HIV and Opportunistic Infections, Coinfections, and Conditions

What is an Opportunistic Infection?

  • Key Points

    • Opportunistic infections (OIs) are infections that occur more often or are more severe in people with weakened immune systems than in people with healthy immune systems. People with weakened immune systems include people living with HIV.
    • HIV damages the immune system. A weakened immune system makes it harder for the body to fight off OIs.
    • HIV-related OIs include pneumonia, Salmonella infection, candidiasis, toxoplasmosis, and tuberculosis (TB).
    • For people with HIV, the best protection against OIs is to take HIV medicines every day. HIV medicines prevent HIV from damaging the immune system. Because HIV medicines are now widely used in the United States, fewer people with HIV get OIs.
  •  

    Word cloud containing the names of various opportunistic infections. 

  • What is an opportunistic infection?

    Opportunistic infections (OIs) are infections that occur more often or are more severe in people with weakened immune systems than in people with healthy immune systems. People with weakened immune systems include people living with HIV.

    OIs are caused by a variety of germs (viruses, bacteria, fungi, and parasites). OI-causing germs spread in a variety of ways, for example in the air, in body fluids, or in contaminated food or water.

    Some OIs that people with HIV may get include candidiasis, Salmonella infection, toxoplasmosis, and tuberculosis (TB). The Guidelines for the Prevention and Treatment of Opportunistic Infections in Adults and Adolescents with HIV provide detailed information on HIV-related OIs.

  • Why do people with HIV get OIs?

    Once a person has HIV, the virus begins to multiply and to damage the immune system. A weakened immune system makes it harder for the body to fight off OIs.

    HIV medicines prevent HIV from damaging the immune system. But without treatment with HIV medicines, HIV can gradually destroy the immune system and advance to AIDS. Many OIs, for example, certain forms of pneumonia and TB, are considered AIDS-defining conditions. AIDS-defining conditions are infections and cancers that are life-threatening in people with HIV.

  • Are OIs common in people with HIV?

    OIs are less common among people with HIV in the United States now than they were in the past. Because HIV medicines are now widely used in the United States, fewer people with HIV get OIs. By preventing HIV from damaging the immune system, HIV medicines reduce the risk of OIs.

    However, OIs are still a problem for many people with HIV. Some people with HIV get OIs for the following reasons: 

    • They may not know that they have HIV. Because of this, they are not getting HIV treatment. An OI may be the first sign that they have HIV.
    • They may know that they have HIV, but they are not getting HIV treatment.
    • They may be getting HIV treatment, but the HIV medicines are not controlling their HIV.
  • What can people with HIV do to prevent getting an OI?

    For people with HIV, the best protection against OIs is to take HIV medicines every day.

    People living with HIV can also take the following steps to reduce their risk of getting an OI.

    Avoid contact with the germs that can cause OIs.
    The germs that can cause OIs can spread in a variety of ways, including in body fluids or in feces. To avoid sexually transmitted infections, use condoms every time you have sex. If you inject drugs, don’t share drug injection equipment. After any contact with human or animal feces, wash your hands thoroughly with warm, soapy water.

    Ask your health care provider about other ways to avoid the germs that can cause OIs.

    Be careful about what you eat and drink.
    Food and water can be contaminated with OI-causing germs. To be safe, don’t eat certain foods, including undercooked eggs, unpasteurized dairy products or fruit juices, or raw seed sprouts.

    In addition, do not drink water directly from a lake or river. For more information, read the ClinicalInfo HIV and Nutrition and Food Safety fact sheet.

    Travel safely.
    If you are visiting a country outside the United States, avoid eating food and drinking water that could make you sick. Before you travel, read the CDC fact sheet on Traveling with HIV.

    Get vaccinated.
    Talk to your health care provider about which vaccines you need. To learn more, read the ClinicalInfo fact sheet on HIV and Immunizations.

  • Can OIs be treated?

