HIV attacks your immune system, making it harder for you to fight off things that can make you sick. As the virus weakens your natural defenses, you might notice signs all over your body. But if you start antiretroviral therapy (ART) medicines early in an HIV infection, you won’t have most of these problems.
These drugs can also have some side effects. You'll need to keep an eye out for problems and take steps to prevent or slow them.
HIV Effects on the Immune System
Your immune system has many types of white blood cells that fight infection. HIV gets inside a kind called CD4 cells and makes copies of itself. The virus kills the cell, and the new viruses go off to find more.
Your body responds by making more CD4 cells, but after a while, it can’t keep up with the virus. This makes your immune system weak. You’re more likely to get sick, even from common germs. Infections last longer, are more severe, and might come back more often.
If you follow your doctor’s directions with ART, it knocks out HIV, stopping it from infecting more CD4 cells and from weakening your immune system.
Stages of HIV infection
About a month after you get HIV, you might feel like you have the flu. This is the first stage, called primary or acute HIV infection. Symptoms include:
- Skin rash
- Sore throat
- Swollen lymph nodes
The next stage is called clinical latency, or chronic infection. You might have no symptoms, or only mild ones, for 10 years or more.
Without treatment, as HIV keeps multiplying inside your body, you’ll move into the third stage, which is AIDS. A person who has HIV is diagnosed with AIDS when they have fewer than 200 CD4 cells per cubic millimeter of blood or when they get what’s called an AIDS-defining condition.
AIDS-defining conditions are certain cancers and illnesses called opportunistic infections.
These infections happen more often or are more severe in people who have weakened immune systems. Some common ones are:
- Candidiasis. This is an infection with a fungus called candida that affects your mouth, esophagus, lower respiratory tract, or deep lung tissue.
- Pneumocystis pneumonia (PCP). A fungus called Pneumocystis jirovecii infects your lungs and causes cough, fever, and trouble breathing.
- Mycobacterium avium complex (MAC). This bacterial infection can spread through your body, causing fever and weight loss.
- Invasive cervical cancer. Cancer starts in your cervix and spreads to other parts of your body.
- Cytomegalovirus. This virus can cause problems in your lungs, belly, brain, and eyes.
- Kaposi’s sarcoma. Tiny blood vessels grow where they shouldn’t. You might have skin lesions or problems with your lungs, intestines, or lymph nodes.
- Lymphoma. This is cancer of your lymph nodes or other tissues of the lymph system.
- Tuberculosis. Bacteria cause infection in your lungs and sometimes other parts of your body.
- Salmonella septicemia. This is a severe form of salmonella infection in which the bacteria overload your immune system.
HIV Effects on the Eyes
Some eye problems are mild, but others can be severe enough to cause blindness. Some of the most common are infections that can lead to bleeding in your retina (the tissue at the back of your eye) and retinal detachment. About 7 in 10 people with untreated AIDS will have AIDS-related trouble with their eyes, usually because of cytomegalovirus.
You may not have any symptoms until the problems are far along, so if you have advanced HIV, it's important to get regular eye exams. Call your doctor if your vision changes, including if:
- You get blurry or double vision.
- Colors don't look right.
- You see spots.
- You have watery or red eyes.
- You're sensitive to light.
- Your eyes hurt.
HIV Effects on the Circulatory System
Several things make your chances of heart-related problems go up. Because HIV affects your immune system, your body will be inflamed as it tries to fight the infection, like it’s on a constant simmer. This kind of inflammation has been linked to heart disease.
Some drugs you take for HIV can also make heart disease more likely. They can cause insulin resistance, which makes you more likely to get diabetes, and problems breaking down fats. Diabetes, in turn, raises your risk of heart disease. You might need medicines to control your blood sugar and cholesterol.
If you smoke, quit. Eat a variety of vegetables and fruits, plenty of whole grains, and foods with omega-3 fatty acids. Choose lean cuts of meat and low-fat dairy products. Exercise, like taking a brisk walk, for 20 to 30 minutes most days of the week.
If you're carrying extra weight, losing as little as 5 or 10 pounds could make a big difference.
HIV Effects on the Kidneys
High blood pressure and diabetes are both related to HIV, and both are major causes of kidney disease. The healthy diet and exercise habits that are good for your heart will help keep your blood pressure and blood sugar under control. That helps protect your kidneys, too.
