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Opportunistic Infections

The body fights off infection with its immune system. HIV infection weakens the immune system. Because of this, people with HIV are at risk for acquiring other infections. Below is a short description of those infections and the signs and symptoms you should report to your doctor immediately.

Table of Contents

Bacterial Infections

Viral Infections

Fungal Infections


Protozoal Infections


Bacterial Infections

Mycobacterium avium Complex (MAC)
MAC is often transmitted through the water supply but there is no definite way to avoid contamination. The organism may exist in the body without causing disease, but in persons with AIDS, infection throughout the body is common. Most often it starts in the intestinal tract.

Symptoms include night sweats, fever, weight loss, and diarrhea.

Tuberculosis (TB)
TB has become a serious health problem for HIV infected persons. In some areas, forms of TB that don't get better with treatment (resistant) are now occurring. Many people are first infected early in life, but the infection does not show symptoms until much later. It becomes active when HIV weakens the immune system. TB is highly contagious and can be spread through coughing or sneezing. TB confined to the lungs is called pulmonary TB. TB that effects other areas of the body is called extrapulmonary.

Symptoms include fatigue, fever, night sweats, weight loss, and a cough producing mucus and sometimes blood.

Salmonellosis (Food poisoning)
Salmonella is acquired by eating contaminated food or drinking contaminated water, particularly undercooked chicken or eggs. Therefore, HIV infected people should avoid food made with raw eggs such as eggnog, homemade ice cream, and some salad dressings. Salmonella can also be found in a person's stool, therefore infection can also occur through oral-anal sexual contact.

Symptoms include stomach cramps, fever, loss of appetite, and diarrhea that may be severe or bloody.

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Viral Infections

Cytomegalovirus (CMV)
CMV is a common virus that is related to the Herpes Simplex virus. In healthy people, the virus does not show symptoms (remains dormant). But in the HIV infected person, the virus multiplies and causes infection throughout the body. When it infects the brain and nervous system, it can cause an inflammation of the brain (encephalitis). It causes pneumonia when in the lungs and stomach cramps and diarrhea when in the intestines. CMV that infects the liver can cause hepatitis. The most common form infects the eyes and causes an inflammation known as CMV Retinitis.

Symptoms include headache, change in mental status, cough, abdominal cramps, diarrhea, vision changes such as spots, floaters or tunnel vision.

Herpes Simplex Virus
Two types of Herpes simplex virus cause problems for the HIV infected person. Type one (HSV-1) cause cold sores or blisters on the mouth and face. Type two (HSV-2) causes similar sores but they appear on the genitals and anal area.

Symptoms include fluid filled blisters that break and crust over. These blisters can be painful, swollen or itchy. Other symptoms can include fever, fatigue or headache.

Varicella-Zoster virus (shingles)
Shingles is the same virus that causes chickenpox. Anyone whose has had chickenpox in their lifetime can get shingles.

Symptoms include the presence of small very painful blisters that follow nerve pathways, usually along one side of the body.

Hepatitis is an inflammation of the liver is of three types; Hepatitis A, B, and C. Hepatitis A can be spread through unsanitary living conditions, sex or contaminated food. Hepatitis B is spread through infected blood and through sexual contact. A vaccination is available to prevent Hepatitis B.

Symptoms include fever, abdominal pain, and a yellow discoloration of the skin and eyes (jaundice).

Epstein-Barr virus (EBV)
EBV is a virus similar to Herpes that is known to cause mononucleosis ("Mono").

Symptoms are primarily extreme fatigue

Ano-gental Warts
Ano-genital warts effect the anal and genital areas and are spread quickly through sexual contact.

Symptoms include the presence of raised bumps are protruding pieces of skin in the anal and genital areas.

Molluscum Contagiosum
These painless warts can occur anywhere on the body but are most common on the face. Their major problem is mostly cosmetic.

Symptoms are the presence of small, white, wart like bumps most often found on the face.

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Fungal Infections

Candidiasis is a form of yeast and are of three types; oral (thrush), esophageal, and vaginal.

Symptoms of oral thrush are the presence of white patches inside the mouth, on the tongue and upper throat. Sore throat and a change in taste can also be present. Chest pain and difficulty swallowing characterize Esophageal thrush. Vaginal itching, burning, and thick white vaginal discharge characterizes recurrent vaginal candidiasis.

Cryptococcal Meningitis
This fungal infection causes an inflammation of the covering of the spinal cord and brain. It is acquired by inhaling dust contaminated with the fungus, usually from some types of bird droppings.

Symptoms can be vague, but include fever, blurred vision with photophobia (lights hurting the eyes), mental confusion, headaches, or a stiff or aching neck.

This infection is most often found in the Midwest, especially Indiana and the Ohio River Valley. There are no drugs currently available to prevent the infection.

Symptoms include fever, swollen glands, cough, shortness of breath, weight loss, weakness and anemia.

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Pneumocystis carinii pneumonia (PCP)
Pneumocystis carinii is a common organism that rarely causes problems in people with healthy immune system. But in the HIV infected person, it causes PCP, the most common and one of the deadliest opportunistic infections. Most often it strikes when the CD4 count drops below 200. For this reason, your doctor will begin antibiotics to prevent PCP infection when your CD4 count is near or below 200.

Early Symptoms include fatigue and shortness of breath. As the infection intensifies, rapid breathing, dry cough, fever, chills, night sweats, and weight loss occurs.

Pneumonia (bacterial)
HIV infected people sometimes experience bacterial pnemonias early in the course of their infection. Bacterial pneumonia develops over the course of days whereas PCP takes more time to develop. A vaccine can be given by your doctor to decrease your risk of bacterial (pneumococcus) pneumonia.

Symptoms include chest pain, a cough producing yellow or green thick sputum, and shortness of breath.

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Protozoal (parasitic) infections


About 50% of the US population have been infected with toxoplasma gondii, but the infection usually shows no symptoms in a person with a healthy immune system. But in the HIV infected patient it causes Toxoplasmosis. The primary way one is infected is by eating undercooked meat; therefore HIV infected people should make sure their meat is thoroughly cooked before eating.

Symptoms may resemble other HIV illnesses and include persistent, dull headache, subtle alterations in mental state, fever, seizure, or stroke-like syndromes.

Cryptosporidiosis is a highly infectious intestinal parasite found most commonly among farm and domesticated animals. It is transmitted through contaminated food and water.

Symptoms usually develop gradually and fluctuate in severity. They include watery diarrhea lasting for months, weight loss, abdominal cramps, nausea, vomiting, fever, and headache.

This organism is most often found in contaminated food and water, especially in Latin America or developing countries.

Symptoms include chronic, watery diarrhea.

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