Medical News Today: What are the complications of HIV?

HIV is a virus that attacks the body’s immune system, reducing its ability to fight off illnesses.

While over 1.1 million people in the United States live with HIV, 1 in 7 are unaware of their condition.

With treatment, some people with HIV can considerably reduce their risk of complications and have a life expectancy comparable to that of the general population.

Without treatment, however, HIV may progress to stage 3 HIV, which is also known as AIDS. Having stage 3 HIV can put a person at risk of several complications, including the development of certain rare infections and cancers.

In this article, we list the most common HIV complications and explain how treatment can prevent their onset.

HIV complications and symptoms

Man with HIv complications describing symptoms to doctor
A person with HIV is at an increased risk of certain infections or cancers.

People with HIV often experience an initial period of flu-like symptoms, followed by several years with few or no symptoms. This second phase, or stage 2 HIV, can last up to 10 years without treatment, or be life-long with treatment.

Without treatment, however, HIV can progress to stage 3 HIV. People with stage 3 HIV are more susceptible to several types of infection, known as opportunistic infections, as well as some cancers.

These complications arise when a person’s CD4 cell count falls below a certain level. CD4 cells are white blood cells that perform an essential role in immune function.

According to the Centers for Disease Control and Prevention (CDC), there are at least 20 opportunistic infections, cancers, and other complications that people with HIV may be at risk of developing.

HIV complications may include:

Infections

People with HIV are more likely than the general population to develop the following infections:

Candidiasis

This fungal infection causes a thick, white coating to form on the skin, nails, and mucous membranes.

Candidiasis commonly affects the mouth, vagina, and esophagus (food tube). When the infection occurs in the vagina, it is generally known as a vaginal yeast infection. When it affects the mouth, it is known as oral thrush.

However, medical professionals only consider this fungus to be an opportunistic infection when it occurs in the esophagus or lower respiratory tract.

Coccidioidomycosis

A fungal infection that usually affects the lungs, coccidioidomycosis results from inhaling fungal spores that are common in hot, dry regions.

It causes a form of pneumonia called desert fever.

Cryptococcosis

This fungal infection enters the body through the lungs, leading to pneumonia. It can then spread to the brain, where it causes swelling.

It also commonly affects the bones, skin, and urinary tract.

Cryptosporidiosis

People can contract this infection by eating or drinking food or water contaminated with the intestinal parasite Cryptosporidium. It causes severe and persistent diarrhea.

Cytomegalovirus

Cytomegalovirus is a viral infection that can cause inflammation of the brain (encephalitis), retina of the eye (retinitis), stomach (gastroenteritis), and other organs.

Herpes simplex (HSV)

HSV is a common virus that affects many people, occasionally causing sores around the mouth or genitals.

But for people with HIV, it can be especially problematic and lead to recurrent sores. It may also infect the bronchus (breathing tube) or esophagus, or lead to pneumonia.

Histoplasmosis

The fungus Histoplasma capsulatum typically infects the lungs, causing symptoms of pneumonia.

People with later stage HIV may be more likely to develop a severe form of histoplasmosis that affects other organs too.

Isosporiasis

Eating contaminated food or water can cause an isosporiasis infection. In those with HIV, symptoms of isosporiasis can be severe and include diarrhea, fever, vomiting, and weight loss.

Mycobacterium avium complex (MAC)

Different types of mycobacteria can cause this infection, which rarely affects people without HIV. In those with HIV, especially stage 3 HIV, this bacterial infection can be life-threatening.

Pneumocystis carinii pneumonia (PCP)

PCP is a fungal lung infection that causes breathing problems, a dry cough, and fever.

Pneumonia

Pneumonia can cause fever and chills.
Pneumonia can cause fever and chills.

Pneumonia is a lung condition that results from an infection by one of several bacteria, viruses, or fungi.

Symptoms of pneumonia include chills, difficulty breathing, fever, and a wet cough. It can be life-threatening in people with HIV.

A vaccination for a particularly severe form of bacterial pneumonia is now available to prevent infection.

Anyone with HIV or AIDS should discuss the benefits of this vaccine with their doctor.

Progressive multifocal leukoencephalopathy

This is a rare viral condition that affects the brain and spinal cord. It predominantly affects people with HIV.

Symptoms include blindness, mental impairment, and paralysis.

Salmonella septicemia

Infection with the Salmonella bacteria causes approximately 1.2 million illnesses in the U.S. every year. Contaminated food is the primary source of infection.

