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Preventing HIV-associated opportunistic infections

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Related Terms
  • Acquired immune deficiency syndrome, acquired immunodeficiency syndrome, active TB, active tuberculosis, AIDS, AIDS-defining illness, AIDS-defining infection, antibiotics, antibodies, antifungal, antiretroviral therapy, antiretrovirals, ART, bacteria, bacterial infection, bacterium, CD4 cell, compromised immune system, disseminated mycobacterium avium complex, DMAC, fungal infection, fusion inhibitors, granulomatous, granulomas, HAART, highly active antiretroviral therapy, HIV, human immunodeficiency virus, immune defense system, immune system, immunocompromised, immunodeficiency, impaired immune system, infection, latent TB, latent tuberculosis, MAC, MAI, Mycobacterium, mycobacterium avium complex, mycobacterium avium intracellulare, Mycobacterium tuberculosis, nodules, OI, opportunistic infection, opportunistic respiratory infection, parasite, parasitic infection, PCP, PIs, Pneumocystis carinii, Pneumocystis jiroveci, pneumonia, prophylactic treatment, prophylaxis, protease inhibitors, pulmonary infection, pulmonary nodules, respiratory infection, reverse transcriptase inhibitors, RTs, systemic infection, TB, toxo, toxoplasmosis, Toxoplasma gondii, tuberculosis, viral infection virus, white blood cells.

Background
  • The human immunodeficiency virus (HIV) is a retrovirus that causes AIDS (acquired immune deficiency syndrome). The retrovirus primarily attacks the body's immune system, making the patient extremely vulnerable to opportunistic infections.
  • Opportunistic infections are conditions that occur in individuals who have a weakened immune system. The organisms (bacteria, fungi or viruses) that cause these infections do not cause illnesses in patients who have healthy immune systems because they are able to fight off the infection.
  • HIV and AIDS patients are vulnerable to opportunistic infections like Pneumocystis jiroveci pneumonia (formerly called Pneumocystis carinii pneumonia or PCP), mycobacterium avium complex (MAC), toxoplasmosis and tuberculosis. Individuals with a CD4 cell (immune cells that HIV primarily infects and destroys) count lower than 200 cells per microliter of blood have the greatest risk of developing opportunistic infections. Certain infections are considered AIDS-defining illnesses. This means that when HIV-infected patients develop the infection, their condition has progressed to AIDS.
  • Preventative treatment is taken when HIV-infected patients are at risk of developing these infections, or if they recently had an opportunistic infection.
  • HIV is transmitted from person to person via bodily fluids, including blood, semen, vaginal discharge and breast milk. It can be spread by sexual contact with an infected person, by sharing needles/syringes with someone who is infected, or, less commonly (and rare in countries like the United States where blood is screened for HIV antibodies), through transfusions with infected blood.

Author information
  • This information has been edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).

Bibliography
  1. AIDS Education & Training Centers National Resource Center. . Accessed March 30, 2009.
  2. Centers for Disease Control and Prevention. . Accessed March 30, 2009.
  3. AIDS Education and Training National Resource Center. . Accessed March 30, 2009.
  4. AIDS Info. . Accessed March 30, 2009.
  5. Hardy, WD, Feinberg J, Finkelstein DM, et al. A controlled trial of trimethoprim-sulfamethoxazole or aerosolized pentamidine for secondary prophylaxis of Pneumocystis carinii pneumonia in patients with the acquired immunodeficiency syndrome. AIDS Clinical Trials Group Protocol 021. N Engl J Med. 1992 Dec 24;327(26):1842-8. .
  6. Natural Standard: The Authority on Integrative Medicine. . Copyright © 2009. Accessed March 30, 2009.

Causes
  • HIV can infect and kill many different types of cells in the body. The primary targets are the CD4 T-cells, which are white blood cells that help coordinate the immune system's response to infection and disease. Healthy individuals have a CD4 cell count between 600 and 1,200 per microliter of blood.
  • As the virus continues to weaken the immune system, patients become increasingly vulnerable to opportunistic infections because they are unable to fight against disease-causing organisms. As untreated HIV infection progresses, the CD4 count declines about 4% each year, making the patient increasingly susceptible to diseases and infections.
  • Patients progress to AIDS when their CD4 cell counts drop to lower than 200 cells per microliter of blood. Individuals with a CD4 cell lower than 200 cells per microliter of blood have the greatest risk of developing opportunistic infections.
  • Certain infections are considered AIDS-defining illnesses. This means that when HIV-infected patients develop the infection, their condition has progressed to AIDS.

Integrative therapies
  • Strong scientific evidence:
  • Iodine: Iodine is commonly used in topical disinfectant preparations for cleaning wounds, sterilizing skin before surgical/invasive procedures, or sterilizing catheter entry sites. Betadine solution, for example, contains povidone-iodine. Other topical disinfectants include alcohol and antibiotics and iodine is sometimes used in combination with these as a skin disinfectant. Commercially prepared iodine products are recommended in order to assure appropriate concentrations.
  • There have been reports of severe and even fatal reactions to iodine. Avoid iodine-based products if allergic to iodine. Do not use for more than 14 days. Avoid lugol solution and the saturated solution of potassium iodide (SSKI, PIMA) with high amounts of potassium in the blood, fluid in the lungs, bronchitis, or tuberculosis. Use cautiously when applying to the skin because it may irritate or burn tissues. Use sodium iodide cautiously with kidney failure. Avoid sodium iodide with gastrointestinal obstruction. Iodine is considered to be safe in recommended doses for pregnant or breastfeeding women. Avoid povidone-iodine for perianal preparation during delivery or postpartum antisepsis.
  • Probiotics: Probiotics are beneficial bacteria and are sometimes called friendly germs. They help maintain a healthy intestine by keeping harmful bacteria and yeasts in the gut under control. Most probiotics come from food sources, especially cultured milk products. Probiotics can be taken as capsules, tablets, beverages, powders, yogurts, and other foods. An increasing number of studies support the use of probiotics as a supplement to antibiotic therapy. Probiotic supplementation during a course of antibiotics has been studied for reducing adverse effects of antibiotics in the intestinal environment. This includes reducing growth of Clostridium difficile bacteria, which can lead to colitis, a common complication of antibiotics, especially in the elderly. Some probiotics may also help prevent the development of antibiotic resistance. In acutely ill children, synbiotics have been linked to greater weight gain and fewer bacterial illnesses after antibiotics are ended. The evidence consistently supports supplementation of antibiotics with probiotics.
  • Probiotics are generally considered to be safe and well-tolerated. Avoid if allergic or hypersensitive to probiotics. Use cautiously if lactose intolerant. Caution is advised when using probiotics in neonates born prematurely or with immune deficiency.
