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Today, human immunodeficiency virus (HIV) infection is a manageable chronic disease. This is largely due 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 can help you catch problems early and get treatment.
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 either of these factors is true:
People with AIDS have a severely weakened immune system. Without treatment, they can usually live for about three years.
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.
Tuberculosis (TB) is a bacterial infection that primarily affects the lungs. In healthy people, the immune system keeps TB from spreading, but people with HIV may have a harder time fighting off this infection. When TB becomes active, it can cause chest pain, night sweats, fatigue, weight loss, fever, and a cough that doesn’t go away.
Despite advances in treatment, TB remains a leading cause of death among people with HIV worldwide. The World Health Organization (WHO) reported that in 2023, 161,000 people with HIV died from TB. The WHO now recommends better ways to treat TB in people with HIV, especially in places where both diseases are common.
Fungal infections are also associated with HIV. Candidiasis is caused by an overgrowth of Candida, a type of yeast that normally lives in the body without causing problems. But when your immune system is weak, Candida can grow too much and lead to infection in the mouth (often called thrush), throat, or vagina. You may notice a white coating or discharge at infected sites. When the infection spreads to your blood, it’s referred to as invasive candidiasis and often accompanied by symptoms like fever or chills.
Cryptococcal meningitis is caused by a fungus commonly found in soil and bird droppings. It affects your nervous system. It causes symptoms such as fever, headaches, a stiff neck, and sensitivity to light.
Pneumocystis pneumonia (PCP) is an opportunistic lung infection. The CDC estimates that between 30 percent and 40 percent of people diagnosed with PCP have HIV/AIDS. However, this number has decreased in recent years due to improved medical treatment.
Viruses can also take advantage of a weakened immune system. Cytomegalovirus (CMV) is a type of virus that’s kept in check by a healthy immune system. However, CMV can cause symptoms when the immune system is severely weakened, like it is in those with lower CD4 counts (a key immune system marker). In people with HIV, CMV most often shows up as an eye condition called CMV retinitis, when the retina (the thin layer at the back of the eye) becomes inflamed. However, the infection can affect other parts of the body as well.
Toxoplasmosis, sometimes called toxo, is caused by a parasite found in undercooked meats and in cat poop. The transmission is most common when people eat raw or undercooked meat and food and water that are dirty or unsafe. A healthy immune system can keep this parasite under control, but it can lead to organ damage in people with very weak immune systems. In these cases, toxo often affects the brain and causes a condition called toxoplasma encephalitis. Toxo is the most common brain infection in people with AIDS who aren’t on preventive medications.
To stave off toxo, eat properly cooked meat, try to avoid cat litter, and wear gloves when working outdoors — 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.
People who are beginning antiretroviral treatment may develop immune reconstitution inflammatory syndrome (IRIS). As your immune system gets stronger, it might notice infections that were already there and start to fight them, which can cause 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 can include fever, fatigue, and pain.
Your immune system is important for fighting off cancer, so having an HIV-weakened immune system brings an increased risk of many types of cancers. Cancers commonly associated with HIV include:
Importantly, even people with well-managed HIV can still face higher cancer risks compared to those without HIV. This may be due to coexisting infections or lifestyle habits, including drinking alcohol or using tobacco.
HIV can infect your brain, causing cognitive changes. This can make it hard to think clearly and may cause mood changes, difficulty sleeping, weight loss, or memory problems. Neurocognitive changes, even slight ones, have been reported in up to 40 percent of people with HIV who take ART. Defined disorders like dementia are rarer, although they may affect between 4 percent and 15 percent of people with HIV. Although dementia is typically irreversible, treatments can help you think more clearly and maintain your quality of life.
Wasting syndrome is an unexpected loss of 10 percent or more of your body weight in addition to more than a month of diarrhea, fever, or weakness. While it’s much less common because of effective ART, wasting syndrome could develop if you don’t eat enough or if your body has a hard time getting the nutrients you need from food. For example, opportunistic infections could cause you to suddenly lose weight by increasing your body’s energy requirements while also making it painful to eat.
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.
You can’t prevent all complications of HIV, but you can reduce your risk of developing them. Take preventive steps such as these:
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.
On myHIVteam, the social network for people with HIV and their loved ones, 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 wondered how HIV affects the brain or body? Share your experience in the comments below, or start a conversation by posting on your Activities page.
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A myHIVteam Member
I had to deal with a good number of these issues, darkest time in my life.