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6 Complications of HIV: What You May Not Know

Medically reviewed by Barry S. Zingman, M.D.
Posted on August 23, 2023

Today human immunodeficiency virus (HIV) infection is a manageable chronic disease, thanks to advances in treatment options like antiretroviral therapy (ART). Even so, you could experience some HIV-related complications, so it’s important to be informed about these conditions.

“I just got out of the hospital — dealing with pneumonia and some other complications,” one myHIVteam member shared. Knowing about potential problems and their signs and symptoms will help you catch any problems early and get the treatment you need.

1. AIDS

AIDS is an advanced stage of HIV infection, in which the virus significantly affects the immune system. According to the Centers for Disease Control and Prevention (CDC), you have AIDS if you have fewer than 200 CD4-positive T cells (immune cells that are infected and destroyed by HIV) per milliliter of blood or if you get certain opportunistic infections, cancers, or other complications. People with AIDS have a severely weakened immune system and the potential for a significantly shortened life span.

2. Opportunistic Infections

Opportunistic infections occur when other viruses, bacteria, fungi, or parasites take advantage of an already weakened immune system. The resulting diseases can be life-threatening for people living with HIV, but with improved antiretroviral therapy, opportunistic infections are becoming less common.

Bacterial Infections

Tuberculosis (TB) is a bacterial lung infection. In healthy people, the immune system keeps TB from spreading, but people with HIV may have a harder time fighting off this infection. TB can cause chest pain, night sweats, fatigue, weight loss, fever, and a cough. In a 2022 U.K. study, researchers found that people with HIV were almost 10 times more likely to have TB than people who didn’t have HIV. Even so, just 7 percent of the participants with HIV were infected.

Fungal Infections

Fungal infections are often caused by yeast, a type of fungus. Opportunistic fungal infections include:

  • Thrush — Caused by the overgrowth of yeast that causes inflammation. Also known as candidiasis, thrush can affect your mouth, throat, or vagina, causing a creamy white coating on infected sites.
  • Cryptococcal meningitis — Caused by a fungus commonly found in the environment. Also known as cryptococcosis, cryptococcal meningitis affects your nervous system, causing symptoms such as fever, headaches, a stiff neck, and nausea.
  • Pneumocystis jirovecii pneumonia (PJP) — An opportunistic lung infection that’s common in people who don’t know they have HIV. The CDC estimates that up to 40 percent of people diagnosed with PJP — formerly known as pneumocystis pneumonia (PCP) — have HIV/AIDS.

Viral Infections

Viruses can also take advantage of a weakened immune system. Cytomegalovirus (CMV) is a type of herpes virus that’s kept in check by a healthy immune system. CMV can damage the eyes, lungs, kidneys, or other organs in people who have a weaker immune system, such as babies and HIV-positive people.

Parasitic Infections

Toxoplasmosis, sometimes called toxo, is caused by a parasite found in undercooked meats and in cat poop. A healthy immune system can keep this parasite under control, but it can lead to organ damage in people with a weakened immune system. To stave off parasitic infections, eat properly cooked meat, try to avoid cat litter, and wear gloves when working outdoors — most people pick up toxo from the soil, such as when gardening. Be sure to wash your hands after being in contact with dirt or scooping out a cat’s litter box.

3. Immune Reconstitution Inflammatory Syndrome

People who are beginning antiretroviral treatment may develop immune reconstitution inflammatory syndrome (IRIS). As your immune system begins to get stronger, it may react to preexisting opportunistic infections or tumors that are causing inflammation in your body. IRIS may affect up to 30 percent of people who have HIV and often occurs during the first six months of starting ART. The specific symptoms of IRIS vary but include fever, swollen lymph nodes, rashes, and difficulty breathing.

4. Cancer

Your immune system is important for fighting off cancer, so having an HIV-weakened immune system brings an increased risk of certain types of cancer. These include:

  • Lymphoma (cancer in white blood cells)
  • Kaposi’s sarcoma, which causes tumors on the walls of blood vessels
  • Cancers caused by HPV, a virus that can cause throat or cervical cancer, as well as other types of genital cancers

5. Dementia

HIV can infect your brain and cause dementia, which can make it hard to think clearly and may cause mood changes, difficulty sleeping, weight loss, or memory problems. Some form of dementia affects 7 percent to 27 percent of people in the later stages of HIV infection. Although dementia is typically irreversible, treatments can help you think more clearly and maintain your quality of life.