    There are many medicines to treat HIV-related OIs, including antiviral, antibiotic, and antifungal drugs. The type of medicine used depends on the OI.

    Once an OI is successfully treated, a person may continue to use the same medicine or an additional medicine to prevent the OI from coming back.

    The Clinicalinfo Drug Database includes information on many of the medicines used to prevent and treat OIs.

  • This fact sheet is based on information from the following sources:

HIV and Hepatitis B

  • Key Points

    • Hepatitis B is a liver infection caused by the hepatitis B virus (HBV).
    • HBV is spread through contact with the blood, semen, or other body fluid of a person who has HBV. Among adults in the United States, HBV is spread mainly through sexual contact.
    • According to the Centers for Disease Control and Prevention (CDC), approximately 10% of people with HIV in the United States also have HBV. Infection with both HIV and HBV is called HIV/HBV coinfection.
    • People with HIV/HBV coinfection should be treated for both infections.
  • What is hepatitis B?

    Hepatitis B is a liver infection caused by the hepatitis B virus (HBV). The abbreviation HBV can stand for either the virus or the infection it causes.

    HBV can be a short-term (acute) or a long-term (chronic) illness:

     

    • Acute HBV occurs within 6 months after a person is exposed to HBV. In some people, acute HBV can lead to chronic HBV.
    • Chronic HBV is a lifelong disease. Without treatment, chronic HBV can cause liver cancer or liver damage that leads to liver failure.

    HBV is a contagious infection that can spread from person to person.

    Approximately 10% of people with HIV in the United States also have HBV.
  • How does HBV spread from person to person?

    HBV is spread through contact with the blood, semen, or other body fluid of a person who has HBV. Among adults in the United States, HBV is spread mainly through sexual contact.

    HBV can also spread from person to person in the following ways:

    • By sharing needles or other injection drug equipment (works) with someone who has HBV
    • By sharing razors, toothbrushes, or similar personal items with someone who has HBV
    • From contact with the blood or open sores of a person who has HBV
    • From an accidental prick or cut from an HBV-contaminated needle or other sharp object
    • From a mother who has HBV to her child during childbirth
  • What is the connection between HIV and HBV?

    Both HIV and HBV spread from person to person in semen, blood, or other body fluids. For this reason, the main risk factors for HIV and HBV are the same: having sex without a condom and injection drug use.

     

    According to the Centers for Disease Control and Prevention (CDC), approximately 10% of people with HIV in the United States also have HBV. Infection with both HIV and HBV is called HIV/HBV coinfection.

     

    Chronic HBV advances faster to cirrhosis, end-stage liver disease, and liver cancer in people with HIV/HBV coinfection than in people with only HBV infection. But chronic HBV doesn’t appear to cause HIV to advance faster in people with HIV/HBV coinfection.

  • Can HBV infection be prevented?

    Yes. The best way to prevent HBV is to get the hepatitis B vaccine

    CDC recommends that people with HIV and people who are at risk for HIV get the HBV vaccine (or the combined hepatitis A virus/HBV vaccine). The housemates and sexual partners of people with HBV should get the HBV vaccine, too.

    People, including people with HIV, can also take the following steps to reduce their risk of HBV infection:

    • Use condoms during sex to reduce the risk of HBV infection and infection with other sexually transmitted diseases, such as gonorrhea and syphilis.
    • Don't inject drugs. But if you do, don’t share needles, syringes, or other drug injection equipment.
    • Don't share toothbrushes, razors, or other personal items that may come in contact with another person's blood.
    • If you get a tattoo or body piercing, make sure the instruments used are sterile.
  • Should people with HIV get tested for HBV?

    CDC recommends that all people with HIV get tested for HBV. Testing can detect HBV even when a person has no symptoms of the infection.

    There are several HBV blood tests. Results of different tests show different things. For example, a positive hepatitis B surface antigen (HBsAg) test result shows that a person has acute or chronic HBV and can spread the virus to others.

