You may need immediate care if you get a severe infection in late-stage HIV disease. If you have HIV, and you develop severe diarrhea, fever higher than 101°F, headache, stiff neck, stomack pain, weakness, trouble thinking clearly, severe cough or shortness of breath, notify your doctor or go to the emergency department.
Urgent care is most commonly required in the later stages of HIV disease, when the immune system becomes so weakened that opportunistic infections are difficult to keep under control. The most common reasons for urgent care include respiratory failure and severe neurological complications.
Pay attention to your nutritional intake, and eat even if you don’t feel hungry. If you have late-stage HIV, you burn energy at a higher rate than most people. Therefore, you will need to eat more just to maintain your normal body weight. At the same time, you may lose your appetite or have diarrhea, both of which lead to weight loss. You need to be constantly aware of your nutrition and eat even when you don’t feel like it. Most doctors recommend high-protein, low-fat, nutrient-rich diets with fresh fruits, vegetables, and whole grains. Small, frequent, regular meals are easier to digest than less frequent, larger meals. Many people with HIV take numerous vitamins and supplements.
Make sure to get regular exercise. Aerobic exercise strengthens your heart and lungs. Weight training or using exercise machines can build muscle mass. Check with your physician before starting a new exercise program.
Your doctor is the best source of information on the drug treatment choices available to you.
Get treated for substance abuse if necessary. Ending the abuse of alcohol, cocaine, heroin, and other drugs is especially critical for people with HIV. Similarly, smoking cessation can improve stamina, restore lung function over time, and reduce the risk of pneumonia. Quitting smoking can also reduce your risk of smoking-related illnesses such as emphysema and lung cancer.
Many people with HIV use some form of alternative medicine. Because HIV infection is a disease for which conventional medicine has no cure, many people infected with the virus seek out alternative treatments. These treatments include acupuncture, herbal remedies, spiritual approaches, homeopathy, and drugs not approved by the Food and Drug Administration for marketing in the U.S. Few alternative therapies have been studied in rigorously controlled clinical trials. It is important that your physician be aware of any alternative therapies being used, because some “natural” remedies can interact with drugs used to treat HIV or HIV-related opportunistic infections.
St. John's wort, an herb sometimes used to treat depression, may interfere with HIV drugs. Make sure your doctor knows if you are taking St. John's wort.
If you are pregnant, you should discuss delaying preventive medication for HIV-related infection until after the first trimester of pregnancy. You should also discuss the effect that your drugs may have on the developing fetus.
Prevention and treatment of opportunistic infections has increased the lifespan of people with AIDS. In the early stages of the epidemic, most people died within two years of developing AIDS. Often patients died because of opportunistic infections rather than HIV itself. Aggressive prevention, treatment, and suppression of opportunistic infections have improved both the quality and quantity of life of people living with AIDS.
Follow-up generally includes laboratory testing at regular intervals. Examples of lab tests include the annual tuberculin skin test (for those who are at risk of acquiring TB), an annual test for syphilis, a yearly Pap smear for women (twice the first year after HIV diagnosis), regular dilated eye examinations for individuals with CD4 counts under 50/µL, and CD4 counts every 3 to 6 months.
If your CD4 count improves and your HIV viral load decreases, your physician may recommend that you stop taking medications that prevent some opportunistic infections.
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