  • Good scientific evidence:
  • Probiotics: Limited evidence with day care children suggests supplementation with Lactobacillus GG may reduce number of sick days, frequency of respiratory tract infections, and frequency of related antibiotic treatments. Fermented milk (with yogurt cultures and L. casei DN-114001) may reduce the duration of gastrointestinal and respiratory infections in elderly people. More research is needed to make a firm conclusion.
  • Probiotics are generally considered to be safe and well-tolerated. Avoid if allergic or hypersensitive to probiotics. Use cautiously if lactose intolerant. Caution is advised when using probiotics in neonates born prematurely or with immune deficiency.
  • Zinc: Zinc formulations have been used since ancient Egyptian times to enhance wound healing. Evidence from human trials suggests that zinc pyrithione shampoo may be an effective treatment for tinea versicolor fungal infections of the scalp. Side effects were not noted. Additional research is needed before a strong recommendation can be made.
  • Zinc is generally considered safe when taken at the recommended dosages. Avoid zinc chloride since studies have not been done on its safety or effectiveness. While zinc appears safe during pregnancy in amounts lower than the established upper intake level, caution should be used since studies cannot rule out the possibility of harm to the fetus.
  • Unclear or conflicting scientific evidence:
  • Alizarin: Limited available evidence suggests that alizarin may be of benefit in the treatment of viral infections. Additional research is needed in this area.
  • Avoid if allergic or hypersensitive to alizarin or any plants in the Rubiaceae family. Alizarin may be toxic and should not be handled for long periods of time, rubbed in the eyes, or eaten. Avoid if pregnant or breastfeeding.
  • Astragalus: Limited available clinical study suggests the potential for benefit of astragalus in patients with tuberculosis. Further well-designed clinical trials are required before recommendations can be made.
  • Avoid if allergic to astragalus, peas, or any related plants or with a history of Quillaja bark-induced asthma. Avoid with aspirin or aspirin products or herbs or supplements with similar effects. Avoid with inflammation (swelling) or fever, stroke, transplant or autoimmune diseases (like HIV/AIDS). Stop use two weeks before surgery/dental/diagnostic procedures with a risk of bleeding and avoid use immediately after these procedures. Use cautiously with bleeding disorders, diabetes, high blood pressure, lipid disorders, or kidney disorders. Use cautiously with blood-thinners, blood sugar drugs, or diuretics or herbs and supplements with similar effects. Avoid if pregnant or breastfeeding.
  • Berberine: Berberine is a bitter-tasting, yellow, plant alkaloid with a long history of medicinal use in Chinese and Ayurvedic medicine. Berberine has been found to possess antimicrobial properties, and there is limited evidence of anti-inflammatory properties as well. Preliminary evidence suggests that berberine eye preparations may be beneficial for trachoma. However, the safety and efficacy of berberine for this indication remains unclear. The benefits of berberine in the treatment of leishmaniasis are widely accepted. Berberine is thought to be equally efficacious as the standard drug treatment of cutaneous leishmaniasis, antimonite (sulfide mineral), although limited study of this treatment probably limits its widespread use. Additional study is needed to confirm the effects of berberine for other parasitic infections.
  • Avoid if allergic or hypersensitive to berberine, to plants that contain berberine (Hydrastis canadensis (goldenseal), Coptis chinensis (coptis or goldenthread), Berberis aquifolium (Oregon grape), Berberis vulgaris (barberry), and Berberis aristata (tree turmeric), or to members of the Berberidaceae family. Avoid in newborns due to the potential for an increase in free bilirubin, jaundice, and development of kernicterus. Use cautiously with cardiovascular disease, gastrointestinal disorders, hematologic disorders, leukopenia, kidney disease, liver disease, respiratory disorders, cancer, hypertyraminemia, diabetes, or low blood pressure. Use cautiously in children due to a lack of safety information. Use cautiously in individuals with high exposure to sunlight or artificial light. Use cautiously for longer than eight weeks due to theoretical changes in bacterial gut flora. Use cautiously if taking anticoagulants, antihypertensives, sedatives, anti-inflammatories, medications metabolized by CYP P450 3A4 including cyclosporin, or any prescription medications. Avoid if pregnant or breastfeeding.
  • Beta-glucan: Beta-glucan is a soluble fiber derived from the cell walls of algae, bacteria, fungi, yeast, and plants. PGG-glucan, an immunomodulator, has been studied in patients undergoing surgery, particularly abdominal surgery. Currently, PGG-glucan appears to have positive results in decreasing postoperative infections. More study is warranted to make a firm conclusion.
  • Avoid if allergic or hypersensitive to beta-glucan. When taken by mouth, beta-glucan is generally considered to be safe. Use cautiously with AIDS or AIDS-related complex (ARC). Avoid using particulate beta-glucan. Avoid if pregnant or breastfeeding.
  • Beta sitosterol: Beta-sitosterol is found in plant-based foods, such as fruits, vegetables, soybeans, breads, peanuts, and peanut products. It is also found in bourbon and oils (such as olive oil, flaxseed, and tuna). Due to data that suggest immune modulating effects of beta-sitosterol and beta-sitosterol glucoside, these sterols have been studied for the adjunct treatment of tuberculosis with antituberculosis regimens. Clinical study is currently limited in this area, and larger populations of patients with tuberculosis should be evaluated.
  • Avoid if allergic or hypersensitive to beta-sitosterol, beta-sitosterol glucoside, or pine. Use cautiously with asthma or breathing disorders, diabetes, primary biliary cirrhosis (destruction of the small bile duct in the liver), ileostomy, neurodegenerative disorders (like Parkinson's disease or Alzheimer's disease), diverticular disease (bulging of the colon), short bowel syndrome, celiac disease, and sitosterolemia. Use cautiously with a history of gallstones. Avoid if pregnant or breastfeeding.
  • Bishop's weed: Limited available human study used 8-methoxypsoralen (8-MOP), a photoreactive plant compound from bishopsweed, for the treatment of tinea versicolor. Clinical studies are needed before a conclusion can be made.
  • Use cautiously in patients with photosensitivity as bishop's weed may be photoreactive, and cause phototoxic skin damage, phototoxic dermatitis, and pigmentary retinopathy. Use cautiously in patients with bleeding disorders or taking anticoagulants, NSAIDs/anti-platelet agents, or herbs or supplements that increase risk of bleeding because bishop's weed may have additive effects and increase the risk of bleeding. Use cautiously in patients taking drugs or herbs or supplements metabolized by cytochrome P450 as bishop's weed may increase the effects of these agents. Use cautiously in patients with eye disorders, as bishop's weed may cause ocular toxicity. Avoid in patients with known allergy/hypersensitivity to bishop's weed, its constituents, or members of the Apiaceae family.