    To learn more about HBV tests, visit the CDC webpage Hepatitis B Questions and Answers for the Public.

  • What are the symptoms of HBV infection?

    Some people with acute HBV don't have symptoms. But some people can have signs of HBV soon after becoming infected. Symptoms of acute HBV can include the following:

    • Loss of appetite
    • Tiredness
    • Nausea
    • Vomiting
    • Fever
    • Abdominal pain
    • Dark urine
    • Clay-colored bowel movements
    • Joint pain
    • Jaundice (yellowing of the skin or the whites of the eyes)

    Most people with chronic HBV don’t have any symptoms and may not have symptoms for many years. Abnormal results on liver function tests may be the first sign of chronic HBV infection.

  • What is the treatment for HBV?

    In general, HBV is treated with antiviral medicines. The medicines work to help limit damage to the liver.

    People with HIV/HBV coinfection should be treated for both infections. Some HIV medicines are effective at treating both HIV and HBV.

    The choice of medicines to treat HIV/HBV coinfection depends on the person. For example, some people may take HIV medicines that are also effective at treating HBV. Other people may take HIV medicines and an HBV antiviral medicine. If you have HIV/HBV coinfection, talk to your health care provider about the best medicines for you.

  • This fact sheet is based on information from the following sources:

    From CDC:

    From the Department of Health and Human Services:

    From the National Institute of Diabetes and Digestive and Kidney Diseases:

HIV and Hepatitis C

  • Key Points

    • Hepatitis C is a liver infection caused by the hepatitis C virus (HCV).
    • HCV is spread mainly through contact with the blood of a person who has HCV. In the United States, HCV is spread mainly by sharing needles or other injection drug equipment (works) with someone who has HCV.
    • According to the Centers for Disease Control and Prevention (CDC), approximately 21% of people with HIV in the United States also have HCV. Infection with both HIV and HCV is called HIV/HCV coinfection.
    • People with both HIV and HCV may be treated for both infections. Health care providers prescribe HIV and HCV medicines carefully to avoid drug-drug interactions and closely monitor those taking the medicines for any side effects.
  • What is hepatitis C?

    Hepatitis C is a liver infection caused by the hepatitis C virus (HCV). The abbreviation HCV can stand for either the virus or the infection it causes.

    HCV can be either a short-term (acute) or a long-term (chronic) illness:

    • Acute HCV occurs within 6 months after exposure. In most people, acute HCV becomes chronic HCV.
    • Chronic HCV can last a lifetime. Without treatment, chronic HCV can cause liver cancer or severe liver damage that can lead to liver failure.
    • HCV is a contagious infection that can spread from person to person.
  • How does HCV spread from person to person?

    HCV is spread mainly through contact with the blood of a person who has HCV. In the United States, HCV is spread mainly by sharing needles or other injection drug equipment (works) with someone who has HCV. HCV can also be spread through sexual contact. While the risk of transmission through sexual contact is low, the risk is increased in people with HIV.

  • What is the connection between HIV and HCV?

    Approximately 25% of people with HIV in the United States also have HCV.

    Because both HIV and HCV can spread in blood, a major risk factor for both HIV and HCV infection is injection drug use. Sharing needles or other drug injection equipment increases the risk of contact with HIV- or HCV-infected blood.

    According to the Centers for Disease Control and Prevention (CDC), approximately 21% of people with HIV in the United States also have HCV. Infection with both HIV and HCV is called HIV/HCV coinfection.

    In people with HIV/HCV coinfection, HIV may cause chronic HCV to advance faster. Whether HCV causes HIV to advance faster is unclear.

  • Can HCV infection be prevented?

    The best protection against HCV is to never inject drugs. If you do inject drugs, always use new, sterile needles, and do not reuse or share needles, syringes, or other injection drug equipment.

