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Opportunistic Infections and HIV

Over the course of time we are all exposed to bacteria, parasites, and viruses no matter how safe and precautious we are, right?!  If you are a healthy individual it is possible that you will never even know that you were exposed because you will never become infected.  However, those with human immunodeficiency virus (HIV) are at a much higher risk of not only becoming infected with these bacteria, parasites, and viruses they are also faced with more serious health threats as well.  These bacteria, parasites, and viruses are known as opportunistic infections (OIs) because they take advantage of a weak immune system and have the ability to cause potentially devastating illnesses.

OIs are the most common cause of death for those with HIV/ AIDS.  If someone who is HIV positive is diagnosed with any of the twenty AIDS-defining OIs they will be given a diagnosis of AIDS.  OIs are life threatening; signs and symptoms associated with OIs, prevention, as well as treatment should not be taken lightly.

What exactly are OIs?

OIs as mentioned above are named for their ability to attack an already weakened immune system.  OIs can be localized to one body part or they can be systemic and spread through multiple parts of the body.  So, when are you at risk of becoming infected with OIs?  Most of the time your body’s CD4 or T-cell count will determine whether or not you are susceptible.  For example the body’s normal CD4/T-cell count is roughly 500-1,600 cells/mm3.  The table below shows you a quick description of what your body is susceptible to with certain CD4/T-cell counts.

CD4/T-cell count: Susceptible to: Symptoms:
>500 cells/mm3 Usually for those with counts over 500 cells/mm3 being at risk is unlikely.  However for those with counts hovering around 500 cells/mm3, yeast infections and vaginal thrush are possible. See thrush symptoms in the box below
200-500 cells/mm3 Candidiasis (Thrush) 

 

 

 

 

 

 

 

 

Kaposi’s Sarcoma (KS)

Oral: loss of appetite, pain in the mouth and/or throat, difficulty swallowing, white patches on the tongue, lining of mouth, or gums 

Vaginal: itching, burning, irritation, white thick discharge

 

Purplish lesions on the skin or in the mouth, rare cases may also experience GI trouble

100-200 cells/mm3 Progressive Multifocal Leukoencephalopathy (PML) 

Pneumocystis Jirovecii Pneumonia (PCP)

 

Histoplasmosis/

Coccidioidomycosis

Dementia, difficulty walking and speaking, confusion, seizures 

Dry cough, fever, shortness of breath, chest pain

 

Headache, coughing, weight loss, fatigue, shortness of breath, chest pain, fever

50-100 cells/mm3 Cryptococcal infection/Cryptococcosis

 

 

 

 

Toxoplasmosis

 

 

 

Cryptosporidiosis

 

 

 

 

Cytomegalovirus (CMV)

Fever, neck stiffness, headache, and fatigue.  Memory loss and mood change may also be possible 

Fever, seizures, confusion, headaches, motor weakness

 

Nausea and vomiting, stomach cramps, weight loss, chronic watery diarrhea

 

Fever, fatigue, swollen glands, and sore throat.  Those with extremely low levels of CD4 can also experience abdominal pain, blurred vision, diarrhea, and swelling that is painful

<50 cells/mm3 Mycobaterium Aviam Complex (MAC) Night sweats, fatigue, diarrhea, abdominal pain

How to Prevent OIs

We know that germs are everywhere and in the case of OIs the infection is so widespread that is may be very difficult to avoid completely.  Like any other infection or illness there are always ways to help avoid OIs.  Keeping your CD4 counts above 500 cells/mm3 will make becoming infected with OIs less likely.  Below is a list of ways to help prevent becoming infected with OIs.

  • Take your HIV drug treatment as prescribed
  • Manage your stress well and get a good night’s rest
  • Quit smoking or doing other recreational drugs
  • Practice safe sex
  • Avoid drinking or cooking with contaminated/unsafe water
  • Get vaccinated
  • If you exercise you different towels to wipe your sweat off yourself and the equipment you use
  • Thoroughly wash all fruits and veggies
  • Thoroughly cook all foods and avoid raw meats, eggs, and unpasteurized dairy products
  • Exercise regularly
  • Eat a healthy diet
  • Use gloves to pick up your pets waste
  • If you are a cat lover, keep your cats indoor to help prevent them from carrying in germs that may put you at risk of becoming ill

This may look like a long list of things to do, but like any other individual who is HIV positive this is part of the lifestyle change.  Becoming aware of where your body is most susceptible and removing yourself for those situations is key.  Over time it will become almost natural to avoid areas and situations that will put you at risk of becoming infected with an OIs.

