Was it my imagination? Seeing four people with worsening asthma in one week had started me thinking: was asthma more of a problem for people with HIV now than it had been five, ten or fifteen years ago?
Some online research showed that asthma has been increasing generally in Australia. Surveys conducted by Adelaide University found that in South Australia, between 1990 and 2003, “asthma prevalence increased significantly, doubling in females (from 7.3% in 1990 to 14.6% in 2003), with a smaller increase in males (from 7.8% to 9.4%).”[1].
Overall, asthma prevalence in Australian adults is around 10 to 12 percent2.
But what about people with HIV? I couldn’t locate any recent Australian data but researchers at McGill University in Quebec, Canada had looked at this issue in 2001. Dr Pierre Ernst compared the prevalence of asthma and related conditions in 248 men with HIV with 236 comparable, randomly selected HIV-negative men3. What he found caused some concern.
Wheezing, in the last 12 months, was two and a half times more common in this study in men with HIV as it was in HIV-negative men (54 percent versus 21 percent). When asked “Have you ever had asthma?” 17 percent of men with HIV said they had, compared to 12 percent for HIV-negative guys.
For smokers the situation was worse. For guys with HIV, 66 percent of smokers had current wheezing compared to 35.8 percent of non-smokers.
These findings, and others not reported here, led Dr. Ernst to comment that “asthma may be under recognized and under treated among the HIV population.” Furthermore, “HIV-positive individuals may be particularly susceptible to the adverse effects of smoking and appear to be at high risk of developing early emphysema,” he wrote. This “may become a significant source of disability as HIV infection becomes better controlled.”
One of the best complementary therapy approaches to reducing asthma in the long-term is the breathing method developed by the Russian doctor and researcher Professor Konstantin Buteyko. ‘Buteyko breathing’ has been the subject of several clinical trials which have shown positive results for people with asthma.
The main Australian trial of Buteyko was conducted at the Mater Hospital in Brisbane in 19984. Thirty-nine people with asthma and significant use of asthma medications were selected. These medications are usually described as either ‘reliever’ medications (such as Ventolin) and are used to stop an asthma attack in the short-term, or ‘preventer’ medications, which are used to prevent asthma attacks occurring.
Of the 39 patients in the Brisbane trial, 20 received usual asthma education and were also taught a physiotherapy breathing technique for treating asthma. The other 19 were taught Buteyko breathing.
After three months the Buteyko group had average reductions of 76 percent in asthma symptoms, 96 percent in use of reliever medication and 49 percent in preventer medication. The people in the control groupA group of patients in a clinical trial who do not receive the drug or treatment being investigated, for the purpose of comparison with those who do. Participants in the control group of a clinical trial are either given standard treatment (excluding the drug being studied) or a placebo. showed no significant changes in these three areas.
A similar trial conducted at Gisborne Hospital in New Zealand found that six months after completing Buteyko training, people with asthma’s use of reliever medication had dropped by 85 percent and preventer medication by 50 percent6. This compared to the control group who reduced their reliever medications by 37 percent with no change in use of preventer drugs.
Researchers concluded that “Buteyko breathing technique is a safe and efficacious asthma management technique.”
The largest trial conducted so far, and with the longest follow-up period, was carried out in London and included 384 people with asthma5. Six months after completing basic training in Buteyko, participants in this trial had an average reduction in asthma symptoms of over 90 percent. This allowed them to reduce their use of reliever and preventer medications by over 90 percent as well. These improvements were maintained at 12 months follow-up.
Buteyko seems to be a revolutionary approach to treating asthma. It offers a drug-free option for asthma management and appears to have a very high success rate. Is it too good to be true?
To check this out for myself I arranged to sit in on several Buteyko classes. These classes typically run for one evening per week for six weeks. I spoke with or listened to around 60 people with asthma – some with relatively mild symptoms and some with severe problems. Virtually everyone who completed the classes and did the breathing exercises as instructed reported obvious benefit – usually starting after only one or two weeks.
A downside is the classes are relatively expensive. However, as one teacher pointed out, people with asthma recover their costs fairly quickly in reduced medication expenses.
Because asthma can be very serious, it’s important to consult a qualified practitioner and discuss your decision with your doctor before making any changes to your asthma management.
Jim Arachne is the Complementary Therapy Treatment Officer for the Victorian AIDS Council. Complementary therapiesA broad range of healing philosophies, approaches, and therapies that Western (conventional) medicine does not commonly use to promote well-being or treat health conditions. Examples include acupuncture, herbs, Traditional Chinese Medicine, etc. information published in Positive Living is intended for symptomatic relief only.
References
1 Trends in asthma prevalence and population changes in South Australia, 1990-2003. Wilson DH., et al., Med J Aust. 2006 Mar 6;184(5):226-9.
2 Asthma in Australia 2005, Guy B Marks, et al., MJA 2005; 183 (9): 445-446
3 Prevalence of bronchial hyperresponsiveness among HIV-infected men. Poirier CD., Am J Respir Crit Care Med. 2001 Aug 15;164(4):542-5.
4 Buteyko breathing techniques in asthma: a blindedA randomized trial is "Blind" if the participant is not told which arm of the trial he is on. A clinical trial is "Blind" if participants are unaware on whether they are in the experimental or control arm of the study; also called masked. randomisedA method based on chance by which study participants are assigned to a treatment group. Randomization minimizes the differences among groups by equally distributing people with particular characteristics among all the trial arms. The researchers do not know which treatment is better. From what is known at the time, any one of the treatments chosen could be of benefit to the participant controlled trialIn clinical trials, one group of participants is given an experimental drug, while another group (i.e., the control group) is given either a standard treatment for the disease or a placebo.. Bowler SD, et al., Med J Aust. 1998 Dec 7-21;169(11-12):575-8.
5 Health Education in Asthma Management – Does the Buteyko Institute Method make a difference? McGowan J., Thorax Medical Journal (Dec 2003 Vol 58 Sup III) – also reported at the British Thoracic Society Winter Conference in London on 4 December 2004.
6 Buteyko Breathing Technique for asthma: an effective intervention. McHugh P., et al., N Z Med J. 2003 Dec 12;116(1187):U710.
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