6. Wasting Syndrome

Wasting syndrome is an unexpected loss of 10 percent or more of your body weight in the span of a month, and it’s associated with advanced HIV/AIDS. While it’s much less common because of effective ART, wasting syndrome could develop if you don’t eat enough or your body has a hard time getting the nutrients you need from food. Opportunistic infections or drug side effects could also cause you to suddenly lose weight.

Talk with your doctor if you notice that you’re losing weight quickly. They can help treat the underlying causes and help you stay at a healthy weight.

How To Prevent HIV Complications

You can’t prevent all complications of HIV, but you can reduce your risk of developing them. Take preventive steps such as these:

  • Consistently take your prescribed ART as directed by your health care provider to suppress HIV, as well as to protect your immune system and allow it to recover from damage.
  • Maintain a healthy lifestyle. Exercise regularly, eat a healthy diet, and manage stress to support your overall well-being as a person with HIV.
  • Attend regular medical checkups so your health care provider can monitor your health, provide preventive medicines or vaccines, and make necessary lifestyle recommendations to help you maintain your quality of life.

HIV treatments have made living a long life with HIV possible. You can take the best care of yourself by learning about potential complications and discussing any new symptoms or concerns with your doctor and HIV care team. They are there to help you and provide the best care possible.

Talk With Others Who Understand

On myHIVteam, the social network for people with HIV and their loved ones, more than 37,000 members come together to ask questions, give advice, and share their stories with others who understand life with HIV.

Did you know about these other conditions related to HIV? Have you experienced any of them? Share your experience in the comments below, or start a conversation by posting on your Activities page.

References
  1. About HIV — Centers for Disease Control and Prevention
  2. AIDS and Opportunistic Infections — Centers for Disease Control and Prevention
  3. Opportunistic Infections — HIV.gov
  4. HIV/AIDS — Mayo Clinic
  5. HIV and Opportunistic Infections, Coinfections, and Conditions — HIVinfo.NIH.gov
  6. Health Conditions in Adults With HIV Compared With the General Population: A Population-Based Cross-Sectional Analysis — EClinicalMedicine
  7. Candidiasis — Centers for Disease Control and Prevention
  8. Invasive Candidiasis — Centers for Disease Control and Prevention
  9. Guidelines for the Prevention and Treatment of Opportunistic Infections in Adults and Adolescents With HIV: Cryptococcosis — Clinicalinfo.HIV.gov
  10. Treatment for HIV‐Associated Cryptococcal Meningitis — The Cochrane Database of Systematic Reviews
  11. Pneumocystis Pneumonia — Centers for Disease Control and Prevention
  12. Cytomegalovirus (CMV) Infection — Mayo Clinic
  13. Toxoplasmosis — Cleveland Clinic
  14. Immune Reconstitution Inflammatory Syndrome — StatPearls
  15. Rejection of Immunogenic Tumor Clones Is Limited by Clonal Fraction — eLife
  16. Cancers Associated With Human Papillomavirus (HPV) — Centers for Disease Control and Prevention
  17. HIV-Associated Neurocognitive Disorders — U.S. Department of Veterans Affairs
  18. HIV-1 Encephalopathy and Aids Dementia Complex — StatPearls
  19. HIV-Associated Dementia — Merck Manual
  20. Dementia (Major Neurocognitive Disorder) — Merck Manual
  21. Wasting Syndrome — International Association of Providers of AIDS Care
  22. 10 Things To Know About HIV Suppression — National Institute of Allergy and Infectious Diseases

Posted on August 23, 2023
All updates must be accompanied by text or a picture.

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Barry S. Zingman, M.D. specializes in HIV/AIDS medicine and general infectious disease. Review provided by VeriMed Healthcare Network. Learn more about him here
Catherine Leasure, Ph.D. is a Ph.D. candidate currently studying at Vanderbilt University in Nashville, Tennessee. Learn more about her here

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