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Burkitt's Lymphoma Candidiasis in the bronchi, trachea, lungs, or esophagus Cervical Cancer Coccidioidomycosis (disseminated or outside the lungs)

Cryptococcosis (outside the lungs) Cryptosporidiosis in the intestines lasting for more than 1 month Cytomegalovirus [CMV] (outside the liver, spleen, or lymph nodes) Cytomegalovirus retinitis [CMV] (with loss of vision) HIV encephalopathy Herpes Simplex lesions lasting for more than one month Herpes Simplex in the bronchi, lung, or esophagus Histoplasmosis (disseminated or outside the lungs) Immunoblastic lymphoma Invasive cervical carcinoma (cancer) Isosporiasis in the intestines lasting for more than one month Kaposi's Sarcoma Lymphoma (primary in the brain) Mycobacterium avium complex [MAC] (disseminated or outside the lungs) Mycobacterium kansasii (disseminated or outside the lungs) Mycobacterium tuberculosis (TB) Mycobacterium [other types] (disseminated or outside the lungs) Pneumocystis carinii pneumonia Pneumonia (recurrent in 12 month period) Progressive multifocal leukoencephalopathy (PML) Salmonella septicemia (recurrent) Toxoplasmosis (in the brain) Wasting syndrome

Protozoa Gastroenteritis Cyptosporidium (inflammation of muris stomach-intestine membranes) Isospora belli Gastroenteritis Investigational only Trimethoprimsulfamethoxazole (Bactrim) Pyrimethamine and leucovorin, plus sulfadiazine, or Clindamycin, Bactrim Nystatin, clotrimazole, ketoconazole Amphotericin B, fluconazole, ketoconazole Amphotericin B, fluconazole, itraconazole Trimethoprimsulfamethoxazole (Bactrim, Septra), Pentamidine, Dapsone Rifampin + ethambutol +

(MAC)

weight loss, lymphadenopathy, severe gastrointestinal disease

Toxoplasma gondii Fungi Candida sp. Coccidioides immitis Histoplasma capsulatum

Encephalitis (brain abscess), retinitis, disseminated

Stomatitis (thrush), proctitis, vaginitis, esophagitis Meningitis, dissemination Pneumonia, dissemination

Pneumocystis carinii Bacteria Mycobacterium aviumcomplex

Pneumonia

Dissemination, pneumonia, diarrhea,

Pneumonia Mycobacterium (tuberculosis), tuberculosis(TB) meningitis, dissemination Viruses Fever, hepatitis, Cytomegalovirus encephalitis, renitis, (CMV) pneumonia, colitis, esophagitis Oral hairy leukoplakia, Epstein-Barr B cell lymphoma Mucocutaneous (mouth, genital, rectal) blisters and/or ulcers, Herpes simplex pneumonia, esophagitis, encephalitis Progressive multifocal Papovavirus J-C leukoencephalopathy Dermatomal skin Varicella-zoster lesions (shingles), encephalitis Cancers Disseminated Kaposi's sarcoma mucocutaneous lesions

clofazimine + cirpofloxacin +/amikacin; clarithromycin & azithromycin (both investigational) Isoniazid (INH) + rifampin + ethambutol +/pyrazinamide

Ganciclovir, Foscarnet Acyclovir

Acyclovir

none Acyclovir, Foscarnet Local injection, surgical excision or

often involving skin, lymph nodes, visceral organs (especially lungs & GI tract) Headache, palsies, Primary seizures, hemiparesis, lymphoma of the mental status, or brain personality changes Fever, night sweats, Systemic weight loss, enlarged lymphomas lymph nodes

radiation to small, localized lesions; Chemotherapy with vincristine & Bleomycin Radiation and/or chemotherapy

