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3.1 – What are the rehabilitation interventions that address impairments common among people living with HIV?

3.1.4: Functions of the cardiovascular, hematological, immunological and respiratory systems

People living with HIV experience impairments related to the heart, blood pressure, hematological system (blood), immune system (including allergies, hypersensitivity) and respiration (breathing).

Possible causes of these impairments include primary HIV infection or secondary bacterial and fungal infections such as cytomegalovirus, Pneumocystis Carinii Pneumonia (PCP) or Tuberculosis (TB). Malignancy such as Kaposi's sarcoma and Non-Hodgkin’s Lymphoma are also secondary complications which affect the cardiovascular, hematological, immunological and respiratory systems. These impairments can also be caused by side effects of medications.

Rehabilitation interventions include chest physiotherapy, aerobic and strength exercise, pain management and adaptation of environment. Potential causes of these impairments and rehabilitation interventions are shown in the table below.

Table 3.1.4: Clinical Aspects of Cardiovascular, Hematological, Immunological and Respiratory Impairments

Impairment Possible Etiologies Rehabilitation Interventions5
(for details, see Section 3.3)

Impairments related to cardiac dysfunction
(e.g., angina pain, anxiety, decreased endurance)

Myocarditis or endocarditis (e.g., from bacterial or fungal infection)

 

Cardiomyopathy (e.g., from viral pathogens or side effects of medication)

Pericarditis or pericardial  effusion (e.g., resulting from infections from multiple pathogens)

Coronary artery disease (e.g., resulting from side effects of medication)

Peripheral vascular disease (e.g., resulting from viral pathogens)

Shortness of breath and other respiratory impairments

Acute lung disease (e.g., pneumonia)

Malignancies (e.g., Kaposi’s sarcoma, Non-Hodgkins Lymphoma)

 

5Choice of rehabilitation interventions will depend on patient assessment and available resources.