Some HIV medications can damage your kidneys. If you already have kidney problems, your doctor may want to avoid those drugs or keep a close eye on their effects.
Your doctor will need to check your kidneys regularly because you might not notice the signs of kidney disease.
HIV Effects on the Digestive System
More than half of people who have AIDS report digestive symptoms as the virus or an opportunistic infection targets the walls of their intestines. Diarrhea is the most common one. Over time, the virus can change how your digestive tract works and even how it looks.
Some HIV medications can damage your liver. Many people with HIV also have a form of inflammation called hepatitis.
Limit how much alcohol you drink, and don't use recreational drugs. Having diabetes, high cholesterol, or triglycerides and being overweight can lead to fatty liver disease, so keep an eye on the carbs, fats, and calories you eat each day.
Talk to your doctor about getting the hepatitis A and hepatitis B vaccines. There’s no vaccine against hepatitis C, but you should get tested for it.
Get regular blood tests to catch any liver problems early.
Your mouth might be one of the first places where you notice signs of HIV. Things like dry mouth, fungal infections, gum disease, cold sores, and canker sores can make chewing or swallowing painful. If they go on too long, you might not be able to take your HIV medication or get the nutrients you need.
Good dental habits can help prevent these issues, so brush and floss regularly. See your dentist for checkups, and tell them if you’re having problems. Most mouth conditions tied to HIV are treatable.
HIV Effects on the Skeletal System
People who have the virus tend to lose bone faster than people who don’t. Your bones may get brittle and can break more easily. Your hips, especially, may hurt and feel weak.
Things that might cause this include the virus itself, the inflammation it causes, the medicines you take to treat HIV or related illnesses (like steroids or antacids), and an unhealthy lifestyle. It might also be from a vitamin D deficiency, which is common in people who have HIV.
To help keep your bones in good shape:
- Make sure you get plenty of calcium and vitamin D.
- Exercise in ways that put weight on your bones, like walking or lifting weights.
- Don't smoke, and limit how much alcohol you drink.
- Ask your doctor to check your vitamin D level.
Talk to your doctor about supplements or other medications to help your bones.
HIV Effects on the Nervous System
About half of people with AIDS have nerve problems related to the virus. Infection or inflammation can damage your spinal cord or brain and keep your nerve cells from working the way they should. Some medications can also affect your nervous system.
Inflammation in your brain and spinal cord can lead to confusion and other thinking problems as well as weakness, headaches, seizures, and balance problems.
When AIDS is far along, you might get dementia and have problems remembering things.
Having HIV can also affect your mental health. Many people living with it have depression or anxiety. Mental health professionals and support groups can help you work through your concerns and manage your life with HIV.
The opportunistic infection cytomegalovirus can attack your nerves, making it hard for you to control your arms and legs or your bladder.
It’s common for tiny holes to form in spinal fibers when people with AIDS don’t get treatment. This is called vacuolar myelopathy and causes trouble walking.
HIV or the drugs that treat it can also damage nerves all over your body, causing neuropathy. You might have pain, numbness, weakness, burning, stiffness, or tingling.
Antiretroviral therapy to treat HIV can lower your risk of getting these conditions or complications. If a medication is causing the problems, your doctor might switch you to a different one.
HIV Effects on the Skin
Many people get a skin rash in the first stage of an HIV infection. It usually goes away without treatment in days or weeks. Over time, a number of things might cause more rashes. It’s always important to let your doctor know about a rash, because it might be a sign of a serious problem, or an HIV medication could be causing it.
People who have HIV are more likely to get viral infections. Herpes zoster, herpes simplex, and Molluscum contagiosum can cause rashes or blisters.
Kaposi’s sarcoma causes lesions, patches, or nodules that are a different color from your skin. Sometimes, you can also get lesions on your internal organs. These may be life-threatening.
Effects of Antiretroviral Drugs on the Body
Antiretroviral therapy helps people who have HIV live longer, healthier lives and lowers their risk of spreading the virus. The drugs can have side effects, many of which go away with time. Overall, the benefits outweigh the risks.
There are several kinds of antiretroviral drugs, and your doctor might combine them in different ways. Side effects can vary from drug to drug or from person to person.
Common side effects of these drugs include:
- Upset stomach and vomiting
- Trouble sleeping
Talk to your doctor if you have any of these problems. They might be able to change your medication or give you something else to deal with the effects.
Make your health a priority. Take your medications as directed, and let your doctor know about any changes or new symptoms.