Other Health Issues of Special Concern for People Living with HIV
Do People with HIV Have Other Health Conditions?
Yes. It’s common for people with HIV to have other health issues.
Some of these issues may be directly related to HIV or its treatment. Others may be completely unrelated.
These health conditions can mean more doctors’ visits, lab tests, and medications to keep up with.
If you have HIV, the best thing you can do to stay healthy is to take HIV medicine (called antiretroviral therapy or ART) exactly as prescribed and get and keep an undetectable viral load—a level of HIV in your blood so low that a standard lab test can’t detect it.
What Are Some Common Coinfections with HIV?
Coinfection is when a person has two or more infections at the same time. There are some common coinfections that affect people with HIV. For example:
Hepatitis B and Hepatitis C. Hepatitis B and C are liver infections caused by a virus. Like HIV, hepatitis B virus (HBV) and hepatitis C virus (HCV) can be transmitted sexually or by injection drug use. About one-third of people with HIV in the United States are coinfected with either HBV or HCV. If left untreated, they can lead to liver disease, liver cancer, and liver failure. Hepatitis B can be prevented with a vaccine. There is no cure for hepatitis B, but treatment can delay or limit liver damage. There is no vaccine for hepatitis C, but treatment cures about 97% percent of people, including those living with HIV, with just 8-12 weeks of oral therapy (pills). Everyone with HIV should be tested for hepatitis B and C. Learn more about hepatitis B and C and people with HIV.
Tuberculosis. Tuberculosis (TB) is a disease caused by germs spread through the air from a person with untreated TB disease. TB usually affects the lungs, but it can affect other parts of the body. It can cause serious health problems if left untreated. TB is an opportunistic infection (OI)—an infection that occurs more often or is 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. In people with HIV, TB disease is considered an AIDS-defining condition, meaning if you have it, you are diagnosed with AIDS (also known as HIV Stage 3), the most serious stage of HIV infection. 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. Worldwide, TB is one of the leading causes of death among people with HIV. That’s why it is important for people with HIV to be tested for TB and for those who test positive to begin treatment. Learn about HIV and TB coinfection.
Opportunistic Infections. Opportunistic infections (OIs) are infections that occur more frequently or are more severe in people with weakened immune systems, such as people with HIV. HIV-related OIs include pneumonia, Salmonella infection, candidiasis, toxoplasmosis, and tuberculosis (TB). People are at greatest risk for OIs when their CD4 count falls below 200. When a person with HIV gets certain OIs or specific cancers, they are diagnosed with AIDS. Taking HIV medication exactly as prescribed, staying in regular medical care, and getting your lab tests done are key to staying healthy and preventing these infections. Learn more about how opportunistic infections affect people with HIV.
What Are Some Other Health Conditions Associated with HIV?
Thanks to improvements in HIV treatment, people with HIV are living longer than ever. But even when HIV is well controlled with medication, people with HIV can have some other health conditions that can sometimes complicate HIV treatment if not addressed. For example:
Cardiovascular Disease. People with HIV can have a 50-100% increased risk for cardiovascular disease. Cardiovascular disease affects the health of your heart and your blood flow and can lead to heart attacks, stroke, or heart failure. Getting and staying on ART is one of the best things you can do to stay healthy. Regular monitoring of your cardiovascular health by your health care provider is also an important part of your ongoing medical care. Also, research points in a positive direction. An NIH-supported study found a daily statin, a medication that helps lower cholesterol, reduced the risk of cardiovascular disease in people with HIV by 35%, potentially preventing one in five major cardiovascular events or premature deaths in this population. Researchers are still investigating whether all statins will have the same effect. Talk to your health care provider about strategies to improve your cardiovascular health and about this new research. Learn more.
Chronic Inflammation. Inflammation is a part of the body's natural process of fighting against infection or injury. It's when your damaged tissue releases chemicals that tell white blood cells to start repairing. Symptoms of inflammation include redness, swelling, pain and/or warmth. Inflammation is damaging when it occurs in healthy tissues or lasts too long. Known as chronic inflammation, it may persist for months or years. Chronic inflammation occurs when individuals have HIV; however, the level of inflammation generally decreases when they start ART. Still, even though the level decreases when a person is on treatment, low levels of chronic inflammation tend to persist. Over time, this low level of inflammation takes a toll on the body, putting the person with HIV at greater risk for health conditions such as cardiovascular disease, kidney disease, diabetes, bone disease, liver disease, cognitive disorders, and some types of cancer. Your health care provider will work with you, or may refer you to a specialist, to treat any of these conditions you may develop.
Mental Health Conditions. People whose lives are affected by mental health issues like depression, anxiety, or the psychological effects of bullying, sexual abuse, or physical abuse, are at greater risk of getting HIV. Depression is one of the most common mental health conditions that people with HIV face. Depression can range from mild to severe, and the symptoms of depression can affect your day-to-day life. Both HIV-related medical conditions and HIV medications can contribute to depression. Learn more about depression and other mental health conditions.
Substance Use Disorders. Alcohol and drug use can damage the body and brain and put a person at greater risk for getting or transmitting HIV. They can also make it harder for people with HIV to take their HIV medicine as prescribed. But behavioral health treatment and services are available. Talk openly and honestly with your health care provider about your substance use so that they can evaluate you and help you find support if you need it. Use SAMHSA’s Behavioral Health Treatment Locator to find mental health and substance use disorder treatment facilities near you.
Medication Side Effects. Some people also experience short-term side effects from HIV medicines, such as nausea and vomiting. Other people may experience side effects from HIV medicines that can continue for a long time, such as an increased risk of cardiovascular disease and kidney disease. See your health care provider regularly and discuss any side effects you experience. Never cut down, skip, or stop taking your HIV medications unless your health care provider tells you to. Your provider will work with you to develop a plan to manage the side effects or may recommend that you change medication.
Be sure to take care of your emotional wellness, eat a healthy diet, exercise, and quit smoking. These all play an important role in living healthy with HIV.
COVID-19 and Mpox
People with advanced or untreated HIV are at risk for more severe outcomes from some other infectious diseases such as COVID-19 and Mpox. View our pages on COVID-19 and People with HIV and Monkeypox and People with HIV for resources and information on how you can prevent these diseases and stay healthy.