  • Bitter orange: Limited available human study found promising results using the oil of bitter orange for treatment of fungal infections. However, due to methodological weakness of this research, further evidence is needed to confirm these results.
  • Avoid if allergic or hypersensitive to bitter orange or any members of the Rutaceae family. Avoid with heart disease, narrow-angel glaucoma, intestinal colic, or long QT interval syndrome. Avoid if taking anti-adrenergic agents, beta-blockers, QT-interval prolonging drugs, monoamine oxidase inhibitors (MAOIs), stimulants, or honey. Use cautiously with headache, hyperthyroidism (overactive thyroid), or if fair-skinned. Avoid if pregnant or breastfeeding.
  • Black tea: Black tea is made from the dried leaves of Camellia sinensis, a perennial evergreen shrub. In early study, inhaled tea catechin was reported as temporarily effective in the reduction of Methicillin-resistant Staphylococcus aureus (MRSA) infection and shortening of hospitalization in elderly patients with MRSA-infected sputum. Additional research is needed to further explore these results.
  • Avoid if allergic or hypersensitive to caffeine or tannins. Skin rash and hives have been reported after caffeine ingestion. Use cautiously with diabetes. Use cautiously if pregnant. Heavy caffeine intake during pregnancy may increase the risk of SIDS (sudden infant death syndrome). Very high doses of caffeine have been linked with birth defects. Caffeine is transferred into breast milk. If breastfeeding mothers consume black tea, it may lead to anemia, decreased iron metabolism, and irritability in their infants.
  • Blessed thistle: Human research of blessed thistle as a treatment for viral infections or bacterial infections is currently lacking. Laboratory studies report that blessed thistle (and chemicals contained in blessed thistle, such as cnicin and polyacetylene) may have activity against several types of bacterial infections and no effects on some types. Early studies report no activity of blessed thistle against herpes viruses, influenza, or poliovirus. Further evidence is necessary in this area before a firm conclusion can be drawn.
  • Blessed thistle is generally considered to be safe when taken by mouth in recommended doses for short periods of time, with few reported side effects such as birth defects, bleeding, breathing problems, bruising, cancer of the nose or throat, increased production of stomach acid, itching, kidney disease, liver toxicity, skin rash, stomach discomfort, stomach ulcers, and vomiting. Allergic reactions to blessed thistle including rash may occur, as well as cross-sensitivity to mugwort and Echinacea. Cross-reactivity may also occur with bitter weed, blanket flower, Chrysanthemum, coltsfoot, daisy, dandelion, dwarf sunflower, goldenrod, marigold, prairie sage, ragweed or other plants in the Asteraceae/Compositae family. Avoid if pregnant or breastfeeding.
  • Bovine colostrum: Bovine colostrum is the pre-milk fluid produced from cow mammary glands during the first two to four days after birth. It confers growth, nutrient, and immune factors to the offspring and has shown potential for immune stimulation. Bovine colostrum that is high in antibodies to certain viruses may help with rotavirus infections. Additional study is needed in this area.
  • Avoid if allergic to dairy products. Use bovine colostrum cautiously because toxic compounds, such as polychlorinated biphenyls (PCBs), dichlorodiphenyltrichloroethane (DDT), and dichlordiphenyldichloroethylene (DDE), have been found in human colostrum and breast milk. Thus, it is possible that these agents may be found in bovine colostrum. Avoid with, or if at risk of, cancer. Use cautiously with immune system disorders or atherosclerosis (hardening of the arteries). Use cautiously if taking medications, such as anti-diarrheal agents (e.g. Imodium®), insulin, or CNS agents (such as amphetamines, caffeine). Avoid if pregnant or breastfeeding.
  • Chlorophyll: Preliminary evidence suggests that chlorophyll intake during chemotherapy treatment in patients with tuberculosis may improve immune parameters and free radical indices, such as malonic dialdehyde. Additional study is needed in this area.
  • Avoid if allergic or hypersensitive to chlorophyll or any of its metabolites. Use cautiously with photosensitivity, compromised liver function, diabetes, or gastrointestinal conditions or obstructions. Use cautiously if taking immunosuppressant agents or agents used to treat diabetes. Avoid if pregnant or breastfeeding.
  • Cinnamon: There is currently a lack of available evidence to support the use of cinnamon for AIDS patients with advanced oral candidiasis. More study is needed in this area.
  • Avoid if allergic or hypersensitive to cinnamon, its constituents, members of the Lauraceae family, or Balsam of Peru. Use cautiously if prone to atopic reactions or if taking cytochrome P450 metabolized agents, anticoagulants (blood thinners), insulin or blood sugar-altering medications, antibiotics, or cardiovascular agents. Avoid if pregnant or breastfeeding.
  • Corydalis: Corydalis may be helpful in the treatment of infections caused by the parasite Echinococcus granulosus caused by the Hydatid worm. More studies are needed to confirm the antiparasitic effects of corydalis.
  • Corydalis is generally considered to be safe. Avoid if allergic or sensitive to corydalis. Avoid if taking sedative or hypnotic drugs, drugs that treat abnormal heart rhythms (including bepridil), pain relievers, and anti-cancer drugs. Avoid if pregnant or breastfeeding.
  • Cranberry: Limited laboratory research has examined the antiviral, antifungal and antibacterial activity of cranberry. Further research is warranted in this area.
  • Avoid if allergic to cranberries, blueberries, or other plants of the Vaccinium species. Sweetened cranberry juice may affect blood sugar levels. Use cautiously with a history of kidney stones. Pregnant and breastfeeding women should avoid cranberry in higher amounts than what is typically found in foods.
  • Garlic: Garlic is used both medicinally and as a food spice. Preliminary research suggests that oral plus intravenous garlic may help manage symptoms of cryptococcal meningitis, a fungal infection that commonly occurs in HIV patients. Further research is needed before recommending for or against the use of garlic in the treatment of this potentially serious condition, for which other treatments are available. Several studies describe the use of garlic as a topical antifungal to treat fungal infections of the skin, including yeast infections. More research is needed in this area.
  • Use cautiously as garlic can cause severe burns and rash when applied to the skin of sensitive individuals. Avoid if allergic or hypersensitive to garlic or other members of the Lilaceae(lily) family (e.g. hyacinth, tulip, onion, leek, or chive). Avoid with a history of bleeding problems, asthma, diabetes, low blood pressure, or thyroid disorders. Stop using supplemental garlic two weeks before and immediately after dental/surgical/diagnostic procedures with bleeding risks. Avoid in supplemental doses if pregnant or breastfeeding.
  • Ginseng: In patients treated with Hochu-ekki-to, which contains ginseng and several other herbs, urinary Methicillin-resistant Staphylococcus aureus (MRSA) has been reported to decrease after 10 weeks. Further study of ginseng alone is necessary in order to draw firm conclusions.
