HIV in Canada: A primer for service providers
Co-infections, Cancers and Other Illnesses Associated with HIV
- Life-threatening co-infections are seen much less frequently than in the early days of the HIV epidemic.
- Co-infections can make it more difficult to manage and treat HIV.
- Some cancers are more common in people with HIV.
There are a number of infections and cancers that can develop in people who are living with HIV.
Firstly, there are infections that can be life threatening. These are also known as opportunistic infections. The more common life-threatening infections include a lung infection called Pneumocystis pneumonia (PCP), an eye infection caused by cytomegalovirus (CMV), a brain infection called toxoplasmosis, and a generalized infection called Mycobacterium avium complex (MAC).
These occur only when the immune system is weak making someone vulnerable to infection. If someone has a very low CD4+ cell count, there are drugs they can take to prevent these infections. This is called prophylaxis. However these infections are preventable with proper care and are seen much less frequently than in the early days of the HIV epidemic.
Secondly, there are co-infections that can make it more difficult to manage and treat HIV. HIV can also complicate the management and treatment of co-infections. Co-infections are illnesses that can also occur in people with normal immune systems. Some of the more common co-infections in people living with HIV are hepatitis B, hepatitis C, tuberculosis, sexually transmitted infections such as human papillomavirus (HPV) and herpes, and fungal infections.
Finally, people living with HIV are more vulnerable to certain types of cancers. Cancers seem to be more common in people with HIV even if their immune system is relatively healthy. However, some cancers occur only when the immune system is weakened.
Cancers that are more common include Hodgkin’s lymphoma, lung cancer, skin cancer, anal cancer, cervical and vaginal cancer in women, and testicular and prostate cancer in men. These cancers can often be successfully treated if they occur in people with HIV who maintain healthy immune systems with HIV treatment.
It is important that people with HIV have regular check-ups with their doctor. CD4+ counts and viral load tests monitor how HIV is affecting the immune system and for those on treatment that the treatment is working effectively. Regular screening for sexually transmitted infections as well as other co-infections is recommended. Pap tests are used to screen for cervical abnormalities in women. Men and women with HIV should also be screened for anal cancer.
HIV-related infections and cancers – Managing your health: a guide for people living with HIV
CATIE. HIV-related infections and cancers. In: Managing your health: a guide for people living with HIV. 2009. Available at http://www.catie.ca/en/practical-guides/managing-your-health/12.