Healthy-eating-for-a-healthy-body

Staying Healthy When HIV Positive

Nutrition is a very important part of life for those infected with HIV.  Once infected with HIV the body begins to go through numerous changes making good nutrition vital.  Those who are HIV positive are more likely to also experience other infections, loss of appetite, as well as nausea and vomiting and/or diarrhea which may result in extreme weight loss.  Fat distribution syndrome or lipodystrophy may also occur which results in the body changing shape and rising levels of cholesterol.  Each of these bodily changes makes having a healthy diet and lifestyle essential.

The Basics to a Healthy Life

Healthy Diet

Healthy Diet

Anyone who is infected with HIV knows that it is important to have a healthy lifestyle and most likely visits a registered dietitian at least a few times a year in order to make sure their diet is fulfilling their bodies needs.  There is no specific HIV/AIDS diet out there today; however those infected do require more calories, vitamins/minerals, and certain food groups which can be discussed with your physician and registered dietitian.

The basic healthy diet consisting of lean, low-fat proteins, limited amounts of sweets and sugary foods, high consumption of vegetables, whole grains, legumes, and fruits that is suggested to everyone is also suggested to those with HIV/AIDS.  As well as incorporating the daily amount of recommended water intake and consuming meals and snacks with proteins, carbohydrates, and a small amount of good fats.  All of these basic diet guidelines will help keep the body regulated and working properly.  With a properly functioning body, one’s life expectancy is increased.

Vitamins and minerals are also very important to those infected with HIV as they need extra vitamins and minerals in order to help repair and heal any and all damaged cells in the body.  Consuming foods with higher amount of immune boosting vitamins and minerals is important.  These vitamin and minerals include:

  • Zinc: which is found in peanuts, milk and dairy products, beans, fish, poultry, and meat
  • Vitamin E: which is found in peanuts, vegetable oils, and green lefty veggies
  • Selenium: which is found in fish, eggs, peanut butter, nuts, whole grains, and poultry
  • Vitamin A: which is found in milk, whole eggs, liver, dark green, yellow, red, or orange fruits/veggies
  • Vitamin C: which is found in citrus fruits
  • B Vitamins: which is found in green leafy veggies, white beans, nuts, grain, fish, meat, chicken, broccoli, and avocados

Being able to get the recommended about of vitamins and minerals may be difficult through diet alone, especially since higher amounts are recommended to those infected with HIV.  Physicians and registered dietitians may recommend including a good multivitamin into your diet, such as the Health Beacon Multivitamins. http://healthbeacon.co.uk/articles/featured/health-beacon/2013/07/optimum-nutrition-complex-what-is-it.aspx

Food Safety

Food safety is also very important to those infected with HIV as they are at a much higher risk of contracting a food-borne illness due to a weakened immune system.  Protecting your body not only from the foods you eat but the preparation of foods is also very important.  These basic guidelines will help keep your body healthy and less at risk.

  • Use separate cutting board for your veggies, fruits, and raw meats (I use a different color for each!)
  • Thoroughly wash all fruits and veggies before consumption
  • Avoid consuming raw eggs, seafood, or meats (this includes sushi, shellfish, and oysters)
  • Thoroughly wash your hands, as well as cutting boards and utensils’ with hot water and soap after each use
  • Drink bottled water if unfamiliar with the area/traveling abroad, as well as ice
  • Avoid unpasteurized juices
  • Only used boiled water for drinking and cooking
  • Do not drink water from natural areas such as ponds, streams, etc.
  • Choose filtered or bottled water just to be on the safe side

Some Inspiration!

Look at Magic Johnson for example; he was diagnosed with HIV during his prime basketball career with the LA Lakers which lead him to early retirement in 1991, at the young age of 32.  Johnson came out of retirement twice within the next few years and finally retired for good in 1996.  Now over twenty years later he has controlled the HIV virus to undetectable levels through a life style change of diet, treatment (medication), and exercise.  Today, he is just like any other healthy man of his age doing what he loves.  Yes he will always be HIV positive as there is no cure, but he is a true inspiration to all.