HIV, other health conditions and opportunistic infections

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When you are first diagnosed with HIV, it is likely that it will be your main health concern for a while. You need time to learn about it and how best to manage it. But, having HIV is only one part of a bigger picture, and thinking about other aspects of your health is important too.

As well as staying healthy by eating well, exercising and getting enough rest, you will need to manage any other health conditions you have with your healthcare professional.

Managing other health conditions

Some people have HIV and another long-term health condition, such as diabetes or epilepsy. This is known as having a co-infection. Many people develop other conditions as they get older, such as cardiovascular disease, osteoporosis, lung disease or kidney disease.1

It’s a good idea to learn about the health conditions that may affect you. In addition to any medication your healthcare professional gives you to treat health conditions, there may be lifestyle changes you can make to improve your health and any symptoms you have.

Talking to your healthcare professional about HIV and other health conditions

When you are managing another health condition alongside HIV, communication with the healthcare professionals treating you is important. Often, you will see one healthcare professional for HIV and another for the other condition. In some cases, drugs for another condition can interact with your HIV treatment, making one or both of them less effective, so it’s important that your healthcare professionals know about the drugs you are taking.2

If possible, the two healthcare professionals could talk to each other directly, but this is not always possible and gaps in communication can happen. The more you learn and understand, the more you can help to keep the flow of information running smoothly. It can be helpful to bring some notes with you to each appointment – such as the names of any drugs you are taking, and any symptoms you want to talk about.

Looking after your mental health

Looking after your health is not just about looking after your physical health. Mental health is also important and mental health problems, particularly depression and anxiety, are very common, although people often find it harder to talk about them.3 Your healthcare professional should take them just as seriously as any physical health problems you experience, and offer advice and treatment if appropriate.

As well as medical help, support from friends and family can also be very helpful in coping with health conditions.

Preventing other health conditions

Certain health conditions are preventable, and there are precautions and lifestyle changes we can take to avoid developing them. For example, you might decide to stop smoking, change your diet or take more exercise to reduce your risk of developing diabetes, heart disease or cancer.
They are also actions we can take to avoid some infections, such as having vaccinations, using condoms to avoid sexually transmitted infections, or using an insecticide-treated bed net in areas where malaria is common.

Common co-infections

Worldwide, tuberculosis (TB) is the most common infection among people living with HIV. It can be very serious and if it is not treated, it can kill. The symptoms of TB include a persistent cough, fever, unintended weight loss and night sweats. Your healthcare professional should test you for TB and if you do have it, you should receive treatment which cures the infection.
Hepatitis B and hepatitis C are also common among people living with HIV. Both are common among people who inject drugs, and hepatitis B is more common in South East Asia and sub-Saharan Africa. Hepatitis affects the liver and can be very serious if untreated. There is a vaccine against hepatitis B, and both hepatitis B and C can be treated.

Opportunistic infections

When someone living with HIV has a weakened immune system (shown by a low CD4 count), they are at risk of other illnesses. These are known as ‘opportunistic infections’ because they take the opportunity of the immune system being weak.

Opportunistic infections include:

• cryptococcal meningitis
• toxoplasmosis
• PCP, a type of pneumonia
• oesophageal candidiasis
• certain cancers, including Kaposi’s sarcoma.

Cotrimoxazole is a medicine used to prevent infections, and it is commonly prescribed to people living with HIV who have a low CD4 count.

WHO recommends cotrimoxazole for:4

• adults with HIV who have a CD4 count below 350, or who are ill because of HIV, until they are on stable HIV treatment
• all adults with HIV in areas where malaria or severe bacterial infections are common
• adults with HIV who also have active tuberculosis (TB).

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• 1. WHO (2013) ‘Consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection’
• 2. Evans-Jones, JG., et al (2010) ‘Recognition of risk of clinically significant drug interactions among HIV-infected patients receiving antiretroviral therapy’, Clinical Infectious Diseases, 50:1419-21
• 3. Smart, T., NAM (2009) ‘Mental health and HIV: a clinical review’
• 4. World Health Organisation (2014) ‘Guidelines on post-exposure prophylaxis for HIV and the use of co-trimoxazole prophylaxis for HIV-related infections among adults, adolescents and children. Recommendations for a public health approach’, December 2014 supplement to the 2013 consolidated ARV guidelines

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Last updated: 19 February 2016

Last full review: 01 May 2015

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