Opportunistic infections refer to the illnesses that occur in a person whose defence system is breaking down or has broken down. They occur as a result of late complications of HIV infection resulting from severe suppression.

Our bodies carry many germs such as bacteria, protozoa, fungi and viruses. When our immune system is working or strong, it controls the germ. But when the defence system is weakened by HIV disease or by some medication, these germs can get out of control and cause health problems.

TESTING FOR OPPORTUNISTIC INFECTIONS
Note: you can be infected with an opportunistic infection and test positive for it even though you do not have the disease

If you are infected with an opportunistic infection, your blood might be tested for antigens or antibodies.

• Antigens are pieces of the germ that causes the opportunistic infection.

• Antibodies are proteins made by the immune system to fight the germs.

If the T-cell count is low (below 50), this is a sign of serious damage to the immune system, and it even allows the opportunistic infection to develop. It shows a sign of active disease.

OPPORTUNISTIC INFECTION AND AIDS
If the immune system is damaged, there is a tendency for you to develop opportunistic infection. Many drugs used to treat cancer suppress the immune system and can aid the development of opportunistic infection.

HIV weakens the immune system so that opportunistic infections can develop, and might result to AIDS. The US Centre for Disease Control (CDC) has developed a list of about 24 opportunistic infections. If you have one or more of these listed opportunistic infection, then you have AIDS.

Many doctors use your CD4 cell count to measure the current status of your immune system. CD4 cells are cells that help to control infections. The normal range for CD4 cells is usually 500 to 1600. If your CD4 cell count falls below 200, there is tendency for you to have certain infections. Tell your doctor for preventive treatment.

MOST COMMON OPPORTUNISTIC INFECTIONS

FUNGAL
• Candidiasis (aka thrush) a fungal infection of the mouth, throat and vagina.
• Pneumocystic pneumonia, a fungal infection that causes fatal pneumonia.
• Toxoplasmosis, a protozoan infection of the brain.
• Mycobacterium avium complex, a bacterial infection that can cause recurring fevers, general sick feeling, problem with digestion and serious weight loss.
• Tuberculosis, TB, a bacterial infection that attacks the lungs and can cause meningitis.
• Cytomegalovirus, CMV, a viral infection that causes eye disease that can lead to blindness.
• Herpes simplex viruses.

PREVENTING OPPORTUNISTIC INFECTIONS
Most of the germs that cause opportunistic infections are quite common and can be prevented by keeping clean always, and avoiding known sources of the germs that cause it.

Even if you are infected with some opportunistic infections, take medications that will prevent the development of active disease. This kind of treatment is called prophylaxis. And the best way is to take strong anti-HIV drugs.

TREATMENT OF OPPORTUNISTIC INFECTIONS
For each opportunistic infection, there are drugs or combination of drugs that seem to work best.
• Strong antiviral drugs can allow a damaged immune system to recover and do a better job of fighting opportunistic infections.
• Tuberculosis is a leading killer of people living with HIV/AIDS. Care and support for TB patients is provided through a strategy known as DOTS (Direct Observation Treatment Strategy), the internationally recommended TB control strategy.
• Currently over 300,000 people in Africa are being treated for TB, under DOTS.
• Worldwide nearly 900,000 people are treated through DOTS
• TB germs are transmitted through the air, spreading from person to person through coughing, sneezing or even talking, especially in crowded environments.
• As the disease progresses, it is characterised by fever, weight loss and violent coughing which effectively disperses the TB germs to infect surrounding individuals.
• Nearly 2 billion people, one-third of the world population, are currently infected with TB germs.
• Between 5 and 10% of these people will eventually become sick with TB.

PROBLEMS OF TAKING ANTIRETROVIRAL DRUGS
Cell metabolism and metabolic changes result in abnormal fat distribution and cholesterol and glucose abnormalities.
Some antiretroviral drugs are toxic to mitochondria (the energy producer in cells that require high levels of energy for tissues like muscles and nerves). Such tissues are most susceptible to the effects of damaged mitochondria. Damaged or disrupted mitochondria can result in muscle wasting, heart failure, peripheral nerve damage, causing numbness and pain, low blood cell count, swelling and fatty degeneration of the liver and inflammation of the pancreas. Other signs include fatigue, depression and high lactic acid levels in the blood. Osteosclerosis, or weakened bones, is another condition that can result.