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Opportunistic Infections Associated with AIDS
or, What are the unusual infections people with AIDS can get?

As the T-cell count gets to lower values (and the HIV viral load gets higher and higher) the person with HIV (who usually has AIDS too) becomes more and more at risk for unusual infections or opportunistic infections (OI.)  Many if not all of these unusual infections are quite deadly especially if they are not recognized and treated quickly.  The early diagnosis and treatment of these infections is also facilitated by (1) the person in question already having been tested and known to infected with HIV and (2) the person in question having had recent T-cell counts.  If the client has not been tested or known to have HIV, much time and expense can be wasted treating more common illnesses all the while the more serious opportunistic infection is getting worse and worse.

See Table 1 below to get information on the most common opportunistic infections (OI). 

Never attempt to diagnose or treat your own opportunistic infection.  Many physicians find it difficult to diagnose and treat opportunistic infections after even years of training.

Once an opportunistic infection is treated, usually preventative or maintenance therapy must be prescribed promptly to keep the infection from coming right back.

One fact is very important to note:  The best prevention and treatment for any opportunistic infection is preservation or improvement of the immune system.

Table 1.  Opportunistic infections associated with AIDS

Opportunistic Infection
type of infection
T-cell range Symptoms Prevention Diagnostic Tests Treatment
esophageal candidiasis
0-200 White cheesy material on gums in mouth, difficulty and/or pain swallowing fluconazole (Diflucan) X-ray of esophagus or esophagoscopy (using a special scope to look down into the esophagus) fluconazole (Diflucan)
Pneumocystis carinii pneumonia
parasite or fungus
0-250 Dry cough, shortness of breath, fevers, chill, sweats, weight loss - all symptoms get slowly but steadily worse over days to weeks Bactrim, dapsone, or atovaquone (Mepron) Chest x-ray, blood oxygen level, exam of sputum Bactrim, pentamidine, atovaquone (Mepron,) clindamycin plus primaquine, dapsone plus trimethoprim
Cryptococcus neoformans meningitis
0-200 Fever, headache, stiff neck, sensitivity to light, dry cough, shortness of breath sometimes fluconazole (Diflucan) Spinal tap, blood cultures, blood tests, chest x-ray, sputum exam, CT or MRI of brain amphotericin B or fluconazole (Diflucan)
0-200 Skin rash, fever, chills, sweats, weakness, ulcers in mouth or on genitals none Blood cultures, urine tests, bone marrow examination, blood tests, skin biopsy amphotericin B or intraconazole (Sporanox)
0-100 Floaters in vision, decreasing vision, fever, cough, shortness of breath, headache sometime valganciclovir (Valcyte) or ganciclovir (Cytovene) Urine tests, blood tests, examination of eyes eye implant (lens), intravenous ganciclovir, intravenous foscarnet (Foscavir,) oral valganciclovir (Valcyte,) intravenous cidofovir (Vistide)
0-100 Severe watery diarrhea drink filtered or bottled water Stool tests intravenous fluids, medications to slow down the bowels, paromomycin, NTZ
disseminated MAC
0-100 High fever, chills, sweats, weight loss, diarrhea, abdominal pain, lymph node swelling azithromycin (Zithromax), clarithromycin (Biaxin) or rifabutin (Mycobutin) Blood cultures, bone marrow exams, lymph node biopsy clarithromycin (Biaxin) or azithromycin (Zithromax) plus ethambutol plus another drug which might be ciprofloxacin (Cipro,) levofloxacin (Levaquin), or rifabutin (Mycobutin)
progressive multifocal leukoencephalopathy
0-200 Stroke-like symptoms, seizures keeping immune system in good shape Spinal tap, MRI of brain improving immune system
0-100 Stroke-like symptoms, fever, headache, seizures Bactrim, dapsone plus pyrimethamine (Daraprim) CT or MRI of brain sulfadiazine plus pyrimethamine (Daraprim), clindamycin plus pyrimethamine, atovaquone (Mepron) plus pyrimethamine


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