Chemother

. Candidiasis (Thrush) A description of candidiasis (thrush), including transmission, symptoms, diagnosis and treatment. [Revised: April 26, 2007] 502. Cryptosporidiosis A description of the opportunistic infection cryptosporidiosis, including symptoms, prevention and treatment. [Revised: April 12, 2007] 503. Cryptococcal Meningitis A description of the opportunistic infection cryptococcal meningitis, including symptoms, prevention and treatment. [Revised: April 26, 2007] 504. Cytomegalovirus (CMV) A description of the opportunistic infection cytomegalovirus (CMV), including symptoms, prevention and treatment. [Revised: April 26, 2007] 505. Dementia and Nervous System Problems A description of dementia and central nervous system problems, including symptoms, prevention and treatment. [Revised: October 27, 2006] 506. Hepatitis: Overview A description of the seven types of viral hepatitis, their symptoms and diagnosis. Basic information on treatment. [Revised: July 23, 2007] 507. Hepatitis C A description of hepatitis C, its diagnosis, treatment and prevention. Discussion of co-infection with both HIV and hepatitis C. [Revised: April 26, 2007] 508. Herpes Simplex (Cold Sores and Genital Herpes) A description of herpes simplex virus that causes cold sores or genital herpes, and its interactions with HIV infection. Transmission, treatment and prevention of herpes simplex. [Revised: May 2, 2007] 509. Herpes Zoster (Shingles)

A description of shingles (herpes zoster), including transmission, symptoms, diagnosis and treatment. [Revised: September 1, 2006] 510. Human Papillomavirus (HPV) A description of human papillomaviruses (HPV) and the problems they can cause, including genital warts and cervical dysplasia. [Revised: November 9, 2006] 511. Kaposis Sarcoma (KS) A description of the opportunistic infection Kaposi?s Sarcoma (KS), including symptoms, prevention and treatment. [Revised: May 13, 2007] 512. Lymphoma A description of the opportunistic infection Non-Hodgkins Lymphoma (NHL), including symptoms, diagnosis, prevention and treatment. [Revised: July 23, 2007] 513. Molluscum A description of the opportunistic infection molluscum contagiosum, including symptoms, diagnosis, prevention and treatment. [Revised: May 13, 2007] 514. Mycobacterium Avium Complex (MAC) A description of the opportunistic infection Mycobacterium Avium Complex (MAC), including symptoms, diagnosis, prevention and treatment. [Revised: July 23, 2007] 515. Pneumocystis Pneumonia (PCP) A description of the opportunistic infection pneumocystis jiroveci pneumonia (PCP), including symptoms, diagnosis, prevention and treatment. [Revised: April 12, 2007] 516. Progressive Multifocal Leucoencephalopathy (PML) A description of the opportunistic infection progressive multifocal leucoencephalopathy (PML), including symptoms, diagnosis and

treatment. [Revised: April 26, 2007] 517. Toxoplasmosis A description of toxoplasmosis, including transmission, symptoms, diagnosis and treatment. [Revised: July 23, 2007] 518. Tuberculosis (TB) A description of tuberculosis (TB), including transmission, symptoms, diagnosis and treatment. [Revised: October 27, 2006] 519. Wasting Syndrome A description of AIDS wasting, including causes and treatments. [Revised: April 12, 2007]

Drugs to Treat Opportunistic Infections


530. Azithromycin (Zithromax) A discussion of the antibiotic drug azithromycin (Zithromax) used to fight some AIDS-related opportunistic infections. [Revised: May 13, 2007] 531. Ciprofloxacin (Cipro) A discussion of the antibiotic drug ciprofloxacin (Cipro) used to fight some AIDS-related opportunistic infections. [Revised: April 26, 2007] 532. Clarithromycin (Biaxin) A discussion of the antibiotic drug clarithromycin (Biaxin) used to fight some AIDS-related opportunistic infections. [Revised: May 13, 2007] 533. Dapsone (Avlosulfon) A discussion of the antibiotic drug dapsone (avlosulfon) used to fight some AIDS-related opportunistic infections. [Revised: September 10, 2006] 534. Fluconazole (Diflucan)

