Strategies for managing
opportunistic infections
May 2008 View PDF En
español
List of AIDS-defining OIs
from the Centers for Disease Control
Candidiasis (thrush) of the throat (esophagus, trachea)
or lungs
Fungal infection. Most people already have candida in their
body. Generally the body keeps it under control. Sugars (including
alcohol) are food for candida. There may be ways to adjust diet
to help prevent candida from becoming problematic.
Cervical cancer, invasive and/or recurrent
Cancer/Viral infection. Often caused by human papilloma
virus (HPV), the virus that causes anal and genital warts. Safer
sex may help reduce the risk of HPV infection, but many women are
infected with HPV even though they may have never had genital warts.
Regular GYN exams are important for checking for cervical cancer.
Coccidioidomycosis, outside the lungs and/or throughout
the body
Fungal infection. Found in soil in the southwestern U.S.
Likely passed through the air or wind, in dust and dirt, but not
from person to person. A fairly large outbreak followed the Northridge
earthquake in southern California and was likely due to dirt and
dust in the air. Most problematic in Kern and Tulare counties and
San Joaquin Valley in California.
Cryptococcosis, outside the lungs
Fungal infection. Found in soil, associated with bird droppings
in the soil. Likely passed through the air or wind, not person to
person. Avoid handling birds, even as pets, and avoid areas with
lots of bird droppings.
Cryptosporidiosis with diarrhea that lasts longer than
one month
Parasite. Found in feces of many species; may contaminate
drinking water. Prevent infection from humans by avoiding feces
(diapers, sex with direct oral/anal contact). Often exposure from
animals occurs from fecal contamination of water. Avoid drinking
from rivers and streams. When appropriate, drink bottled water and
or use filters on tap water that can filter out crypto.
Cytomegalovirus (CMV) disease of an organ other than the
liver, spleen or lymph nodes, including in the eye (CMV retinitis)
Viral infection. Most (50–85%) people likely infected
already. CMV is passed through close contact (sex, saliva, urine
and other body fluids) and from mother to child (during pregnancy
and breast-feeding). If not infected, safer sex may help prevent
it.
Herpes simplex virus (HSV) outbreak lasting over one month,
or HSV infections in the lungs/throat
Viral infection. Genital herpes is passed sexually. Safer
sex can decrease risk of infection. Oral-to-genital spread of herpes
possible.
Histoplasmosis, outside the lungs and/or throughout the
body
Fungal infection. Found in soil in eastern and central
US. Grows in soil contaminated with bat or bird droppings. Can pass
through the air when contaminated soil is disturbed—as in
exploring caves. Not passed from person to person.
HIV encephalopathy (“HIV dementia” or “AIDS
dementia”)
Viral infection. Caused by HIV. Possibly preventable by
using anti-HIV drugs that cross the blood-brain barrier.
HIV wasting syndrome
Viral infection. Caused by HIV, inflammation or as a result
from OIs. Possibly preventable, to some degree, by improving nutrition.
Isosporiasis with diarrhea that lasts more than one month
Parasite. Found in feces, may contaminate food or drinking
water. Most common in tropical and subtropical region of the U.S.
Prevent infection from humans by avoiding feces (diapers, sex with
direct oral/anal contact). Often exposure from animals occurs from
fecal contamination of water. Avoid drinking from rivers and streams.
When appropriate, drink bottled water or use filters on tap water.
Cook food thoroughly.
Kaposi’s sarcoma (KS)
Cancer/viral infection: Caused by human herpes virus 8
(HHV8 or KSHV). How it is passed is unknown, but believed to be
passed through close sexual contact and from mother to child. Practicing
safer sex may help avoid infection.
Lymphoma of the brain
Cancer. Unknown cause, but Epstein Barr Virus (EBV) may
play role in risk for lymphoma.
Lymphoma – Burkitt or non-Burkitt type
Cancer. Unknown cause.
Lymphoma – immunoblastic type
Cancer. Unknown cause.
Mycobacterium tuberculosis (TB) disease
Bacterial infection. Passed through the air, can be passed
from person to person by close contact, kissing or saliva. Transmission
may occur very casually, especially in closed-in spaces like low
income housing, shelters, jails or other places with close living
quarters.
Mycobacterium avium complex (MAC) or M. kansasii disease,
outside the lungs and/or throughout the body
Bacterial infection. Found everywhere in the environment—soil,
food and animals. Avoid handling soil, carefully handle and prepare
food. Difficult, perhaps impossible, to prevent exposure as it’s
in so many places in the environment.
Mycobacterium disease of unknown type, outside the lungs
and/or throughout the body
Bacterial infections. Likely found in soil, food and animals. May
be difficult to prevent exposure.
Pneumocystis jiroveci pneumonia (PCP)
Likely caused by a fungus, Pneumocystis jiroveci, found in many
places in the environment. Likely not preventable except with therapy
when risk for OI increases.
Pneumonia, recurrent
Bacterial infections. Likely caused by blood exposure to bacteria.
Most common in injection drug users. May be airborne and exposure
may occur through casual contact/saliva.
Progressive multifocal leukoencephalopathy (PML)
Viral infection. Caused by the JC virus. Most people likely already
infected. Causes disease in about 1% of people with HIV. Its cause
in some but not in others is not well understood. Possibly passed
through sexual contact, mother to child, etc.
Salmonella septicemia, recurrent
Parasite. Some forms likely passed through contaminated poultry
(chicken, etc.). Also found in water, soil, kitchen surfaces, animal
feces, raw eggs, raw meat (particularly chicken, pig and fish) and
on certain animals (reptiles).
Toxoplasmosis of the brain in people older than one month
of age
Parasite. Cats and birds are major sources of infection. Indoor
cats less of risk, but toxo-negative cats that go outside can carry
it back in. Cat feces should be avoided (use gloves to change litter).
Avoid handling birds. Toxo also found in undercooked meats.
NEXT