AIDS & HIV opportunistic infections: What you can do to stay healthier

HIV (human immunodeficiency virus) attacks the body's white blood cells -- specifically a subset called CD4 or helper T cells. This attack allows opportunistic infections to take advantage of a weakened immune system, and can lead to illnesses, cancers, or neurological problems. If you have HIV and develop an opportunistic infection (OI)), your HIV infection may have progressed to AIDS     (acquired immunodeficiency syndrome). But with careful monitoring, self-care, and treatment, you can prevent many infections and stay healthier if you do develop an infection.

Where HIV opportunistic infections come from

A wide variety of germs can cause HIV opportunistic infections. These include bacteria, viruses, protozoa, or fungi. Even before you have HIV, you have many of these in your body. But a healthy immune system normally keeps them under control. These are examples of other places where you can pick up germs that cause HIV opportunistic infections:

• Unwashed raw foods
• Soil or water
• Contact with animal faeces
• Contact with other people, through unsafe sex or in places where germs are common, such as hospitals, childcare centres, or schools
• Contact with blood through sharing needles or intravenous drugs

Common HIV opportunistic infections

Almost any disease can become an HIV opportunistic infection when the immune system is weak. Some are more common than others, though. And some are more likely to occur at certain levels of CD4 counts than others. Here are some of the more common HIV opportunistic infections:

• Candidiasis (thrush): a fungal infection in the mouth, throat, or vagina
• Cryptococcus neoformans (Crypto): a fungus that can lead to meningitis, a serious inflammation of membranes surrounding the brain and spinal cord
• Cryptosporidiosis and microsporidiosis: protozoa affecting the gastrointestinal tract.
• Cytomegalovirus (CMV): a virus that causes eye disease and can lead to blindness
• Herpes simplex: viruses that can cause severe genital or cold sores
• 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 fatal pneumonia.
• Progressive multifocal leukoencephalopathy (PML): a virus affecting the brain.
• Toxoplasmosis (Toxo): a protozoa that sometimes causes encephalitis, an inflammation of the brain.
• Tuberculosis (TB): a bacterial infection that attacks the lungs and can lead to meningitis.

There are some differences between women and men with respect to opportunistic infection. Here are a few of them:

• Men are eight times more likely to develop a cancer called Kaposi's sarcoma.
• Women are more likely to develop bacterial pneumonia and herpes simplex infections.
• Women are also more at risk of certain infections that can lead to cancers of the reproductive system.

Preventing HIV opportunistic infections

Many germs that cause HIV-related opportunistic infections are very common. You can undergo tests to learn which ones are already in your body. This will help your doctor know how to treat them and which ones you can focus on preventing. Unfortunately, according to a report from the Health Protection Agency, there were an estimated 73,000 adults aged over 15 with HIV in the UK in 2006, a third of whom were unaware of their infection. Some don't find out until they end up in the hospital with a serious HIV-related opportunistic infection.

HIV makes copies of itself more quickly when HIV-related opportunistic infections occur. So early treatment is important not only to prevent serious results of infection, but also to preserve the immune system. Here's what you can do to get diagnosis and treatment as early as possible.

• See your healthcare professionals regularly - 2 to 12 times a year. If you can, make sure you have a GP who is experienced in HIV treatment and knows how to co-ordinate care well with other specialists.
• If you're a woman, get regular pelvic examinations and smear tests to spot infections, pre-cancers, or cancers of the reproductive system.
• Keep a record of symptoms to help with diagnosis of HIV-related opportunistic infections. These include raised temperature for more than two days, weight loss, a change in vision, or mouth problems, skin problems, or breathing problems.
• Go to your doctor if you have any new or unusual symptoms. Don't wait for your regularly scheduled visit.
• Prepare for appointments by coming with questions and be prepared to take notes.
• Complete your course of treatment. Don't stop taking it early.