Opportunistic Infections: Brain


Cryptoccoccal Menigitis This is a yeast-like fungus infection that usually involves the brain and lungs, although it can affect almost any organ. The fungus that causes this condition is found in soil throughout the world. It is most common in soil contaminated by bird droppings. This disease most often occurs when a person's CD4+ T cell count falls below 100 cells per cubic millimeter of blood. HIV-related Encephalopathy Encephalopathy is a term for diseases that alter brain function or structure, leading to problems with cognitive function, or mental processes, and memory. In people with HIV and AIDS, encephalopathy is usually caused by an infectious agent, such as a bacteria, virus or prion. Encephalopathy most often occurs when a person's CD4+T cell count falls below 50 cells per cubic millimeter of blood. Toxoplasma-seropositive patients who have a CD4+T cell count of less than 100 cells per cubic millimeter of blood should be treated with prophylaxis to prevent developing encephalopathy. Progressive Multifocal Leukoencephalopathy (PML) Progressive multifocal leukoencephalopathy is a rare disorder of the nervous system caused by a common human polyomavirus, JC virus. It leads to the destruction of the myelin sheath that covers nerve cells. The myelin sheath is the fatty covering that acts as an insulator on nerve fibers in the brain. Symptoms include mental deterioration, vision loss, speech disturbances, inability to coordinate movements, paralysis and ultimately coma. In rare cases, seizures may occur. This disease can occur when the CD4+T cell count falls below 200 cells per cubic millimeter of blood. Toxoplasmosis This condition occurs when a parasite infects the brain. Symptoms include confusion or delusional behavior, severe headaches, fever, seizures and coma. It can affect the eye, causing eye pain and reduced vision. Toxoplasmosis most likely occurs when the CD4+ T cell count falls below 100 cells per cubic millimeter of blood. Preventative treatment usually with trimethoprim-sulfamethoxazole, also called Septra and Bactrim may

be administered when the CD4+ T cell count falls below 100 cells per cubic millimeter of blood.

Opportunistic Infections: Eyes


Cytomegalovirus (CMV) Although this virus can affect the entire body, it commonly affects the eye's retina, causing blurry vision and in severe cases, blindness. Other common symptoms include chronic diarrhea and nerve problems. It is most likely to occur when a persons CD4+ T cell count falls below 100 cells per cubic millimeter of blood.

Opportunistic Infections: Gastrointestinal Tract


Cryptosporidiosis This is a parasite that can cause chronic diarrhea. Other symptoms include stomach cramps, nausea, fatigue, weight loss, appetite loss, vomiting and dehydration. This infection is difficult to treat and there is no definitive effective treatment. Symptom control and treatment of HIV are necessary. Cytomegalovirus Although this virus can affect the entire body, it commonly occurs in the stomach, causing fever, diarrhea and stomach pain. It most likely occurs when the CD4+ T cell count falls below 50 cells per cubic millimeter of blood. Mycobacterium Avium Complex This is a bacterial infection that can cause persistent fever, night sweats, fatigue, weight loss, anemia, abdominal pain, dizziness, diarrhea and weakness. The bacteria that cause this infection is found in water, dust, soil and bird droppings. This disease most likely occurs when the CD4+T cell count falls below 50 cells per cubic millimeter of blood. Preventive treatment, usually with azithromycin, is administered when CD4+ T cells are less than 50 cells per cubic millimeter of blood.

Opportunistic Infections: Genitals


Candidiasis Candidiasis is an infection caused by the candida fungi. Also known as a yeast infection, it's the most common HIV-related fungus infection. It can affect the entire body, but most commonly occurs in the mouth, called thrush, or vagina. An overgrowth of yeast in the vagina can cause irritation, itching, burning and thick white discharge.

Herpes Simplex This virus causes genital herpes, which are painful blisters in the genital area, or cold sores. Severe conditions are more common in the advanced stage of AIDS. Human Papilloma Virus (HPV) This condition is considered the most common sexually transmitted disease (STD) in the United States. It can cause warts on the anus, cervix, esophagus, penis, urethra, vagina and vulva. Studies have shown that certain types of HPV can contribute to the development of cervical and anal cancer. Individuals with HIV and AIDS are at increased risk for developing precancerous and cancerous lesions.