  • Avoid with a known allergy to plants in the Araliaceae family. There has been a report of a serious life-threatening skin reaction, possibly caused by contaminants in ginseng formulations.
  • Goldenseal: The goldenseal component berberine has shown effects against bacteria and inflammation. Several poorly designed human studies report benefits of berberine used in the eye to treat trachoma (Chlamydia trachomatosis eye infection). Better research is needed before a strong recommendation can be made.
  • Avoid if allergic or hypersensitive to goldenseal or any of its constituents, like berberine and hydrastine. Use cautiously with bleeding disorders, diabetes, or low blood sugar. Avoid if pregnant or breastfeeding.
  • Green tea: Green tea is made from the dried leaves of Camellia sinensis, a perennial evergreen shrub. Green tea has a long history of use, dating back to China approximately 5,000 years ago. Green tea, black tea, and oolong tea are all derived from the same plant. Preliminary research suggests that green tea may decrease viral load in carriers of the human T-cell lymphocytic virus. Additional well-designed controlled research is needed before a conclusion can be made.
  • Avoid if allergic or hypersensitive to caffeine or tannins. Use cautiously with diabetes or liver disease.
  • Honey: Currently, there is insufficient available evidence for the use of honey in the treatment of Fournier's gangrene. Additional study is needed.
  • Avoid if allergic or hypersensitive to honey, pollen, celery or bees. Honey is generally considered to be safe in recommended doses. Avoid honey from the genus Rhododendron because it may cause a toxic reaction. Avoid in infants younger than 12 months of age. Use cautiously with antibiotics. Potentially harmful contaminants (like C. botulinum or grayanotoxins) can be found in some types of honey and should be used cautiously in pregnant or breastfeeding women.
  • Hydrotherapy: Hydrotherapy is broadly defined as the external application of water in any form or temperature (hot, cold, steam, liquid, ice) for healing purposes. It may include immersion in a bath or body of water (such as the ocean or a pool), use of water jets, douches, application of wet towels to the skin, or water birth. These approaches have been used for the relief of various diseases and injuries, or for general well being. There is preliminary evidence that some hydrotherapy techniques may reduce skin bacteria. There may be benefits in people with skin wounds or ulcers who are at risk of infection. Evidence that infection of the skin itself (cellulitis) is improved is currently lacking. More research is needed in this area.
  • Avoid sudden or prolonged exposure to extreme temperatures in baths, wraps, saunas, or other forms of hydrotherapy, particularly with heart disease, lung disease, or if pregnant. Avoid with implanted medical devices, such as pacemakers, defibrillators, or liver infusion pumps. Vigorous use of water jets should be avoided with fractures, known blood clots, bleeding disorders, severe osteoporosis, open wounds, or during pregnancy. Use cautiously with Raynaud's disease, chilblains, acrocyanosis, erythrocyanosis, or impaired temperature sensitivity, such as neuropathy. Use cautiously if pregnant or breastfeeding. Hydrotherapy should not delay the time to diagnosis or treatment with more proven techniques or therapies, and it should not be used as the sole approach to illnesses. Patients with known illnesses should consult their physicians before starting hydrotherapy.
  • Iodine: Povidone-iodine has been suggested as a topical treatment for molluscum contagiosum. Research is limited in this area.
  • There have been reports of severe and even fatal reactions to iodine. Avoid iodine-based products if allergic to iodine. Do not use for more than 14 days. Avoid lugol solution and the saturated solution of potassium iodide (SSKI, PIMA) with high amounts of potassium in the blood, fluid in the lungs, bronchitis, or tuberculosis. Use cautiously when applying to the skin because it may irritate or burn tissues. Use sodium iodide cautiously with kidney failure. Avoid sodium iodide with gastrointestinal obstruction. Iodine is considered to be safe in recommended doses for pregnant or breastfeeding women. Avoid povidone-iodine for perianal preparation during delivery or postpartum antisepsis.
  • Lavender: Early laboratory studies suggest that lavender oils may have topical antibiotic activity. However, this has not been well tested in human studies.
  • Avoid if allergic or hypersensitive to lavender. Avoid with a history of seizures, bleeding disorders, eating disorders (such as anorexia or bulimia), or anemia (low levels of iron). Avoid if pregnant or breastfeeding.
  • L-carnitine: Preliminary study suggests antibacterial activity may be increased in patients with tuberculosis given acetyl-L-carnitine. Additional research is needed to confirm these findings.
  • Avoid with known allergy or hypersensitivity to carnitine. Use cautiously with peripheral vascular disease, hypertension (high blood pressure), alcohol-induced liver cirrhosis and diabetes. Use cautiously in low birth weight infants and individuals on hemodialysis. Use cautiously if taking anticoagulants (blood thinners), beta-blockers, or calcium channel blockers. Avoid if pregnant or breastfeeding.
  • Lime: Limited available study found that lime juice used in sauces may aid in cholera prevention. Another preliminary study suggested that using limes in the main meal may also have a protective effect; both studies were investigated by the same primary author. Additional study is needed before a firm conclusion can be made.
  • Lime is considered safe when used in amounts typically found in foods. Avoid if allergic or hypersensitive to lime or any members in the Rutaceae family. Use cautiously with drugs that are broken down by the liver. Use cautiously with drugs that cause sun sensitivity. Avoid if pregnant or breastfeeding.
  • Oregano: Early study shows that taking oregano by mouth may help treat parasites. Further research is needed to confirm these results.
  • Research suggests that oregano is well tolerated in recommended doses. Avoid if allergic or hypersensitive to oregano. Use caution if allergic or hypersensitive to other herbs from the Lamiaceae family including hyssop, basil, marjoram, mint, sage and lavender. Use caution with diabetes and bleeding disorders.Pregnant or breastfeeding women should not consume oregano at doses above those normally found in food.
  • Peppermint: There is currently not enough available scientific evidence to support the use of peppermint for tuberculosis. More research is needed in this area.
  • Peppermint oil may be safe in small doses, although multiple adverse effects are possible. When used on the skin, peppermint oil has been associated with allergic/hypersensitivity reactions, skin rash/hives/contact dermatitis, mouth ulcers/sores, chemical burn, and eye irritation. Lung injury has occurred following an injection of peppermint oil. Peppermint oil taken by mouth may cause headache, dizziness, heartburn, anal burning, slow heart rate, or muscle tremor. Very large doses of peppermint oil taken by mouth have resulted in muscle weakness, brain damage, and seizure. Peppermint oil should be used cautiously by people with G6PD deficiency or gallbladder disease. Use in infants or children is not recommended due to potential toxicity.
