Many different kinds of germs can cause opportunistic infections. They're called "opportunistic" because they take advantage of the weaker immune system of someone with HIV. People with healthy immune systems aren't bothered by them.
HIV attacks CD4 cells, which help to find and destroy bacteria, viruses, fungi, and other invasive germs. Without enough CD4 cells to fight them off, the resulting infections can lead to illnesses, cancers, and brain and nerve problems. Certain opportunistic infections can be a sign that your HIV has become AIDS.
If your CD4 count stays up, opportunistic infections are less likely to be a problem. When your CD4 count is low, your doctor may want you to take preventive drugs to lessen your chances of getting sick. And you can take medicine to help your body fight some infections after you get them.
Common Opportunistic Infections
Almost any disease can become an opportunistic infection when your immune system is weak. Some are more common than others, and depending on your CD4 count, some are more likely to occur.
- Candidiasis or thrush, a fungal infection in your mouth, throat, or vagina
- Cryptococcus neoformans (Crypto), a fungus that can lead to meningitis, a serious inflammation of the membranes that surround your brain and spinal cord
- Cryptosporidiosis and microsporidiosis, which are protozoa that mess up your gut
- Cytomegalovirus (CMV), a virus that causes eye disease and can lead to blindness (It can also cause severe diarrhea and ulcers.)
- Herpes simplex, a group of viruses that can cause bad sores around your mouth (cold sores) and on your genitals
- Mycobacterium avium complex (MAC), a bacterium that can cause fevers, problems with digestion, and serious weight loss
- Pneumocystis pneumonia (PCP), a fungus that can cause a deadly lung infection
- Progressive multifocal leukoencephalopathy (PML), a virus that affects your brain
- Toxoplasmosis (Toxo), a protozoa that can cause encephalitis, which is an inflammation of the brain, as well as blurry vision and eye damage
- Tuberculosis (TB), a bacterial infection that attacks your lungs (It can also invade other organs and lead to meningitis.)
Men are 8 times more likely to develop a cancer called Kaposi's sarcoma.
Women are more likely to develop bacterial pneumonia and herpes infections. They also have a greater chance of getting certain infections that can lead to cancers of the reproductive system.
Some of the germs that cause opportunistic infections are so widespread that they're difficult to avoid. Besides practicing healthy habits (including safe sex), you can take steps to lower your chances of picking some of them up.
Wash and cook all of your food well. Avoid raw or undercooked meats and eggs, and unpasteurized dairy. Thoroughly clean and disinfect your hands, knives, cutting boards, and counters where you make food.
Have someone else handle cat litter or pick up dog waste, or use gloves if you do. Keep cats indoors so they don't bring in germs that could harm you.
Use a towel on shared gym equipment and a different towel to dry yourself.
Try not to swallow water in pools, lakes, or streams.
See your doctor regularly -- at least twice a year, every month if needed. Work with a primary care doctor who's experienced with HIV treatment and can coordinate your care with other specialists. Get any vaccinations your doctor recommends. Take your HIV drugs as directed to keep your immune system strong.
If you're a woman, get regular pelvic exams and Pap tests to spot infections, precancers, or cancers.
Diagnosis and Treatment
You can get lab tests to find out which germs are already in your body. This will help your doctor know how to treat you and which infections you should focus on preventing.
Keep a record of your symptoms, and pay attention to:
- Fever for more than 2 days
- Weight loss
- A change in vision
- Problems with your mouth, skin, or breathing
Call your doctor when you have new or unusual symptoms. Don't wait for your next scheduled visit.
Because the HIV virus makes copies of itself more quickly when you have an opportunistic infection, early treatment is important. It will help you avoid the serious consequences of infection, as well as preserve your immune system.
Follow through with all of the treatment. Don't quit early. Your doctor might also prescribe medication to prevent the infection from coming back, and if your immune system recovers, you may be able to stop taking that.