    People, including people with HIV, can also take the following steps to reduce their risk of HCV infection:

    • Do not share toothbrushes, razors, or other personal items that may come in contact with another person’s blood.
    • If you get a tattoo or body piercing, make sure the instruments used are sterile.
    • Use condoms during sex. The risk of HCV infection through sexual contact is low, but the risk increases in people with HIV. Condoms also reduce the risk of HIV transmission and infection with other sexually transmitted diseases, such as gonorrhea and syphilis.
  • Should people with HIV get tested for HCV?

    Every person who has HIV should get tested for HCV. Usually, a person will first get an HCV antibody test. This test checks for HCV antibodies in the blood. HCV antibodies are disease-fighting proteins that the body produces in response to HCV infection.

    A positive result on an HCV antibody test means that the person has been exposed to HCV at some point in their life. However, a positive antibody test does not necessarily mean the person has HCV. For this reason, a positive result on an HCV antibody test must be confirmed by a second test. This follow-up test checks to see if HCV is present in the person’s blood. A positive result on this test confirms that a person has HCV.

  • What are the symptoms of HCV infection?

    Most people with acute HCV do not have symptoms. But some people can show signs of HCV soon after becoming infected. Symptoms of acute HCV can include the following:

    • Fever
    • Tiredness
    • Loss of appetite
    • Nausea
    • Vomiting
    • Abdominal pain
    • Dark-colored urine
    • Clay-colored bowel movements
    • Joint pain
    • Jaundice (yellowing of the skin or the whites of the eyes)

    Most people with chronic HCV do not have any symptoms. Chronic HCV is often discovered based on results from routine liver function tests.

  • What is the treatment for HCV?

    HCV is treated with antiviral medicines. Many newer HCV medicines are more effective and have fewer side effects than older medicines. The newer medicines can cure HCV in most people.

    People with HIV/HCV coinfection may be treated for both infections. However, when to start each treatment and what medicines to take depends on the person. For example, some HIV and HCV medicines cannot be safely used together because of drug-drug interactions.

    Health care providers prescribe HIV and HCV medicines carefully to avoid drug-drug interactions and closely monitor those taking the medicines for any side effects.

    If you have HIV/HCV coinfection, talk to your health care provider about the best medicines for you.

  • This fact sheet is based on information from the following sources:

    From CDC:

    From the Department of Health and Human Services:

    From the National Institute of Diabetes and Digestive and Kidney Diseases:

    Also see the HIV Source E-book for a collection of HIV links and resources.

HIV and Tuberculosis (TB)

  • Key Points

    • Tuberculosis (TB) is a disease caused by bacteria called Mycobacterium tuberculosis. The TB bacteria can spread from person to person through the air.
    • Once in the body, TB can be inactive or active. Inactive TB is called latent TB infection. Active TB is called TB disease.
    • TB usually affects the lungs, but it can affect any part of the body, including the kidneys, spine, or brain. If not treated, TB disease can cause death.
    • HIV weakens the immune system, increasing the risk of TB in people with HIV. 
    • People who have both HIV and TB should be treated for both diseases; however, when to start treatment and what medicines to take depends on a person’s individual circumstances.
  • What is tuberculosis?

    Tuberculosis (TB) is a disease caused by bacteria called Mycobacterium tuberculosis. The TB bacteria can spread from person to person through the air.

    TB usually affects the lungs, but it can affect any part of the body, including the kidneys, spine, or brain. If not treated, TB can cause death.

  • How does TB spread from person to person?

    When a person with TB disease of the lungs coughs or speaks, droplets of TB bacteria spread through the air. People nearby who breathe in the TB bacteria can get TB.

    Once in the body, TB can be inactive or active. When the TB bacteria is inactive, this is called latent TB infection. When the TB bacteria is active, this is called TB disease. The image below shows the difference between latent TB infection and TB disease.

     

    Graphic comparing and contrasting latent TB infection and TB disease.

  • What is the connection between HIV and TB?