  • Pomegranate: In clinical study, an extract of pomegranate was shown to be as effective as a commonly used oral gel when used topically to treat candidiasis associated with denture stomatitis (mouth sores). Additional study is needed to confirm pomegranate's antifungal effects.
  • Avoid if allergic or hypersensitive to pomegranate. Avoid with diarrhea or high or low blood pressure. Avoid taking pomegranate fruit husk with oil or fats to treat parasites. Pomegranate root/stem bark should only be used under the supervision of a qualified healthcare professional. Use cautiously with liver damage or liver disease. Pomegranate supplementation may be unsafe during pregnancy when taken by mouth. The bark, root, and fruit rind may cause menstruation or uterine contractions. Avoid if breastfeeding due to a lack of scientific data.
  • Prayer/distant healing: Prayer can be defined as a "reverent petition," the act of asking for something while aiming to connect with God or another object of worship. Prayer may help reduce the length of hospital stay as well as the duration of fever in patients with infections. However, early study is controversial and additional study is needed before a conclusion can be drawn.
  • Prayer is not recommended as the sole treatment approach for potentially serious medical conditions, and it should not delay the time it takes to consult with a healthcare professional or receive established therapies. Sometimes religious beliefs come into conflict with standard medical approaches and require an open dialog between patients and caregivers.
  • Probiotics: Combining a probiotic yeast (Saccharomyces boulardii) with antibiotics in the treatment of acute amoebiasis (amoebic dysentery) may decrease the duration of symptoms. Early research suggests that cheese containing probiotics may help reduce the risk of a fungal mouth infection, called thrush, in the elderly. As a bacterial reservoir, the nose may harbor many varieties of potentially disease-causing bacteria. There is limited evidence that probiotic supplementation may reduce the presence of bacterial infections in the upper respiratory tract. Children receiving Bifidophilus-supplemented milk-based formula may be protected against rotavirus infection. Lactobacillus GG has shown mixed results, while early evidence suggests that L. rhamnosus is not effective. Some studies suggest shorter duration of diarrhea, less chance of a protracted course, and faster discharge from the hospital with Lactobacillus GG, while others suggest it is ineffective compared to breastfeeding. Results are mixed regarding the ability of probiotics to reduce infective complications of medical treatment. Reduced incidence of infection has been seen in patients treated for brain injury, abdominal surgery and liver transplantation. Other studies have shown no such reduction in elective abdominal surgery and critical care patients. More studies are needed to determine the effectiveness of probiotics for these indications.
  • Probiotics are generally considered to be safe and well-tolerated. Avoid if allergic or hypersensitive to probiotics. Use cautiously if lactose intolerant. Caution is advised when using probiotics in neonates born prematurely or with immune deficiency.
  • Propolis: Propolis is a natural resin created by bees to make their hives. Propolis is made from the buds of conifer and poplar trees and combined with beeswax and other bee secretions. Animal and laboratory studies suggest that propolis may be a beneficial treatment for various types of bacterial, parasitic, and fungal infections. Initial human research reports possible benefits against oral/dental bacteria, genital herpes, urine bacteria, intestinal giardia infections or H. pylori. In humans, a commercial propolis ethanol extract from Brazil, formulated to ensure physical and chemical stability, was found to inhibit fungal infections of the mouth, such as oral candidiasis. Additional research is needed to confirm these findings.
  • Avoid if allergic or hypersensitive to propolis, black poplar (Populas nigra), poplar bud, bee stings, bee products, honey, or Balsam of Peru. Severe allergic reactions have been reported. There has been one report of kidney failure with the ingestion of propolis that improved upon discontinuing therapy and deteriorated with re-exposure. Avoid if pregnant or breastfeeding because of the high alcohol content in some products.
  • Saccharomyces boulardii: Saccharomyces boulardii is a non-pathogenic yeast strain that has been used to treat amoebiasis. Evidence from limited available clinical study showed improvement of symptoms in patients with amoebiasis treated with Saccharomyces boulardii, in addition to standard therapy. Further clinical trials are required before a firm conclusion can be made.
  • Avoid if allergic/hypersensitive to yeast, Saccharomyces boulardii, Saccharomyces cerevisiae, or other species in the Saccharomycetaceae family. Use cautiously in immunocompromised or critically ill patients. Use cautiously with indwelling central venous catheters, colitis, cancer, or constipation. Use cautiously in individuals undergoing chemotherapy and in infants. Use cautiously if taking antidiarrheal agents. Avoid with a yeast infection.
  • Seaweed, kelp, bladderwrack: Bladderwrack (Fucus vesiculosus) is a brown seaweed found along the northern coasts of the Atlantic and Pacific oceans and North and Baltic seas. Another seaweed that grows alongside bladderwrack is Ascophyllum nodosum, andit is often combined with bladderwrack in kelp preparations. Laboratory research suggests that bladderwrack may have antifungal and antibacterial activity. However, reliable human studies to support this use are currently lacking in the available literature.
  • Avoid if allergic or hypersensitive to Fucus vesiculosus or iodine. Avoid with a history of thyroid disease, bleeding, acne, kidney disease, blood clots, nerve disorders, high blood pressure, stroke, or diabetes. Avoid if pregnant or breastfeeding.
  • Selenium: Selenium is a mineral found in soil, water, and some foods. Preliminary research reports that selenium may be beneficial in the prevention of several types of infection, including recurrence of erysipelas (bacterial skin infection associated with lymphedema) or Mycoplasma pneumonia. Further research is needed to confirm the effects of selenium for infection prevention. Commercially available 1% selenium sulfide shampoo has been reported as equivalent to sporicidal therapy in the adjunctive treatment of the yeast infection tinea capitis. Selenium sulfide shampoo has also been studied as a possible treatment for tinea versicolor. However, research results are inconclusive.
  • Avoid if allergic or hypersensitive to products containing selenium. Avoid with a history of non-melanoma skin cancer. Selenium is generally regarded as safe for pregnant or breastfeeding women. However, animal research reports that large doses of selenium may lead to birth defects.
  • Sorrel: There is currently not enough evidence on the proposed antiviral and antibacterial effects of sorrel. More research is needed.
  • Avoid large doses of sorrel because there have been reports of toxicity and death. This may be because of the oxalate found in sorrel. Many sorrel tinctures contain high levels of alcohol and should be avoided when driving or operating heavy machinery. These sorrel formulations may cause nausea or vomiting when taken with the prescription drugs metronidazole (Flagyl®) or disulfiram (Antabuse®). Avoid if pregnant or breastfeeding.
  • Soy: It has been suggested that soy may be beneficial for tuberculosis when taken with standard medications. According to early research, soy may improve the process of detoxification, have positive effects on the liver, reduce cell damage, and decrease inflammation. Therefore, soy supplements may allow patients to safely take higher doses of antimicrobial drugs that are used to treat tuberculosis.
