Preventing Opportunistic Infections in HIV/AIDS

HIV attacks the cells of your body's immune system. You need a strong immune system to fight off germs like bacteria and viruses and to fight off many kinds of cancer. HIV may give those cancers or germs a better opportunity to make you sick. When germs take advantage of your weakened defense system, they are called opportunistic infections (OI).

Opportunistic infections that other people might fight off easily or never even get could make you really sick if you have HIV. Getting one or more of these infections could mean that your HIV has advanced to AIDS. In fact, opportunistic infections are the most common cause of death for people with HIV/AIDS. The good news is that you have plenty of ways to prevent them.

Opportunistic infections you need to know about

There are more than 20 serious diseases that can become opportunistic infections if you have HIV/AIDS. You might have one of these diseases and be healthy enough to fight it off normally. But if your immune system is compromised it may be harder to fight these infections.

If you have one or more of the diseases on this list, you could be considered to have AIDS. That’s why they are called AIDS-defining conditions. Here are the most common opportunistic infections:

  • Candidiasis. A fungal infection you can get in your mouth, throat, digestive system, or vagina.

  • Cytomegalovirus. A viral infection that can cause pneumonia or blindness.

  • Herpes simplex virus. This can cause a serious outbreak of cold sores.

  • Mycobacterium avium complex. A bacterium that causes fever, digestive problems, and weight loss.

  • Pneumocystis. A fungal infection that can cause a severe type of pneumonia.

  • Toxoplasmosis. A protozoal infection that can cause brain damage.

  • Tuberculosis. A bacterium that can infect your lungs, your brain, or your bones.

  • Kaposi's sarcoma. A cancer often marked by red, purple, brown, or black skin blotches or nodules.

Others include lymphoma, encephalopathy (AIDS dementia), and wasting syndrome. Signs of wasting syndrome often include weight loss, ongoing fever, diarrhea, and malnutrition.

Preventing opportunistic infections

HIV targets cells in your body called CD4 cells. Measuring your CD4 count is one of the best ways for your healthcare provider to tell how well your immune system is working. One of the best ways to prevent an OI is to keep your CD4 count above 200. A CD4 count below 200 means you have AIDS and could be at risk for OIs. Health experts recommend starting HIV treatment as soon as you are willing to start therapy, no matter how high the CD4 count. Always see your healthcare provider about when to start treatment.

Some of these infections can be prevented by avoiding them, or by getting vaccinated. Some infections are really common, so you need to take special precautions to prevent being exposed to them. If you do develop an opportunistic infection, it's important to get diagnosed and treated right away. So it's a good idea to see your healthcare provider at least once every 3 months or as recommended.

Here are other important tips:

  • Practice safe sex. Several opportunistic infections are transmitted sexually. You can help prevent them by always practicing safe sex. Use condoms consistently and correctly to prevent exposure to infection.

  • Practice safe food preparation. Some infections can get into your body through the food and water that you eat and drink. Don't eat foods such as undercooked eggs, raw (unpasteurized) milk or cheese, unpasteurized fruit juices or raw seed sprouts. Avoid drinking water that may not be clean, such as from lakes and rivers, or when traveling to foreign countries. Use bottled water when in doubt.

  • Take care around animals. Animals can spread some infections to people with HIV/AIDS. Make sure pets are vaccinated and your cat stays inside. Wash your hands after handling any animals, and wear gloves when changing cat litter. Avoid animal feces when working outside in the soil.

  • Take care around people. People-to-people spread of opportunistic infections is also common. Avoid people who are sick, especially with diseases like pneumonia or tuberculosis. Use your own towel to wipe off gym equipment. Never share needles.

  • Get vaccinated. Your healthcare provider will tell you which vaccines you need.

Keep a health journal and write down any new symptoms. If you have a new symptom, don't wait 3 months to see your healthcare provider. Make an appointment right away. If you get treated for an infection, make sure to take all prescribed medicine and keep all your follow-up appointments.

If you are having trouble keeping your CD4 count above 200, your healthcare provider may consider putting you on preventive or maintenance therapy. That means taking medicines to prevent an infection or to prevent an infection from coming back. Working closely with your healthcare provider and taking reasonable precautions will help you reduce your risk of getting an opportunistic infection. And don't forget about healthy lifestyle choices like good nutrition, proper sleep, and regular exercise. 

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