    TB is an opportunistic infection (OI). OIs are infections that occur more often or are more severe in people with weakened immune systems than in people with healthy immune systems. HIV weakens the immune system, increasing the risk of TB in people with HIV.

    Infection with both HIV and TB is called HIV/TB coinfection. Untreated latent TB infection is more likely to advance to TB disease in people with HIV than in people without HIV. In people with HIV, TB disease is considered an AIDS-defining condition. AIDS-defining conditions are infections and cancers that are life-threatening in people with HIV.

    Treatment with HIV medicines is called antiretroviral therapy (ART). HIV medicines protect the immune system and prevent HIV from advancing to AIDS. In people with HIV and latent TB infection, treatment with HIV and TB medicines reduces the chances that latent TB infection will advance to TB disease.

  • How common is HIV/TB coinfection?

    Worldwide, TB disease is one of the leading causes of death among people with HIV. In the United States, where HIV medicines are widely used, fewer people with HIV have TB disease than in the past. But TB disease still affects many people with HIV in the United States, especially those born outside the United States.
  • Should people with HIV get tested for TB?

    Yes, all people with HIV should get tested for TB infection. If test results show that a person has latent TB infection, additional testing is needed. More testing will determine whether the person has TB disease.
  • What are the symptoms of TB?

    People with latent TB infection have no symptoms. But people with TB disease that affects the lungs may have the following symptoms:
    • A persistent cough that may bring up blood or sputum
    • Chest pain
    • Weakness or fatigue
    • Loss of appetite
    • Weight loss
    • Chills
    • Fever
    • Night sweats

    When TB disease affects other parts of the body, a person may have other symptoms.

  • What is the treatment for TB?

    TB medicines are used to prevent latent TB infection from advancing to TB disease and to treat TB disease. The choice of TB medicines and the length of treatment depend on whether a person has latent TB infection or TB disease.

    People with HIV/TB coinfection should be treated for both HIV and TB; however, when to start treatment and what medicines to take depends on a person’s individual circumstances. Taking certain HIV and TB medicines at the same time can increase the risk of drug-drug interactions and side effects. People being treated for HIV/TB coinfection are carefully monitored by their health care providers.

    If you have HIV/TB coinfection, talk to your health care provider about a treatment plan that works for you.

  • This fact sheet is based on information from the following sources:

    From the Centers for Disease Control and Prevention (CDC): From the Department of Health and Human Services (HHS):

HIV and Sexually Transmitted Diseases (STDs)

  • Key Points

    • Sexually transmitted diseases (STDs) are infections that spread from person to person through sexual activity, including anal, vaginal, or oral sex.
    • HIV is an STD. Chlamydia, gonorrhea, human papillomavirus (HPV) infection, and syphilis are examples of other STDs.
    • Having an STD can make it easier to get HIV. For example, an STD can cause a sore or a break in the skin, which can make it easier for HIV to enter the body. Having HIV and another STD may increase the risk of HIV transmission.
    • To prevent STDs, including HIV, choose less risky sexual behaviors and use condoms correctly every time you have sex.
  • What is an STD?

    STD stands for sexually transmitted disease. STDs are sometimes called sexually transmitted infections (STIs). STDs are infections that spread from person to person through sexual activity, including anal, vaginal, or oral sex. STDs are caused by bacteria, parasites, and viruses.

    HIV is an STD. Chlamydia, gonorrhea, human papillomavirus (HPV) infection, and syphilis are examples of other STDs.

  • What is the connection between HIV and other STDs?

    Behaviors that put people at risk for HIV also increase their risk for other STDs. These behaviors include the following:
    • Having sex without a condom.
    • Having sex with many partners, especially anonymous partners.
    • Having sex while using drugs or alcohol. Using drugs and alcohol can affect a person's judgement, which can lead to risky behaviors.
    Having an STD can make it easier to get HIV. For example, an STD can cause a sore or a break in the skin, which can make it easier for HIV to enter the body. Having HIV and another STD may increase the risk of HIV transmission.
  • How can I reduce my risk of getting an STD?