  • Avoid if allergic to soy. Soy, as a part of the regular diet, is traditionally considered to be safe during pregnancy and breastfeeding, but there is limited scientific data. The effects of high doses of soy or soy isoflavones in humans are unclear, and therefore, not recommended. There has been a case report of vitamin D deficiency rickets in an infant nursed with soybean milk that was not specifically designed for infants. People who experience intestinal irritation from cow's milk may experience intestinal damage or diarrhea from soy. It is unknown if soy or soy isoflavones share the same side effects as estrogens (e.g. increased risk of blood clots). The use of soy is often discouraged in patients with hormone-sensitive cancers, such as breast or prostate cancers. Other hormone-sensitive conditions, such as endometriosis, may also be worsened. Patients taking blood-thinning drugs (e.g. warfarin or aspirin) should check with their doctors before taking soy supplements.
  • Tea tree oil: Tea tree oil is purported to have antiseptic properties, and has been used traditionally to prevent and treat infections. Laboratory studies report that tea tree oil has activity against methicillin-resistant Staphylococcus aureus (MRSA) colonization. It has been proposed that using tea tree oil ointment in the nose and a tea tree wash on the body may treat colonization by these bacteria. However, there is currently not enough information from human studies to make recommendations for or against this use of tea tree oil. Although tea tree oil has been found to have activity against several fungus species in laboratory study, there is currently insufficient human evidence to determine if it is an effective topical treatment for onychomycosis, tinea pedis (athlete's foot), or thrush (oral Candida albicans).
  • Tea tree oil may be toxic when taken by mouth and therefore, should not be swallowed. Avoid if allergic to tea tree oil or plants of the Myrtle (Myrtaceae) family, Balsam of Peru, or benzoin. Use cautiously with a history of eczema. Avoid if pregnant or breastfeeding.
  • Thyme: Thyme has been used medicinally for thousands of years. Beyond its common culinary application, it has been recommended for many indications based on proposed antimicrobial, antitussive, spasmolytic, and antioxidant activity. Thyme essential oil and thymol have been shown to have antifungal effects. Topical thymol has been used traditionally to treat paronychia (skin infection around a finger or toenail) and onycholysis (fungal nail infection). Currently, there is insufficient reliable human evidence to recommend for or against the use of thyme or thymol as a treatment for fungal infections.
  • Avoid if allergic or hypersensitive to thyme, members of the Lamiaceae (mint) family, any component of thyme, or rosemary (Rosmarinus officinalis). Avoid oral ingestion or non-diluted topical application of thyme oil due to potential toxicity. Avoid topical preparations in areas of skin breakdown or injury or in atopic patients due to multiple reports of contact dermatitis. Use cautiously with gastrointestinal irritation or peptic ulcer disease due to anecdotal reports of gastrointestinal irritation. Use cautiously with thyroid disorders due to observed anti-thyrotropic effects in animal research of the related species Thymus serpyllum. Avoid if pregnant or breastfeeding.
  • Thymus extract: Thymus extracts for nutritional supplements are usually derived from young calves. Although inconclusive, preliminary evidence suggests that thymus extract may improve effectiveness of antibacterial therapy in patients with tuberculosis. Well-designed clinical trials are required before recommendations can be made.
  • Avoid if allergic or hypersensitive to thymus extracts. Use bovine thymus extract supplements cautiously due to potential for exposure to the virus that causes "mad cow disease." Avoid use with an organ transplant or other forms of allografts or xenografts. Avoid if receiving immunosuppressive therapy or hormone therapy. Avoid with thymic tumors, myasthenia gravis (neuromuscular disorder), or untreated hypothyroidism. Avoid if pregnant or breastfeeding.
  • Traditional Chinese medicine (TCM): Traditional Chinese medicine (TCM) is a broad term that refers to many different treatments and traditions of healing. They share a common heritage of technique or theory rooted in ancient Chinese philosophy (Taoism) that dates back over 5,000 years. Currently, study results conflict, but overall results show promise for TCM in immunomodulation effects and decreasing depression associated with SARS (severe acute respiratory syndrome). More studies are needed in this area.
  • Chinese herbs can be potent and may interact with other herbs, foods, or drugs. Consult a qualified healthcare professional before taking. There have been reports of manufactured or processed Chinese herbal products being tainted with toxins or heavy metal or not containing the listed ingredients. Herbal products should be purchased from reliable sources. Avoid ma huang, which is the active ingredient in ephedra. Avoid ginseng if pregnant or breastfeeding.
  • Turmeric: Turmeric is a perennial plant native to India and Indonesia, and it is often used as a spice in cooking. Based on early research, turmeric may help treat various viral infections. However, reliable human studies are lacking in this area. Well-designed trials are needed.
  • Avoid if allergic or hypersensitive to turmeric (curcumin), yellow food colorings, or plants belonging to the Curcuma or Zingiberaceae (ginger) families. Use cautiously with a history of bleeding disorders, immune system deficiencies, liver disease, or gallstones. Use cautiously with blood thinners (e.g. warfarin). Use cautiously if pregnant or breastfeeding.
  • Vitamin A: After deworming, children supplemented with vitamin A may be less prone to Acaris parasitic infection. These benefits may be less in children with stunted growth. More research is needed to make a conclusion.
  • Avoid if allergic to vitamin A. Vitamin A toxicity can occur if taken at high dosages. Use cautiously with liver disease or alcoholism. Smokers who consume alcohol and beta-carotene may have an increased risk of developing lung cancer or heart disease. Vitamin A appears safe in pregnant women if taken in recommended doses. Use cautiously if breastfeeding because the benefits or dangers to nursing infants are not clearly established.
  • Zinc: In a few studies, patients with cutaneous leishmaniasis were injected with zinc sulfate under the skin. Zinc may decrease the severity of infection and re-infection of S. mansoni, but does not seem to prevent initial infection. More research is necessary. The effects of zinc on the rate of parasitic re-infestation has been examined in children. No significant effect of zinc treatment was found. Recent data suggest that supplementation with zinc and vitamin A may favorably alter infection rate and duration among children. Due to conflicting results in this area, more research is needed before zinc can be recommended for the treatment of parasites. A few studies have examined the efficacy of zinc treatment in leprosy. Studies of zinc taken by mouth report positive results, while one study of topical zinc reports negative results. Further research is needed before a conclusion can be drawn.
  • Zinc (zinc sulfate, zinc acetate, zinc glycine, zinc oxide, zinc chelate, and zinc gluconate) is generally considered safe when taken in the recommended dosages. Avoid zinc chloride since studies have not been done on its safety or effectiveness. While zinc appears safe during pregnancy in amounts lower than the established upper intake level, caution should be used since studies cannot rule out the possibility of harm to the fetus.
