Treating HIV/AIDS-Related Illnesses
3.1 Preventing Opportunistic and HIV-related Diseases
The best way of preventing opportunistic infections is by taking Anti-retroviral(ARVs) drugs. However, for people with CD4 counts higher than 200, antiretroviral therapy is not recommended (see antiretroviral treatment below).
People in other stages of HIV infection can prevent and treat opportunistic infections that may occur before they develop AIDS.
Most opportunistic infections are caused by common micro-organisms that may live in a person's body for years. The bacteria that causes Tuberculosis(TB), for instance, is carried by a third of the world's population, but only about 8-million people contract active TB every year (see Tuberculosis and HIV/AIDS below)
Because HIV makes the immune system weaker, these common micro-organisms have far greater "opportunities" to attack the body.
Common strategies for the prevention of opportunistic infections include:
The prevention of the micro-organisms that cause opportunistic infectionsIn some cases, people can prevent the micro-organisms from ever reaching their body by being careful while handling food and drink, handling pets and while having sex. However, these measures do not prevent the re-activation of micro-organisms already in the body.
Primary prophylaxisHIV-infected people can prevent an opportunistic infection from first developing by taking special prophylactic treatment. There are common opportunistic infections that occur at predictable CD4 count levels, making it easier to predict and prevent these infections.
Secondary prophylaxisOnce a person has experienced and treated an opportunistic infection, they can prevent additional episodes of the infection by taking "maintenance therapy", usually consisting of smaller doses of drugs taken for the original infection.
Both these prevention techniques carry the risk of drug resistance and side effects associated with long-term prophylaxis. Common preventative measures in South Africa include:
- offering symptomatic patients Co-trimoxazole (an antibiotic treatment that prevents bacteria from reproducing) to prevent infections such as Pneumocystis carinii pneumonia, toxoplasmosis, bacterial pneumonia and Diarrhoea
- administering a PAP smear to detect human papillomavirus-associated genital epithelial cancers that can be treated
- administering Hepatitis B and Influenza vaccines — SA National Department of Health (2000)
3.2 Treating Opportunistic and HIV-Related Diseases
The SA National Department of Health's Recommendations for the prevention and treatment of opportunistic and HIV-related diseases in Adults has guidelines on the management of opportunistic infections.
Some common opportunistic conditions associated with HIV/AIDS include:
| Condition/Disease | Description |
| Tuberculosis | An illness caused by bacteria that infects the lungs, but can be found in other organs. Read more on AIDSmap. |
| Chronic Diarrhoea | Caused by many types of infection, diarrhoea usually results in frequent bowel movement, stomach pains and a liquid stool. Read more on AIDSmap. |
| Pneumocystis carinii Pneumonia (PCP) | A lung disease cause by a fairly common micro-organism that usually only infects the lungs when CD4 counts fall below 100 cells/mm3. Can also grow in other parts of the body. Read more on AIDSmap. |
| Kaposi's sarcoma (KS) | A cancer that causes lesions on skin but can spread all over the body. Read more on AIDSmap. |
Most opportunistic infections are treatable, although some require special attention due to the interaction between ARVs and other types of drugs. Once AIDS develops, opportunistic infection treatment is less likely to be successful and the infection can result in death if Anti-retroviral treatment (ART) is not taken.
3.3 Opportunistic Infections and Mortality
Deaths associated with opportunistic infections can give an indication of the progress of the HIV/AIDS epidemic.
Key Research
- According to the Treatment Action Campaign (TAC) newsletter, June 2006, there were over 67,000 recorded TB deaths in 2003, compared with 22,000 recorded deaths in 1997.
- According to a report by Statistics South Africa, Mortality and causes of death in South Africa, 1997 – 2003, deaths due to influenza and pneumonia more than doubled from 1997 with 24 698 deaths to 2001 with 55 115 deaths.
According to the TAC, although some of these deaths are not associated with HIV/AIDS, the huge increase can only be explained by the HIV/AIDS pandemic. (For more information see HIV/AIDS statistics)
Sources:
TAC Electronic Newsletter. June 21, 2006.
Statistics South Africa. Mortality and causes of death in South Africa, 1997–2003
