What are the opportunistic infections that affect patients with HIV?

Opportunistic infections are serious infections that exploit a weakened immune system. In healthy people, these infections are less common or less severe, but they pose a major risk to people with HIV who have weakened immune systems. HIV destroys the white blood cells that fight infection, making the body susceptible to these infections. People with AIDS, which is the most severe stage of HIV infection, have severely damaged immune systems, making them particularly vulnerable to opportunistic infections. In some cases, the onset of certain opportunistic infections can be a sign of an AIDS diagnosis.

Causes of Opportunistic Infections

Although effective HIV medications have reduced the frequency of opportunistic infections, they still occur for several reasons. Some people may not be aware they have HIV and, therefore, do not receive treatment. Others may be aware of their infection but do not adhere to treatment. In some cases, HIV treatment may not work properly, leading to a persistently weakened immune system and an increased risk of opportunistic infections [1].

Common Types of Opportunistic Infections

There are a variety of opportunistic infections that can affect people with HIV, including:

• Bacterial infections: Such as tuberculosis (TB), Salmonella infections, and Mycobacterium avium complex (MAC) [1].
• Viral infections: Such as cytomegalovirus (CMV) and herpes simplex virus type 1 (HSV-1) [1].
• Fungal infections: Such as candidiasis (yeast infection), Pneumocystis pneumonia (PCP), and histoplasmosis. Cryptococcosis, a fungal infection, is a common cause of life-threatening fungal infections in people with HIV/AIDS [1] [2].
• Parasitic infections: Such as cryptosporidiosis and toxoplasmosis [1].

In addition, people with HIV are more susceptible to serious complications from common illnesses such as the flu. If you have HIV and develop flu symptoms, you should contact your doctor immediately, as immediate antiviral treatment is recommended [3].

Treatment and Prevention of Opportunistic Infections

If a person with HIV develops an opportunistic infection, treatments such as antiviral medications, antibiotics, and antifungals are available. The type of medication the doctor prescribes depends on the specific opportunistic infection. After successful treatment of the infection, the patient may need to continue taking the same medication or another medication to prevent recurrence [1].

The best way to prevent opportunistic infections is to adhere to taking HIV medications (Antiretroviral Therapy - ART) regularly [1]. This therapy reduces the viral load and strengthens the immune system, significantly lowering the risk of developing opportunistic infections and their complications [3]. Other preventive steps include:

• Avoid exposure to contaminated food and water: Avoid eating undercooked eggs, unpasteurized dairy products or fruit juices, and raw sprouts. Do not drink water directly from lakes or rivers [1].
• Talk to your doctor about preventive medications and vaccines: For example, an annual flu vaccine is recommended for people with HIV, and the vaccine should be an injection (not a nasal spray) [3]. The pneumococcal vaccine is also important to protect against diseases such as pneumonia and meningitis [3].
• Practice good hygiene: Wash hands thoroughly with warm water and soap after any contact with human or animal feces [1].
• Avoid sharing needles, syringes, or other drug injection equipment [1].

If you experience symptoms such as fever, severe headache, stiff neck, nausea and vomiting, or vision changes, especially if you have HIV, these may be signs of a serious opportunistic infection such as cryptococcosis, which can affect the brain. In these cases, you should contact your healthcare provider immediately to evaluate your condition and receive appropriate treatment [2]. For more information on prevention and treatment, you can visit Opportunistic infections in people with HIV: Prevention and treatment (Arabic).

Medical references

• HIV and Infections
• Cryptococcosis
• Flu and People with HIV