Pneumocystis Carinii This condition occurs when a fungus infects the lungs. Symptoms may include fever, cough, difficulty breathing, weight loss, night sweats and fatigue. It is most likely to occur when the CD4+ T cell count falls below 200 cells per cubic millimeter of blood. Preventative treatment may be administered when the CD4+ T cell count falls below 200 cells per cubic millimeter of blood. Treatment is usually trimethoprim-sulfamethoxazole, also called Septra or Bactrim, dapsone or atovoquone. Recurrent Pneumonia People with AIDS are at risk for recurrent bacterial pneumonia. Bacteria can infect the lungs, which may lead to problems ranging from a mild cough to severe pneumonia. Recurrent pneumonia is most likely to occur when the CD4+ T cell count falls below 200 cells per cubic millimeter of blood. Tuberculosis (TB) This is a serious, and often deadly, bacterial infection that primarily infects the lungs. TB is transmitted when a person with active TB coughs or sneezes, releasing microscopic particles into the air. If inhaled, these particles may transmit the condition. Once infected by TB, most people remain healthy and develop only latent infection. People with latent infection are neither sick nor infectious. However, they do have the potential to become sick and infectious with active TB. It can occur at any CD4+ T cell level but especially when the CD4+ T cell count falls below 350 cells per cubic millimeter of blood.

Opportunistic Infections: Liver


Liver Disease Liver disease is one of the leading causes of death among AIDS patients, especially liver disease caused by the hepatitis B and hepatitis C virus. Many drugs used in the treatment of HIV and AIDS can cause liver disease or hepatitis. It is important that patients infected with hepatitis receive treatment and follow-up care.

Opportunistic Infections: Lungs


Coccidiomycosis This infection is caused by inhaling an infective fungus called Coccidioides immitis, found mainly in contaminated soil in the southwestern United States, Mexico, Central America and parts of South America. The lungs are most commonly affected by this infection. In severe cases, it can involve the kidneys, lymph system, brain and spleen. Symptoms include cough, weight loss and fatigue. Meningitis is a common complication when left untreated. Histoplasmosis This infection almost always involves the lungs, although other organs may be affected. The fungus that causes this condition is found in southern parts of the United States and South America. It is usually found in soil contaminated with bird droppings and must be inhaled to cause infection. Signs and symptoms include high fever; weight loss; respiratory complaints; an enlarged liver, spleen, or lymph nodes; depressed production of white cells, red blood cells and platelets from the bone marrow; and lifethreatening, unstable, low blood pressure.

Opportunistic Infections: Lymphatic System


Non-Hodgkin's Lymphoma Non-Hodgkin's lymphoma is a disease in which tumors develop from white blood cells in the lymphatic system. It is another common disease associated with AIDS. See AIDS-related lymphoma.

Opportunistic Infections: Mouth and Throat


Candidiasis This is the most common HIV-related fungus infection. It can affect the entire body, but most commonly occurs in the mouth (thrush) or vagina. An overgrowth of yeast causes white patches on gums, tongue or lining of the mouth, pain, difficulty in swallowing and loss of appetite. Candida in the esophagus, trachea, bronchi or lungs is AIDS defining.

Opportunistic Infections: Skin


Herpes Simplex This virus causes cold sores or genital herpes, which are painful blisters in the genital area. Chronic herpes simplex virus (HSV) lesions and severe mucocutaneous HSV disease are common in the advanced stages of AIDS. Kaposi's Sarcoma This is the most common AIDS-related cancer. It causes reddish-purple lesions that usually appear on the skin. They also can appear on the lymph nodes, mouth, gastrointestinal tract and lungs. Shingles Shingles are caused by a reactivation of the chicken pox virus. It may cause a painful rash or blisters that follow the path of nerves.

A discussion of the antifungal drug fluconazole (Diflucan) used to fight some AIDS-related opportunistic infections. [Revised: April 12, 2007] 535. Trimethoprim/Sulfamethoxazole A discussion of the combination of antibiotic drugs trimethoprim and sulfamethoxazole (also called Bactrim, Septra, TMP/SMX, Cotrimoxazole) used to fight some AIDS-related opportunistic infections. [Revised: June 25, 2007] 536. Filgrastim (Neupogen) A description of the drug filgrastim (neupogen) used to treat neutropenia, a shortage of a type of white blood cell. [Revised: June 25, 2007] 537. Pentamidine A discussion of the drug Pentamidine used to fight some AIDSrelated opportunistic infections. [Revised: July 23, 2007] 538. Atovaquone (Mepron) A discussion of the drug Atovaquone used to fight some AIDSrelated opportunistic infections. [Revised: April 26, 2007]