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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 by weakening your immune system. When germs take advantage of your weakened immune system, they are called opportunistic infections (OI).

OIs that other people might fight off easily or never even get could occur more often and be more severe if you have HIV. Getting one or more of these infections could mean that your HIV has advanced to AIDS. In fact, OIs 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 OIs 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 may have AIDS. That's why they are called AIDS-defining conditions. Here are the most common OIs:

  • 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 sores in the mouth, esophagus, genitals, or rectum.

  • 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 infection and brain damage.

  • Tuberculosis. A bacterium that can infect your lungs, brain, bones, and other parts of the body.

  • Cryptococcosis. A fungus that can cause infection of the spinal fluid and brain (meningitis; meningoencephalitis) and the bloodstream.

Others include progressive multifocal leukoencephalopathy, microsporidiosis, and cryptosporidiosis.

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 you are at high risk for OIs. Health experts recommend starting HIV treatment as soon as possible after HIV is diagnosed, no matter how high the CD4 count.

Some of these infections can be prevented by avoiding them, or by getting vaccinated. Some infections are from common germs that we are frequently exposed to in daily life. So you may need to take special precautions to prevent being exposed to them or to lessen the chance of becoming sick with them after exposure. If you do develop an OI, it's important to get diagnosed and treated right away. If your CD4 count is less than 200, 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 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. Don't drink water that may not be clean, such as from lakes and rivers, or when traveling to foreign countries. When in doubt, use bottled water.

  • 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. Wear gloves when changing cat litter. Avoid animal feces when working outside in the soil.

  • Take care around people.  Person-to-person spread of the germs that cause OIs is also common. Stay away from 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.

  • Take preventive medicines if needed. If you are at high risk for an OI, your healthcare provider may be able to prescribe antibiotics to prevent certain infections. Always take these antibiotics as directed.

  • Take antiretroviral medicines for your HIV. Your healthcare provider will almost always suggest that you take medicines to control your HIV. These will help your body fix the damage from HIV. They will also strengthen your immune system to fight off complications such as OIs. Always take these medicines as directed.

  • Keep a health journal and write down any new symptoms. If you have a new symptom, make an appointment with your healthcare provider right away. If you get treated for an infection, make sure to take all prescribed medicine and keep all your follow-up appointments.

Working closely with your healthcare provider and taking reasonable precautions will help you reduce your risk of getting an OI. And don't forget about healthy lifestyle choices like good nutrition, proper sleep, and regular exercise. 

Online Medical Reviewer: Barry Zingman MD
Online Medical Reviewer: L Renee Watson MSN RN
Online Medical Reviewer: Raymond Turley Jr PA-C
Date Last Reviewed: 3/1/2021
© 2000-2021 The StayWell Company, LLC. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.
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