    Sexual abstinence (never having vaginal, anal, or oral sex) is the only way to eliminate any chance of getting an STD. But if you are sexually active, you can take the following steps to lower your risk for STDs, including HIV.

    Choose less risky sexual behaviors.
    • Reduce the number of people you have sex with.
    • Don't drink alcohol or use drugs before and during sex.
    Use condoms correctly every time you have sex.
  • I have HIV. How can I prevent passing HIV to others?

    Take HIV medicines daily. Treatment with HIV medicines (called antiretroviral therapy or ART) helps people with HIV live longer, healthier lives. One of the goals of ART is to reduce a person's viral load to an undetectable level. An undetectable viral load means that the level of HIV in the blood is too low to be detected by a viral load test. People with HIV who maintain an undetectable viral load have effectively no risk of transmitting HIV to their HIV-negative partner through sex.

    If your viral load is not undetectable—or does not stay undetectable—you can still protect your partner from HIV by using condoms and choosing less risky sexual behaviors. Your partner can take medicine to prevent getting HIV, which is called pre-exposure prophylaxis, or PrEP. PrEP is an HIV prevention option for people who don't have HIV but who are at risk of getting HIV. PrEP involves taking a specific HIV medicine every day to reduce the risk of getting HIV through sex or injection drug use. To learn more, read the Clinicalinfo Pre-Exposure Prophylaxis (PrEP) fact sheet.

  • What are the symptoms of STDs?

    Symptoms of STDs may be different depending on the STD, and not everyone will experience the same STD symptoms. Examples of possible STD symptoms include painful urination (peeing), unusual discharge from the vagina or penis, and fever.

    STDs may not always cause symptoms. Even if a person has no symptoms from an STD, it is still possible to pass the STD on to other people.

    Talk to your health care provider about getting tested for STDs and ask your sex partner to do the same.

    To find STD information and testing sites near you, call CDC-INFO at 1-800-232-4636 or visit CDC's GetTested webpage.

  • What is the treatment for STDs?

    STDs caused by bacteria or parasites can be cured with medicine. There's no cure for STDs caused by viruses, but treatment can relieve or eliminate symptoms and help keep the STD under control. Treatment also reduces the risk of passing on the STD to a partner. For example, although there's no cure for HIV, HIV medicines can prevent HIV from advancing to AIDS and reduce the risk of HIV transmission.

    Untreated STDs may lead to serious complications. For example, untreated gonorrhea in women can cause pelvic inflammatory disease, which may lead to infertility. Without treatment, HIV can gradually destroy the immune system and advance to AIDS.

HIV and Heart Disease

  • Key Points

    • There are many different types of heart disease. Coronary heart disease is the most common type of heart disease, and it is the leading cause of death in the United States. In this fact sheet, the term “heart disease” refers specifically to coronary heart disease.
    • Heart disease is caused by the buildup of plaque inside the blood vessels that carry blood to the heart (called the coronary arteries).
    • Risk factors for heart disease, such as high blood pressure or smoking, are the same for people with HIV and people without HIV. However, HIV and some HIV medicines may increase the risk of heart disease in people with HIV.
    • Lifestyle changes, such as eating a healthy diet, being more active, and quitting smoking, can help prevent and treat heart disease. Treatment for heart disease can also include medicines and surgery.
  • What is heart disease?

    There are many different types of heart disease. Coronary heart disease (also called coronary artery disease) is the most common type of heart disease. It is the leading cause of death in the United States. In this fact sheet, the term “heart disease” refers specifically to coronary heart disease.
  • What causes heart disease?

