverse the effect of endothelin, a substance in the walls of blood vessels that causes them to narrow. These drugs may improve your energy level and symptoms. However, these drugs shouldn't be taken if you're pregnant. Also, these drugs can damage your liver and you may need monthly liver monitoring.

6. Sildenafil and tadalafil: sildenafil (revatio, viagra) and tadalafil (cialis, adcirca) are sometimes used to treat pulmonary hypertension. These drugs work by opening the blood vessels in the lungs to allow blood to flow through more easily.

6. High-dose calcium channel blockers: these drugs help relax the muscles in the walls of your blood vessels. They include medications, such as amlodipine (norvasc), diltiazem (cardizem, tiazac, others) and nifedipine (procardia, others). Although calcium channel blockers can be effective, only a small number of people with pulmonary hypertension respond to them.

7. Soluble guanylate cyclase (sgc) stimulator: soluble guanylate cyclase (sgc) stimulators (adempas) interact with nitric oxide and help relax the pulmonary arteries and lower the pressure within the arteries. These medications should not be taken if you're pregnant. They can sometimes cause dizziness or nausea.

8. Anticoagulants: your doctor is likely to prescribe the anticoagulant warfarin (coumadin, jantoven) to help prevent the formation of blood clots within the small pulmonary arteries. Because anticoagulants prevent normal blood coagulation, they increase your risk of bleeding complications. Take warfarin exactly as prescribed, because warfarin can cause severe side effects if taken incorrectly. If you're taking warfarin, your doctor will ask you to have periodic blood tests to check how well the drug is working. Many other drugs, herbal supplements and foods can interact with warfarin, so be sure your doctor knows all of the medications you're taking.

9. Digoxin: digoxin (lanoxin) can help the heart beat stronger and pump more blood. It can help control the heart rate if you experience arrhythmias.

10. Diuretics: commonly known as water pills, these medications help eliminate excess fluid from your body. This reduces the amount of work your heart has to do. They may also be used to limit fluid buildup in your lungs.

11. Oxygen: your doctor might suggest that you sometimes breathe pure oxygen, a treatment known as oxygen therapy, to help treat pulmonary hypertension, especially if you live at a high altitude or have sleep apnea. Some people who have pulmonary hypertension eventually require continuous oxygen therapy.

Surgeries

1. Atrial septostomy: if medications don't control your pulmonary hypertension, this open heart surgery might be an option. In an atrial septostomy, a surgeon will create an opening between the upper left and right chambers of your heart (atria) to relieve the pressure on the right side of your heart.

2. Lung transplantation: in some cases, a lung or heart lung transplant might be an option, especially for younger people who have idiopathic pulmonary arterial hypertension.

Reducing complications

1. The complications need to be reduced by taking proper health care. Healthy diet needs to be taken regularly along with proper medications. Smoking should be stopped and exercising sessions should be attended daily without any fail

2. Overweight or obesity needs to be controlled properly for reducing the complications. Specialized caring strategies need to be maintained for avoiding severe kinds of health complications that are quite annoying.

Pulmonary Hypertension: How to Treat It?

You are out in public, and a person next to you is incessantly coughing. It is natural to be worried if it is bronchitis and the possibility of you getting infected. Read on to know about the condition and if it is really contagious. Bronchial tubes are the airways in the lungs, and when they are inflamed due to an infection or an underlying medical condition, it results in bronchitis. Bronchitis can be acute or chronic and depending on the cause, may or may not be contagious.

Types of bronchitis
Chronic bronchitis occurs when the airways in the lungs get irritated again and again. Though it s a severe health condition that requires medical attention, it is not as contagious as it occurs due to the exposure to certain chemicals, dust, cigarette smoke or smoke from a fire, air pollutants that irritate the lungs.

On the other hand, acute bronchitis that usually lasts for one to three weeks is considered to be contagious because this particular type of bronchitis happens due to the flu or cold viruses. It is the infectious properties of the viruses causing it that makes it contagious.

Transmission
In the case of acute bronchitis, since it is caused mainly due to viral infections when an infected person coughs, sneezes or talks, the viruses get transmitted to others in the surrounding. Hence it can spread quickly.

Symptoms
Some of the common symptoms of acute bronchitis are a hacking cough, production of excessive mucus, shortness of breath, and feelings of discomfort in the chest. Note that as long as the infection is present, acute bronchitis remains contagious. Once the infection is gone, it is no longer contagious, though, the symptoms, like a persisting cough, may stay for several weeks afterward.

Prevention
Maintaining a healthy hygiene, such as washing hands regularly or keeping the surfaces clean, or using a handkerchief when coughing or sneezing can help in preventing the spread of the infection as well as getting affected with it. Also, taking flu vaccinations and quitting to smoke can also assist in preventing lung infections.

Treatment
For the majority cases of acute bronchitis, the condition is resolved by itself within a few weeks and antibiotics may not be an ideal treatment option if the acute bronchitis is caused by a virus. The most recommended treatment options that can quicken the recovery process are taking rest, opting for prescribed over-the-counter medications, drinking lots of fluids, inhaling the steam of hot water, whether from the shower or a bowl of hot water.

People who have asthma or chronic bronchitis sometimes may develop acute bronchitis as a result of further complications of their present lung conditions and not as a result of virus invasion. Therefore, the chances of such acute bronchitis being contagious are less than those caused by influenza viruses or bacteria.

Thus, acute bronchitis due to a viral infection is more contagious than chronic bronchitis that is due to an underlying medical condition like asthma and other lung diseases. With a few simple and effective measures, such contagious infections can be prevented.

Bronchitis - Can It Be Contagious?

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