Your symptoms will depend on the pathogen involved, the site of your infection, and the health of your immune system [Table 1]. HIV-related infections may affect any part of your body. Some opportunistic infections may also cause symptoms that spread through several areas of your body. In general, the healthier your immune system, the less severe the disease. For example, tuberculosis is usually confined to the lungs in people whose immune systems are still rather strong. As the immune system weakens, tuberculosis may spread outside the lungs to other areas of the body.
| Disease |
Symptoms |
| Pneumonia |
Fever, fatigue, weight loss, cough, difficulty breathing, night sweats. |
| Encephalitis |
Altered mental states, focal paralysis, seizures, severe headaches, fever. |
| Gastroenteritis |
Diarrhea, abdominal cramping, nausea, vomiting, fatigue, gas, weight loss, loss of appetite, constipation, dehydration. |
| Tuberculosis |
Cough, coughing up blood, weight loss, night sweats, fatigue, fever, swollen glands. May spread to central nervous system, gastrointestinal tract, or skeleton. |
| Disseminated infection |
Fever, night sweats, fatigue, weight loss, diarrhea, anemia, abdominal pain, weakness, dizziness, nausea, enlarged glands, enlarged liver and spleen. |
| Meningitis |
Headaches, stiffness in the neck, malaise, fever, nausea, fatigue, loss of appetite, altered mental status. |
| Oral yeast infections |
White patches on the gums, tongue, or lining of the mouth; loss of appetite. |
| Vaginal yeast infections |
Vaginal burning, itching, and discharge. |
| Histoplasmosis |
Fever, weight loss, skin lesions, difficulty breathing, anemia, enlarged glands. |
| CMV retinitis |
Vision loss, seeing “floaters” or flashing lights. |
| Enterocolitis |
Diarrhea, weight loss, abdominal pain. |
| Encephalitis |
Headache, fever, focal paralysis, confusion, seizures. |
| Pneumonitis |
Cough, difficulty breathing, fever, chest pain. |
| Herpes simplex virus |
Painful blisters, ulcers, and/or itching on the lips, anus, or genitals. |
| Shingles |
Itching, burning, painful blisters with that erupt in a discrete band on the skin, fever, muscle pain, malaise, rash. |
| Kaposi's sarcoma |
Purple or deep-red skin lesions, most commonly on the face, genitals, extremities, and in the mouth; can also involve internal organs. |
| Genital warts |
Warts on the genitals or anus. |
| Anogenital neoplasia |
Cervical or anal cancer. |
| Oral “hairy” leukoplakia |
Painless white lesions (lines or plaques) on the sides of the tongue and insides of the cheeks. |
| Nervous system tumor |
Confusion, slowness, personality changes, seizures. |
Your risk of developing opportunistic infections depends on the health of your immune system [Table 2]. The health of your immune system is measured by the number of a certain kind of white blood cell (CD4 cells) per microliter (µL) of blood. The fewer CD4 cells you have, the more likely you are to get sick. Certain diseases are likely to occur at different levels of CD4 counts. For example, tuberculosis and oral thrush occur even in people whose immune systems are relatively healthy (CD4 counts >200/µL), while other infections usually don't appear until late in the course of HIV disease (CD4 counts <50/µL).
| CD4 Count |
Disease |
| 200-500/µL |
Pneumonia (usually caused by bacteria) |
| Tuberculosis in the lungs |
| Oral or vaginal yeast infections |
| Shingles (viral skin infection) |
| Oral hairy leukoplakia |
| Kaposi's sarcoma |
| 100-200/µL |
All of the above plus: |
| Pneumonia due to Pneumocystis carinii (PCP) |
| Chronic diarrhea |
| 50-100/µL |
All of the above, plus: |
| Encephalitis (usually due to toxoplasmosis) |
| Esophagitis due to yeast or viruses |
| Meningitis (usually due to cryptococcus) |
| Tuberculosis outside the lungs |
| Chronic herpes simplex virus (HSV infection |
| Primary brain lymphoma |
| <50/µL |
All of the above, plus: |
| Widespread infection due to Mycobacterium avium complex |
| Retinitis, diarrhea, encephalitis due to cytomegalovirus |
Engaging in unsafe sexual practices increases your risk of exposure to pathogens that cause HIV-related opportunistic infections.
Having unprotected sex (sex without condoms) increases your risk of getting sexually transmitted diseases. In addition, engaging in sexual practices where your mouth comes in contact with your partner’s anus increases your risk of acquiring certain gastrointestinal and liver infections.
Sharing needles or intravenous drugs puts you at serious risk of exposure to and infection with hepatitis B, hepatitis C, additional strains of HIV, and other blood-borne pathogens.