    Heart disease is caused by the buildup of plaque inside the blood vessels that carry blood to the heart (called the coronary arteries). Plaque is a waxy substance made up of fat, cholesterol, calcium, and other substances found in the blood. Over time, plaque buildup in the coronary arteries (called atherosclerosis) reduces the blood flow to the heart, which can cause chest pain (called angina) or a heart attack.

  • What are the risk factors for heart disease?

    Some risk factors for heart disease can be changed or controlled by lifestyle changes or medicines, while other risk factors cannot. Risk factors that can be controlled to prevent or delay heart disease include the following:

    • High blood pressure
    • High blood cholesterol levels
    • Diabetes
    • Eating an unhealthy diet
    • A lack of physical activity
    • Smoking
    • Being overweight or obese
    • Stress

    Risk factors for heart disease that can’t be changed include having a family history of early heart disease and older age.

  • Are people with HIV at risk for heart disease?

    Yes. The risk factors for heart disease are the same for people with HIV and people without HIV. However, HIV and some HIV medicines may increase the risk of heart disease in people with HIV.

    Research is underway to understand the connection between HIV and heart disease. Use the ClinicalInfo clinical trial search to find HIV research studies related to heart disease. Click on the Complications/Side Effects category and then select Cardiovascular Effects. For help with your search, call an ClinicalInfo health information specialist at 1-800-448-0440 or email ContactUs@HIVinfo.NIH.gov.

  • What are the symptoms of heart disease?

    Some people who have heart disease have no symptoms. However, some people may have chest pain, shortness of breath, fatigue, or weakness. If you have any of these symptoms, contact your health care provider.

    Chest pain that does not go away or occurs while a person is resting may be a sign of a heart attack. If you think you may be having a heart attack, call 9-1-1 immediately.

  • What is the treatment for heart disease?

    Treatment for heart disease often includes lifestyle changes. For example, people with heart disease may change their eating habits, exercise more to lose weight, or quit smoking.

    Medicines and surgery are also used to treat heart disease.

    Medicines
    Medicines used to treat heart disease include drugs to lower blood pressure, reduce cholesterol levels, or prevent or relieve chest pain. Some of these medicines may interact with HIV medicines. Health care providers carefully consider potential drug interactions between HIV medicines and any other medicines a person may be taking.

    Surgery
    Coronary artery bypass grafting (CABG) is the most common type of surgery to treat heart disease in adults. During CABG, a healthy artery or vein from the body is used to bypass (go around) the blocked part of a coronary artery.

    Visit the National Heart, Lung, and Blood Institute’s Heart Surgery webpage to learn more about the different types of heart surgery.

  • I am living with HIV. How can I reduce my risk of heart disease?

    You can take the following steps to reduce your risk of heart disease:
    • Take your HIV medicines every day to keep your HIV under control.
    • Eat a healthy diet that includes lots of vegetables, fruits, and whole grains, and is low in saturated fats, added sugars, and salt.
    • Be physically active on a regular basis.
    • Quit smoking.
    • Keep all of your medical appointments. During your visits, talk to your health care provider about your risk for heart disease.
    For more information on how to lower your risk of heart disease, visit the How to Prevent Heart Disease webpage from MedlinePlus.

HIV and Kidney Disease

  • Key Points

    • The kidneys are two fist-sized organs in the body that are located near the middle of the back on either side of the spine. The main job of the kidneys is to filter harmful waste and extra water from the blood.
    • Injury or disease, including HIV infection, can damage the kidneys and lead to kidney disease.
    • High blood pressure and diabetes are the leading causes of kidney disease. In people with HIV, poorly controlled HIV infection and coinfection with the hepatitis C virus (HCV) also increase the risk of kidney disease.
    • Some HIV medicines can affect the kidneys. Health care providers carefully consider the risk of kidney damage when recommending specific HIV medicines to include in an HIV regimen.
    • Kidney disease can advance to kidney failure. The treatments for kidney failure are dialysis and a kidney transplant. Both treatments are used to treat kidney failure in people with HIV.
  • What are the kidneys and what do they do?

