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HIV and Infections
Reviewed by Medicinsk Expert•Last updated: 2026-10-22•Infections

HIV and Infections

HIV weakens the immune system, leaving individuals vulnerable to opportunistic infections that are typically less severe in healthy populations.

What are opportunistic infections (OIs) in HIV?

Having HIV weakens your body's immune system. It destroys the white blood cells that fight infection. This puts you at risk for opportunistic infections (OIs). OIs are serious infections that take advantage of your weak immune system. These infections are less common and less severe in healthy people.

People who have AIDS, the most severe stage of HIV infection, have badly damaged immune systems. This puts them especially at risk for OIs. Getting certain OIs is one of the ways that people can get diagnosed with AIDS.

OIs are becoming less common in people with HIV because of effective HIV medicines. But some people with HIV still develop OIs for different reasons:

  • They may not know they have HIV, so they aren't getting treatment for it
  • They know that they have HIV but are not taking treatment
  • Their HIV treatment may not be working properly

What are the different types of opportunistic infections (OIs)?

There are many types of OIs:

  • Bacterial infections, including tuberculosis, Salmonella infection, and Mycobacterium avium complex (MAC)
  • Viral infections, such as cytomegalovirus (CMV) and herpes simplex virus 1 (HSV-1)
  • Fungal infections, like yeast infections, Pneumocystis carinii pneumonia (PCP), and histoplasmosis
  • Parasitic infections, such as cryptosporidiosis and toxoplasmosis

Having HIV can make infections harder to treat. People with HIV are also more likely to have complications from common illnesses such as the flu.

What are the treatments for opportunistic infections (OIs)?

If you develop an OI, there are treatments available such as antiviral, antibiotic, and antifungal drugs. The type of medicine your health care provider prescribes will depend on which OI you have.

After the OI has been successfully treated, you may still need to take the same medicine or another medicine to prevent the OI from coming back.

Can opportunistic infections (OIs) be prevented?

The best way to prevent OIs is by taking your HIV medicines. Other steps you can take to help prevent OIs include:

  • Avoiding exposure to contaminated food and water:
    • Don't eat undercooked eggs, unpasteurized dairy products or fruit juices, or raw seed sprouts
    • Don't drink water directly from a lake or river
  • Talking to your provider about medicines and vaccines that prevent certain OIs
  • Preventing exposure to other sexually transmitted infections (STIs) by using condoms every time you have sex
  • Washing your hands thoroughly with warm, soapy water after any contact with human or animal feces (poop)
  • Not sharing needles, syringes, or other drug injection equipment

Frequently Asked Questions

Starting ART is the most effective way to prevent opportunistic infections. By suppressing the viral load and allowing CD4 cell counts to recover, the immune system regains its ability to fight off pathogens. However, in some cases, starting treatment can trigger an immune reconstitution inflammatory syndrome (IRIS), where the recovering immune system reacts strongly to a pre-existing, often hidden infection. This can cause symptoms to temporarily worsen before improving, so close monitoring by a healthcare provider is essential during the first few months of treatment.
You should seek immediate medical attention if you experience persistent fever, unexplained weight loss, night sweats, or a cough that lasts more than two weeks. Other urgent signs include confusion, difficulty breathing, or new skin lesions that do not heal. Because HIV can mask typical infection signs, any persistent or unusual symptom requires prompt evaluation to rule out opportunistic infections like tuberculosis or pneumonia.
Yes, prevention is critical. Doctors typically recommend vaccinations against influenza, pneumococcus, and hepatitis B, as these infections can be more severe in immunocompromised individuals. Additionally, prophylactic medications may be prescribed based on your CD4 count. For example, if your CD4 count drops below 200, you may be prescribed trimethoprim-sulfamethoxazole to prevent Pneumocystis pneumonia (PCP). If your count is below 50, you might receive medication to prevent toxoplasmosis.
Source: MedlinePlus, National Library of Medicine

MedlinePlus brings together authoritative health information from the National Library of Medicine (NLM), the National Institutes of Health (NIH), and other government agencies and health-related organizations.

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