For people with HIV, this infection may progress to a severe form called salmonella septicemia that affects the entire body.

Toxoplasmosis

Cats, rodents, and other animals often carry the Toxoplasma gondii parasite. When transmitted to humans, it can affect the eyes, lungs, heart, liver, and more. If it reaches the brain, toxoplasmosis can cause seizures.

Toxoplasmosis may develop if a person with a weakened immune system comes into contact with cat litter and other sources of animal feces. It can also come from eating undercooked red meat and pork.

Tuberculosis (TB)

TB is a bacterial infection of the lungs that leads to symptoms such as a cough, fatigue, fever, and weight loss. It may spread to other areas of the body too.

TB is one of the most common opportunistic infections causing death in people with HIV. It is less common in the United States than in some other countries because medications for HIV are widely available.

Cancers

People with HIV can develop several types of cancer, including:

Invasive cervical cancer

This cancer begins in the cervix, which is the bottom section of the uterus. Without treatment, it can spread to other areas of the body.

Regular cervical checks can help prevent the development and progression of cervical cancer.

Kaposi’s sarcoma (KS)

KS is rare in people who do not have HIV. It causes tumors in the walls of the blood vessels that appear as pink, purple, or black lesions on the skin.

If KS spreads to the lungs, lymph nodes, or other organs, it can be life-threatening.

Lymphoma

There are many forms of this cancer, which affects the white blood cells and lymph nodes.

One early symptom is swelling of the lymph nodes. Types that often affect people with HIV are Hodgkin lymphoma and non-Hodgkin lymphoma.

Other complications

Additional complications include:

  • Neurological conditions. HIV is associated with complications such as anxiety, confusion, depression, and dementia.
  • Wasting syndrome. People with this condition lose at least 10 percent of their body weight and experience diarrhea, fever, or weakness for at least 1 month. This complication is less common today, thanks to better HIV treatments.

Stage 3 HIV

Woman organising prescription pills
Maintaining a treatment plan can help prevent HIV complications.

Modern treatments, known as antiretroviral therapy, mean that most people with HIV do not develop stage 3 HIV.

Without treatment, a person will develop stage 3 HIV, usually within 10 years.

Stage 3 HIV indicates serious and irreversible damage to the immune system. A person living with stage 3 HIV has an increased likelihood of developing infections and other complications.

The earlier a person seeks treatment, the lower their risk of HIV progressing to Stage 3 HIV.

Staying healthy

The best way to help prevent complications from HIV is to receive treatment as soon as possible. Antiretroviral therapy can improve a person’s quality of life and reduce the risk of transmission.

The following lifestyle habits may also help people with HIV stay healthy:

  • Eating a balanced diet, full of fresh fruits and vegetables, whole grains, and lean protein sources.
  • Avoiding raw meat, seafood, eggs, and unpasteurized dairy products, which may increase the risk of food poisoning.
  • Preparing and storing food in a hygienic manner.
  • Not drinking water directly from lakes or rivers.
  • When in a foreign country, drinking bottled water and avoiding ice and foods that may be a source of infection, such as raw meat or peeled fruits and vegetables.
  • Always using condoms to avoid getting other STIs.
  • Never sharing needles or syringes with anyone else.
  • Avoiding people who have contagious infections.
  • Avoiding some supplements, such as St. John’s wort and garlic supplements, which may interfere with antiretroviral medications.
  • Practicing good hygiene around pets, especially cats, and their feces. Wear gloves when changing litter trays and wash hands thoroughly afterward.
  • Asking a doctor about vaccinations to help prevent pneumonia and other serious infections.

Treatment

Several effective medications are available to treat HIV symptoms and prevent the virus progressing to stage 3 HIV.

When a person receives antiretroviral treatment, it reduces their viral load. The viral load is the amount of virus in a person’s blood or fluids. When a person’s viral load becomes undetectable, it means that they can no longer transmit the virus to other people.

Everyone with HIV should begin antiretroviral medications as soon as possible, regardless of their age, symptoms, or CD4 cell count.

To ensure the most effective treatment, individuals should stick to their treatment plan and see a doctor regularly for monitoring.

Outlook

Although people with HIV are at risk of several complications, the outlook for those with the condition has improved drastically over the last few decades. Modern treatments can prevent both symptoms and complications developing.

Together with lifestyle changes, antiretroviral medications mean that most people with HIV can enjoy a lifespan similar to that of the general population.