  • Fair negative scientific evidence:
  • Macrobiotic diet: A macrobiotic diet has been advocated to preserve intestinal health. However, it apparently does not reduce the incidence of antibiotic resistant bacteria, nor infections caused by resistant strains in the gastrointestinal tract, compared to a diet with animal products.
  • Use cautiously with cancer or other medical conditions without expert planning or supplementation. Avoid in children or adolescents without professional guidance or appropriate supplementation. Avoid in pregnant or lactating women due to potential deficiencies, unless properly supplemented.
  • Probiotics: Bacterial infection translocation, the passage of bacteria from the gut to other areas of the body where they can cause disease, is of special concern in surgery. Limited evidence suggests that supplementation with probiotics may not reduce this problem.
  • Probiotics are generally considered to be safe and well-tolerated. Avoid if allergic or hypersensitive to probiotics. Use cautiously if lactose intolerant. Caution is advised when using probiotics in neonates born prematurely or with immune deficiency.

Prevention
  • General: HIV patients may receive medications to help prevent infections from developing. Specific preventative treatment is administered when HIV-infected patients are at risk of developing opportunistic infections or to prevent recurrence of a recent opportunistic infection. Treatment is typically given to patients who have Pneumocystis jiroveci pneumonia, mycobacterium avium complex (MAC), toxoplasmosis or latent tuberculosis (TB).
  • In addition, HIV patients typically receive highly active antiretroviral therapy (HAART), which suppresses the virus and helps restore and maintain the immune system. Patients with a healthy or near healthy immune system are less likely to develop opportunistic infections.
  • Pneumocystis jiroveci pneumonia: Antibiotics should be administered as a preventative treatment in HIV patients who have CD4 cell counts lower than 200 cells per microliter of blood or with a history of Pneumocystis jiroveci pneumonia or oral thrush (fungal infection in the mouth). Antibiotics may also be considered in patients who have a CD4 cell counter higher than 200, if their CD4 cell percentage is below 14%, they have other opportunistic infections, or they have a fever above 100 degrees Fahrenheit that has lasted for longer than two weeks. Preventative treatment can be discontinued if the patient's CD4 cell count increases and can be maintained above 200 cells per microliter of blood for at least three months, in response to antiretroviral therapy.
  • The main medication used in prevention of PCP is a combination product called trimethoprim-sulfamethoxazole (Cotrimoxazole®, Bactrim® or Septra®), also called TMP/SMX. Patients typically take one single-strength (400/80mg) or double-strength (800/160mg) tablet daily. Allergic reactions to the drug usually cause a skin rash and sometimes a fever.
  • Patients who have a history of drug-induced allergic reactions may take dapsone (Avlosulfon®) instead. Dapsone is an antibiotic similar to TMP/SMX. Dapsone is almost as effective against PCP and causes fewer allergic reactions than TMP/SMX.100mg of dapsone may be taken orally daily, or 50mg may be taken orally twice a day. Alternatively, 50mg of dapsone may be taken orally once a day with 50mg of oral pyrimethamine once per week and 25mg of oral leucovorin once per week. A third treatment option is 200mg of dapsone with 75mg of pyrimethamine and 25mg of leucovorin once per week.
  • Aerosolized pentamidine is another alternative treatment option. Patients typically receive 300mg once a month. However, this treatment may increase the risk of extrapulmonary pneumocystis, pneumothorax and bronchospasms. This treatment is not recommended in patients who may have tuberculosis because it increases the risk of transmitting the TB infection to others.
  • Atovaquone (Mepron®) is a drug used in people with mild or moderate cases of PCP who cannot take TMP/SMX or pentamidine. Patients typically receive 1,500mg of atovaquone suspension daily.
  • Mycobacterium avium complex (MAC): Preventative treatment for mycobacterium avium complex (MAC) should be administered when the patient's CD4 cell count is below 50 cells per microliter of blood. Patients with a history of MAC should receive lifelong antibiotics to prevent the infection from recurring. Preventative treatment can be discontinued if the patient's CD4 cell count increases to more than 100 cells per microliter for longer than three months with antiretroviral therapy.
  • Clarithromycin (Biaxin®) is a macrolide antibiotic that has been approved by the U.S. Food and Drug Administration (FDA) for the prevention of MAC. Studies have shown that the drug reduces the number of MAC infections in HIV patients by 69%.
  • Clarithromycin is considered to be the most effective drug for the prevention of MAC. However, some researchers are concerned that if a person develops MAC while taking clarithromycin, the infection will be resistant to treatment. According to several studies, about 50% of patients who developed MAC while taking clarithromycin developed MAC infections that were resistant to the drug.
  • Based on the results of a multi-center trial, rifabutin (Mycobutin®) can reduce the rate of MAC by nearly half in AIDS patients. Several other studies show that the drug may help people live longer lives. Researchers have shown that taking rifabutin as a preventative treatment reduces the risk of death by 14%. The most serious side effects of rifabutin are low white blood cells counts and elevated liver enzymes.
  • Azithromycin (Zithromax®), a medication in the same class as clarithromycin, is the most recent drug to be FDA-approved for the prevention of MAC. This drug can be taken once a week because it takes a long time for it to be eliminated from the body. One study found that azithromycin was more effective than rifabutin. The efficacy of azithromycin has not been compared to clarithromycin in studies.
  • Toxoplasmosis: Preventative treatment should be given to patients who have CD4 cell counts lower than 100 cells per microliter of blood or in patients who test positive for Toxplasma. Treatment can be discontinued if the patient's CD4 cell count increases above 200 cells per microliter of blood for at least three months, in response to antiretroviral therapy.
  • TMP-SMX is the standard preventative treatment for toxoplasmosis. Patients typically take one single-strength (400/80mg) or double-strength (800/160mg) tablet daily.
  • Patients who have a history of drug-induced allergic reactions to TMP-SMX may take dapsone (Avelosulfon®) instead. 50mg of dapsone may be taken by mouth daily with 50mg of oral pyrimethamine once per week and 25mg of oral leucovorin once per week. A third treatment option is 200mg of dapsone with 75mg of pyrimethamine and 25mg of leucovorin once per week.
  • Alternatively, 1,500mg of atovaquone (Mepron®), with or without 25mg of pyrimethamine and 10mg of leucovorin may be taken daily.
  • Tuberculosis: Preventative treatment for tuberculosis (TB) is not dependent on the patient's CD4 cell count. Instead, treatment is given to HIV patients who are diagnosed with latent TB or who are in close contact with someone who has active (infectious) TB.