    The kidneys are two fist-sized organs in the body. They are located near the middle of the back on either side of the spine.

    The main job of the kidneys is to filter harmful waste and extra water from the blood. The waste and water become urine, which is flushed from the body. The kidneys also release hormones that help control blood pressure, make red blood cells, and keep bones strong.

    Kidney function declines as people age. Injury or disease, including HIV infection, can damage the kidneys. Damage to the kidneys can lead to kidney disease (also called renal disease). Kidney disease can advance to kidney failure.

  • What are the causes of kidney disease?

    Diabetes and high blood pressure are the leading causes of kidney disease. Other factors that increase the risk of kidney disease include heart disease and a family history of kidney failure.

    A person's risk of kidney disease increases as they get older. The longer a person has diabetes, high blood pressure, or heart disease, the greater their risk of kidney disease.

    The risk of kidney failure is especially high among African Americans, Hispanics, and American Indians, partially because these communities have high rates of diabetes and high blood pressure.

  • Are people with HIV at risk for kidney disease?

    The risk factors for kidney disease in people with HIV include all those listed above. In addition, poorly controlled HIV infection and coinfection with the hepatitis C virus (HCV) increase the risk of kidney disease in people with HIV.

    Antiretroviral therapy (ART) is the use of HIV medicines to treat HIV. People on ART take a combination of HIV medicines (called an HIV regimen) every day. HIV medicines are recommended for everyone who has HIV. Some HIV medicines can affect the kidneys. Health care providers carefully consider the risk of kidney damage when recommending specific HIV medicines to include in an HIV regimen. If a person with HIV shows signs of kidney disease, their health care provider may adjust the dose of their HIV medicines or change which HIV medicines are included in their HIV regimen.

  • What are the symptoms of kidney disease?

    Kidney disease can advance very slowly. Slowly worsening kidney disease is called chronic kidney disease.

    As kidney disease gets worse, a person may have swelling of the legs, feet, or ankles (called edema). Symptoms of advanced chronic kidney disease can include:

    • Increased or decreased urination
    • Feeling tired or having trouble sleeping
    • Nausea and vomiting
    • Itching or numbness
    Blood and urine tests are used to detect kidney disease. Care for people with HIV includes testing for kidney disease.
  • What is the treatment for kidney disease?

    People with kidney disease can take steps to protect their kidneys from further damage. For example, many people with kidney disease take medicines to control high blood pressure. They may also reduce the amount of salt and protein in their diet to manage their kidney disease.

    Some people live with kidney disease for many years; in others, kidney disease progresses to kidney failure. The treatments for kidney failure are dialysis and a kidney transplant. Both treatments take over the job of the failed kidneys.

    • There are two main types of dialysis. Like the kidneys, both types filter harmful waste and extra water out of the blood. In hemodialysis, a machine outside of the body is used to filter the blood. In peritoneal dialysis, the lining of the abdomen filters the blood inside the body.
    • A kidney transplant is surgery to place a healthy kidney from a donor into the body of a person with kidney failure. The donated kidney can be from a person who just died or from a living person.
    Both dialysis and a kidney transplant are used to treat kidney failure in people with HIV.
  • I am living with HIV. How can I reduce my risk of kidney disease?

    Take the following steps to reduce your risk of kidney disease:

    • Take your HIV medicines every day to keep your HIV under control.
    • Eat a healthy diet that includes fresh fruits, fresh or frozen vegetables, whole grains, and low-fat or fat-free dairy products. Cut back on foods high in salt and sugar.
    • Be physically active for 30 minutes or more on most days.
    • Keep all of your medical appointments. During your visits, talk to your health care provider about your risk for kidney disease.
  • This fact sheet is based on information from the following sources:

    From the Department of Health and Human Services:
    From the U.S. Department of Veterans Affairs:
    From the National Institute of Diabetes and Digestive and Kidney Diseases: