The Friends of AIDS Foundation/Topics/HIV and Opportunistic Infections

HIV AND OPPORTUNISTIC INFECTIONS

Having HIV weakens your immune system—your body’s natural defense against infections. When the
immune system is weakened, your body loses its ability to fight disease, putting you at greater risk
for getting other infections. These other infections, called Opportunistic Infections (OIs), are fairly
common infections that don’t cause harm in healthy people. However, people with HIV are at risk for
OIs, and these infections can be serious and perhaps even life-threatening.

Any type of infection can become an OI for people with HIV. The important thing is to stay as healthy
as possible so that a simple infection does not turn into an OI. In order to make sure you stay
healthy with HIV, it’s important to learn as much as you can about OIs. This includes knowing the
common types of infections, locations in the body that are most affected, and the symptoms to watch
for.

Common locations for Opportunistic Infections include the following parts of the body:

Brain
Eyes
Mouth and Throat
Lungs
Gut
Skin
Genitals

Some common symptoms of Opportunistic Infections are:

Coughing and trouble breathing
Seizures and lack of coordination
Mental symptoms, such as confusion and forgetfulness
Severe diarrhea
Fever
Trouble seeing
Nausea, stomach cramps, and vomiting
Weight loss
Trouble sleeping, night sweats
Fatigue
Headaches
Coma

If you have any of these symptoms, you should seek medical attention immediately.

The Centers for Disease Control and Prevention has put together a list of infections that are both
serious and life-threatening for people with HIV. These diseases are called AIDS-defining OIs
because when a person with HIV becomes infected, it usually results in a diagnosis of AIDS.

Some of the most common Opportunistic Infections are:

Pneumocystic carinii pneumonia (PCP): This is the most common and serious infection for
people living with HIV. This OI is caused by the fungus Pneumocystic carinii. Symptoms include
fever, cough, or trouble breathing.
Mycobacterium avium complex (MAC): This bacterial infection is caused by two different
germs: Mycobacterium avium or Mycobacterium intracellulare. Symptoms include night sweats,
weight loss, abdominal pain, feeling tired, diarrhea, and anemia.
Tuberculosis (TB): TB is caused by the bacteria Mycobacterium tuberculosis. It is most often
found in the lungs, but can also affect other areas of the body such as the kidneys, spine, or
brain. It’s spread through the air when someone who is infected sneezes or coughs.
Symptoms usually start with a general feeling of sickness, weakness, weight loss, fever, and
night sweats. When it infects the lungs, you will also have coughing, which can include
coughing up blood, and chest pain. When other areas of the body are infected with TB, the
symptoms may vary, so it’s important to always tell your doctor about any symptoms you have.
Cytomegalovirus (CMV): CMV is a viral infection that is part of the herpes virus family. This
includes the herpes simplex viruses and the viruses that cause chickenpox (varicella zoster)
and infectious mononucleosis (Epstein-Barr). It can be transferred through bodily fluids (such
as saliva and urine), transmitted during sex, or passed on from mother to child during birth.
Many people with CMV have no symptoms at all; but some may have fever, sore throat,
fatigue, and swollen glands.
Toxoplasmosis (Toxo): This condition is caused by the Toxoplasma parasite. It can be found
in under-cooked meats, so be sure to cook your meat through thoroughly. Cats and birds are
another source of infection. Indoor cats have less of a risk; but if your indoor cat also goes
outside, it can carry the parasite into your house. It’s most likely found in a cat’s feces, so it is
important to use gloves when changing the litter box. Symptoms of toxo include headache,
confusion, fever, nausea, poor coordination, and even seizures.
Cryptosporidiosis (Crypto): This infection is caused by the Cryptosporidium parasite. The
parasite lives in the intestine of infected humans or animals, and is spread in feces. The most
common forms of infection come from soil, food, water, or surfaces that have come into contact
with feces from infected animals or individuals. To avoid this parasite, never drink unfiltered
water, such as that from rivers or streams. If possible, drink bottled water or use filters for tap
water to make sure that crypto is filtered out. You should also be aware of the symptoms of
crypto, which include stomach cramps or pain, dehydration, nausea, vomiting, fever, and
weight loss.
Hepatitis C: Hepatitis C is very common among people with HIV; about 25% of people with
HIV in the United States are also infected with hepatitis C. It is caused by infection with the
hepatitis C virus and transmitted through the blood by sharing needles or other equipment
used to inject drugs. Oftentimes, hepatitis C does not have any symptoms until liver problems
have developed. Because of this, it is important for all people with HIV to get tested for
hepatitis C.
Human papillomavirus (HPV): HPV is a sexually transmitted disease that causes cancer of
the cervix in women and cancer of the anus as well as genital warts in both men and women.
Transmission occurs through skin-to-skin during sex.

The good news is that some opportunistic infections can be prevented. You can reduce your risk of
sexually transmitted OIs by simply practicing safer sex. This means not having sex or using
protection whenever you do. Vaccines are also a good option for some OIs, such as the recently
approved HPV vaccine. You can reduce your risk of sexually transmitted OIs by simply practicing safer
sex.

In cases where infections can be found in contaminated food, it’s important to carefully handle and
prepare food so that you don’t get sick. It is also helpful to be aware of the things (beyond food)
that may cause you harm and avoid them whenever possible. Even with all of these precautions, you
may still come into contact with an OI. Considering the risk, you should ask your doctor to test you
for such infections whenever you think you may have been exposed. In some cases, testing can
tell you if you’ve already been exposed to an infectious fungus or parasite.

HIV medications can play a large role in preventing OIs. Remember to keep your CD4 counts above
200 to help keep your body healthy and protect you from OIs. It is recommended that you start HIV
therapy if your CD4 count drops below 350. HIV treatment is also recommended for anyone with
symptoms of HIV, regardless of CD4 counts. HIV therapy can help stop the virus from destroying the
immune cells that can help keep you healthy.

If you have come into contact with an OI or have been treated for one, you may require maintenance
medications. It might be necessary for you to take certain medications for life to prevent OIs from
returning. Such medications may also improve your quality of life—if you have repeated bouts of a
certain type of infection, maintenance medications might be your only option to prevent it from
returning. Talk to your doctor about any infections you have or have had, and to see if maintenance
medications are right for you.

Each type of OI has a different type of treatment. The one thing all OIs have in common is that they
need to be treated. Talk to your doctor if you have any suspicious symptoms so that he or she may
test you for an OI. It’s critical to treat OIs in order to stop the infection from causing further damage
to your immune system. Even if the infection is not an OI, treatment is still important.

When treating OIs, the most important thing is to be diagnosed early. This can stop OIs from
infecting other organs in the body, such as the lungs, colon, brain, or even bone marrow. The earlier
it’s treated, the more likely you’ll be to respond to treatment. Be sure to see your doctor for regular
checkups (at least every 3 months) and talk to him or her about any symptoms you think you may
have.

As a person living with HIV, you can go through several stages of HIV before AIDS develops. There is
no set timeline for the progression of HIV to AIDS—it varies from person to person and is affected by
outside factors, such as stress and poor nutrition. OIs, however, can speed your progression from
HIV to AIDS. This is because being infected with an OI for a long period of time can also lead to an
AIDS diagnosis. Simply coming down with an infection doesn’t automatically mean you will be
diagnosed with AIDS. But, having an OI that lasts for a long period of time—even with treatment—
will lead to a positive AIDS diagnosis. This is why it’s important to talk to your doctor whenever you
have symptoms of an infection. Early treatment is the key to a healthy life when living with HIV.

Source: patientedu.org/HIV