  • Patients typically receive a combination of antibiotics. Isoniazid, rifampin (Rifadin®, Rimactane®), ethambutol (Myambutol®) and pyrazinamide are available for preventative treatment. Some of these drugs may be available in a single combination tablet, which helps make the treatment regimen less complicated. For instance, Rifater® contains isoniazid, rifampin and pyrazinamide.
  • While rifabutin (Mycobutin®) is also used to treat TB in patients who do not have HIV, this drug should not be used to treat HIV patients who are taking the protease inhibitor saquinavir (Invirase®) or the non-nucleoside reverse transcriptase inhibitor delavirdine (Rescriptor®) because there is an increased risk of serious side effects like uveitis (inflammation of the inner eye).
  • Highly active antiretroviral therapy (HAART): HIV patients should receive highly active antiretroviral therapy (HAART), which suppress the virus and helps restore the body's immune system. Research has shown that HAART dramatically slows the progression of opportunistic infections in HIV/AIDS patients.

Opportunistic infections
  • General: The most common opportunistic infections associated with HIV and AIDS are Pneumocystis jiroveci pneumonia, mycobacterium avium complex (MAC), toxoplasmosis and tuberculosis. Patients at risk of developing these infections typically receive medication to prevent infections
  • Pneumocystis jiroveci pneumonia: Pneumocystis jiroveci pneumonia (formerly called Pneumocystis carinii or PCP) is the most common opportunistic infection among HIV patients. Originally, researchers thought a one-cell organism called Pneumocystis carinii caused the disease. However, recent research suggests that a fungus called Pneumocystis jiroveci is the cause. The condition is still commonly referred to as Pneumocystis carinii pneumonia (PCP).
  • According to the National Centers for Disease Control and Prevention (CDC), PCP is considered an AIDS-defining illness. This means that when HIV-infected patients develop PCP, their condition has progressed to AIDS. Individuals with a CD4 cell (helper T-cells that help fight against disease and infection) count lower than 200 cells per microliter of blood have the greatest risk of developing PCP. In addition, people who have CD4 cell counts lower than 300 and have already had another opportunistic infection have an increased risk of developing PCP.
  • This infection almost always affects the lungs, causing a type of pneumonia. The first signs of PCP are difficulty breathing, fever, and a dry cough. Other common symptoms include chest discomfort, weight loss, chills, tachypnea (rapid breathing), tachycardia (fast heart rate), mild crackles (bubbling or rattling sounds that occur when air moves through fluid-filled airways), cyanosis (bluish discoloration of the skin), nasal flaring and intercostal retractions (visible use of muscles between the ribs, which indicates labored breathing). The patient may also spit up blood, although this is considered a rare symptom.
  • Historically, mortality ranged from 20-40%, depending on the severity of the disease when it was diagnosed. Today, however, mortality rates range between 10-20%.
  • Today PCP is almost entirely preventable, and it can be treated effectively with medication. Unfortunately, PCP is still common in patients who are infected with HIV for a long time before they begin antiretroviral therapy (ART). In fact, 30-40% of HIV patients develop PCP if they begin treatment when their CD4 cell counts are around 50.
  • Mycobacterium avium complex (MAC): Mycobacterium avium complex (MAC), or mycobacterium avium intracellulare (MAI), is a bacterial infection that is caused by either Mycobacterium avium or Mycobacterium intracellulare. These bacteria are commonly found in water, soil, dust and food. In fact, these bacteria are present in almost every human. However, a healthy immune system will prevent the bacteria from causing an infection. Therefore, HIV/AIDS patients are at risk of developing MAC.
  • According to the CDC, MAC is considered an AIDS-defining illness. It is estimated that up to 50% of individuals with HIV/AIDS develop MAC, especially if their CD4 count is lower than 50 cells per microliter of blood. MAC rarely causes infections in patients who have CD4 cell counts higher than 100 cells per microliter of blood.
  • MAC infections may be localized (limited to one part of the body) or disseminated (spread throughout the entire body, sometimes called DMAC). MAC infection often occurs in the lungs, intestines, bone marrow, liver and spleen.
  • Common symptoms of MAC include weight loss, fever, chills, night sweats, swollen glands, abdominal pain, diarrhea, inflammation and a general feeling of overall weakness. MAC usually affects the intestines and inner organs first.
  • The most common complication of DMAC is anemia (low levels of red blood cells), which may require a blood transfusion. If the infection involves many organs, it may lead to respiratory failure and death. Patients who have localized infections have a low mortality rate.
  • Toxoplasmosis: Toxoplasmosis (toxo) is a parasitic infection that is caused by a single-celled parasite called Toxoplasma gondii.
  • Toxoplasma gondii is one of the most common parasites, found all over the world. Individuals may be exposed to the parasite in soil, cat feces or in raw or undercooked meat (especially lamb, pork or venison). There have also been rare reports of toxoplasmosis infection as a result of organ transplantation or blood transfusion.
  • It is estimated that more than 60 million Americans carry the parasite. However, 80-90% of infected patients are carriers (experience no symptoms) because the body's immune system prevents the parasite from causing illness. Toxoplasmosis is considered an AIDS-defining illness, according to the CDC.
  • HIV patients often experience symptoms such as headache, confusion, poor coordination, seizures, ocular toxoplasmosis (severe inflammation of the retina), as well as lung problems that are similar to tuberculosis or pneumocystis pneumonia (lung infections).
  • Tuberculosis: Tuberculosis (TB) is a bacterial infection of the lungs, which is caused by the microorganism Mycobacterium tuberculosis. Symptoms may include cough, shortness of breath, pleurisy (pain with breathing or coughing), fever, weight loss, night sweats, chills and loss of appetite. The disease can cause serious respiratory problems, which can be life threatening, especially if left untreated.
  • Tuberculosis is highly contagious. The disease is transmitted through airborne droplets when a person with the infection coughs, talks or sneezes.
  • About 10 to 15 million Americans have latent TB infection, which means they are not sick, but they carry the bacterium that causes the disease. Only 10% of individuals with latent TB ever develop the infection.
  • While tuberculosis is not considered an AIDS-defining illness, HIV patients have an increased risk of developing TB because they have weakened immune systems. The risk of developing active TB increases 7-10% in HIV patients who have latent TB. HIV patients are more likely to experience symptoms in areas of the body other than the lungs. This is called extrapulmonary TB. The disease may affect the bones, joints, nervous system or urinary tract. Also, TB appears to make HIV infection worse. Researchers have found that HIV replicates faster when tuberculosis is also present.

Copyright © 2011 Natural Standard (www.naturalstandard.com)


The information in this monograph is intended for informational purposes only, and is meant to help users better understand health concerns. Information is based on review of scientific research data, historical practice patterns, and clinical experience. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions.

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