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Home \ Publications \ Specialist guides and publications \ Medical conditions \ A-Z of medical conditions \ HIV / AIDS \ Most common disabling conditions

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Most common disabling conditions

A list of the most common disabling HIV related conditions is set out in the table below. AIDS defining conditions (ADCs) are identified within the table with a tick but please note that the list of AIDS defining conditions is not complete.

Condition ADC CD4 count Description Clinical features Specific treatment Response to treatment
Allergy   Any Caused by many antibiotics and other drugs Rashes, fever etc Stop drug Usually good
Autonomic neuropathy

 

 <200 HIV infection of autonomic nerves Postural hypotension (blood pressure falls on standing) and may result in dizziness, diarrhoea, impotence, incontinence Various Usually poor
Bacterial pneumonia

 

 <350 Bacterial lung infection Cough, fever, breathlessness Antibiotics Usually good but repeated infection may result in chronic lung damage
Cerebral toxoplasmosis

v

 <200 Protozoal infection of brain Fever, confusion, headaches and seizures Antibiotics Usually good if treatment started early
Cervical carcinoma

 

 <350 Tumour of cervix Intermenstrual bleeding (bleeding inbetween periods) Varies according to stage of disease Varies according to stage of disease but usually advanced and more likely to relapse than in HIV negative women.
Cryptococcal meningitis

v

 <100 Fungal infection of brain Headache, vomiting, fever, psychiatric disturbance Antifungal agents Usually good but may require lifelong treatment
Cytomegalovirus encephalitis   <100 Virus infection of brain Rapidly progressive confusion, dementia, fever, convulsions Antiviral agents Poor but treatment may reduce progression
Cytomegalovirus retinitis v <100 Virus infection of eyes Blurring of vision progressing to complete blindness Antiviral agents Variable
Diarrhoea Crypto-sporidiosis v <200 Parasitic infection Diarrhoea and wasting Drugs to reduce stool volume but no treatment eradicates organism Poor
Diarrhoea - cytomegalovirus   <100 Virus infection Bloody diarrhoea, abdominal pain, intestinal perforation Antiviral agents Good
Diarrhoea Micro-sporidiosis   <200 Parasitic infection Diarrhoea and wasting Albendazole Poor
Diarrhoea - Mycobacterium Avium Complex (MAC)   <50 Bacterial infection Diarrhoea and wasting Antibiotics Usually good
Diarrhoea non - specific   <350 Almost all people with HIV develop diarrhoea and is presenting feature in up to 30%. Caused by various organisms including salmonella, shigella etc Diarrhoea Depends upon organism Usually good
Genital problems   Any Sexually transmitted diseases such as genital herpes or genital warts Varies according to condition Usual treatments May be resistant to treatment but not usually disabling
Haematological (blood problems)   Any
  • Anaemia (low red cell count)
  • Neutropaenia (low white cell count)
  • Thrombocytopaenia (low platelet count)
  • Anaemia ( fatigue, weakness, breathlessness)
  • Neutropaenia (increased susceptibility to infection)
  • Thrombocytopaenia (increased susceptibility to bleeding)
 HAART, transfusions etc Variable
HIV encephalopathy v <100 HIV infection of brain and spinal cord Poor concentration, memory loss, unsteadiness, poor coordination, weakness, seizures, incontinence, depression, apathy, agitation, hyperactivity None Poor, survival is usually less than 2 years if develops despite taking HAART

Good if responds to introduction of HAART
Kaposi’s sarcoma v <200 Tumour of skin and palate (mucocutaneous) , lungs, gastrointestinal tract, lymphatic system (visceral) caused by human herpes virus 8 Purple lesions on skin or palate (mucocutaneous), breathlessness, cough, coughing blood, abdominal pain, gastrointestinal bleeding, fevers, night sweats and weight loss Radiotherapy or injection of chemotherapy agents in mucocutaneous disease; Chemotherapy for visceral disease Good for mucocutaneous disease. Variable for visceral disease ( remission may be induced)
Mouth conditions   Any Thrush, ulcers, leukoplakia (white lesions usually on tongue), gum infections and dental abscesses Varies according to condition Usual treatments May be resistant to treatment but not usually disabling
Mycobacterium Avium Complex (MAC) v <50 Bacterial infection affecting multiple organs Fever, night sweats, weight loss, general malaise, anaemia Antibiotics Usually good, requires long term treatment
Myelopathy   <200 HIV infection of spinal cord Bilateral leg weakness, incontinence None Usually poor
Oesophageal candidiasis v <200 Fungal infection of oesophagus Pain on swallowing Antifungal agents Usually good but resistance to treatment may develop
Oesophageal ulceration   <200 Ulcers of oesophagus caused by cytomegalovirus, herpes simplex virus or unknown cause Pain on swallowing, vomiting blood (haematemesis) Antiviral agents or steroids Usually good
Oral candidiasis   <400 Fungal infection of the mouth producing white coating of mouth and tongue Sore mouth Antifungal agents Good
Peripheral neuropathy   <200 HIV infection of nerves. Common complication of treatment with HAART Pain, pins and needles, sensory loss, weakness and wasting Antidepressants, anticonvulsants and analgaesics Variable relief of symptoms.
Pneumocystis pneumonia (PCP) jirovecii previously known as carinii. v <200 Fungal lung infection Cough, fever, breathlessness Antibiotics Variable
Primary cerebral lymphoma v <50 Tumour of brain Fever, confusion, headaches and seizures Radiotherapy to brain and steroids Poor, survival is usually less than 6 months
Progressive multifocal leuco-encephalopathy (PML) v <100 Virus (JC virus) infection of brain Progressive weakness, unsteadiness and aphasia (language difficulties) None Poor, survival is usually less than 6 months
Skin conditions   Any Fungal (e.g. athletes foot), viral (e.g. shingles and cold sores), bacterial (e.g. boils) or others such as psoriasis, acne and seborrhoeic dermatitis Varies according to skin condition Usual treatments May be resistant to treatment but not usually disabling
Systemic non-Hodgkins Lymphoma v <100 Tumour of lymphatic system that has spread to other organs, including brain and bone marrow Symptoms vary according to organ involvement. Brain involvement presents with clinical features resembling brain tumour Chemotherapy and radiotherapy Variable. About 50% respond well to chemotherapy. For the other 50% survival is usually less than 6 months
Tuberculosis   <350 Bacterial infection affecting mainly lung but may affect other organs Cough, fever, breathlessness, weight loss Antibiotics Usually good but increasing incidence of multidrug resistance leading to treatment failure
Wasting v <200 Usually due to specific cause, commonly a protozoal gastrointestinal infection Weight loss, malaise, fatigue Treat cause, dietary advice, testosterone, anabolic steroids, appetite stimulants, growth hormone Varies

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