| Infection | Symptoms | Treatment |
| BACTERIAL INFECTIONS |
| MYCOBACTERIUM AVIUM COMPLEX (MAC) |
Persistent fever, night sweats, fatigue, weight loss, chronic diarrhea, low blood platelets, nausea, dizziness, abdominal pain, soft-tissue masses; swollen lymph glands, kidney, or spleen. |
Clarithromycin or azithromycin and ethambutol; ciprofloxacin; rifabutin (but first check for TB and watch for rifampin resistance). Experimental: IL-12, GM-CSF (sargramostim). |
| TUBERCULOSIS (TB) |  Night sweats, cough, fever, weight loss, swollen lymph glands, fatigue, organ-specific symptoms. | First-line therapy: Isoniazid (INH) and rifampin and ethambutol, or INH and streptomycin and pyrazinamide for two months, then four months of INH/rifampin. (Note: rifampin can't be used with protease inhibitors). Rifater, a combination pill, is also available. First-line therapy for resistant TB: Cycloserine-capreomycin with other anti-TB drugs. Alternatives: rifabutin, ethambutol, streptomycin, L-ofloxacin, ethionamide. Experimental: IL-8, methylprednisone. |
| SYPHILIS | Many people have no symptoms. Initial signs: Chancres or sores on body, especiallly genitals. Secondary syphilis: 10-12 weeks after infection, a rash on hands and feet that spreads; fever, swollen lymph glands, diarrhea. Tertiary syphilis: Severe neurological disorders. | Aggressive treatment with penicillins (or other antibiotics if allergic). Monitor syphilis for recurrence. Treat neurosyphilis with long-acting tetracyclines after penicillin. |
| SALMONELLA | Persistent diarrhea, cramping, fever, weakness, loss of appetite. | Standard antibiotics. |
| Infection | Symptoms | Treatment |
| CANCERS |
| Kaposi's sarcoma | Cancer of skin and organs associated with a new herpes virus, HHV-8; small, purplish lesions visible on skin. Bronchoscopy used for diagnosis in lungs. | Local therapy: Cryotherapy, radiation, intralesional vinblastine, alpha interferon, Panretin (alitretinoin). Systemic therapy: Doxil (liposomal doxorubicin, liposomal donorubicin (Daunoxome) Taxol (paclitaxel). Experimental: angiongenesis inhibitors (IM862,SU-5416), thalidomide, IL-12 |
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Non-Hodgkin's lymphoma (NHL) or B-cell lymphomas | Cancer of lymphocytes; may also affect bone marrow and central nervous syndrome; B-cell lymphomas linked to Epstein-Barr virus (EBV). | First-line therapy is CHOP (cyclophosophamide, doxorubicin, vincristine, prednisone); or low-dose mBACOD; infusional CDE or EPOCH, modified doses for patients under 100 CD4 T-cells. Experimental: C2B8 monoclonal antibody (rituximab), IL-2, bone marrow transplant. |
| Infection | Symptoms | Treatment |
| FUNGAL INFECTIONS |
| Candidiasis (thrush) | White patches on gums, tongue; pain and difficulty swallowing; loss of appetite; vaginal itching, burning, discharge. | Fluconazole, nystatin, clotrimazole, Nizoral, oral solution itraconazole. Experimental: ABLC, D0870 for fluconazole-resistant oral strains, MK-0991, terbinafine, LY303366, SCH56592. Oral ampho-B for patients failing other therapies. Natural agents for vaginal infection: Yogurt, vinegar douche, garlic. |
| Cryptococcal Disease | Meningitis: Mild headaches, intermittent fevers, malaise, nausea, fatigue, loss of appetite, altered mental status, seizures (rare). Skin ulcers, pneumonia (concurrent with PCP). | Fluconazole, liposomal amphotericin B, 5-flucytosine, itraconazole. For meningitis, lowering cranial pressure is vital. |
| Histoplasmosis | Skin infections, fever, swollen lymph glands, weight loss, anemia, difficulty breathing; also pneumonia. | Itraconazole, fluconazole, ampho B. |
| Infection | Symptoms | Treatment |
| PROTOZOAL INFECTIONS |
| Cryptosporidiosis | Diarrhea with watery stool, abdominal cramping, nausea, vomiting, fatigue, flatulence, weight loss, poor appetite, dehydration, electrolyte imbalances. | No treatments proven effective; initiate HAART. Experimental for diarrhea: nitazoxanide (NTZ), nutritional supplements, Allicin (high-dose garlic). |
| Pneumocystis carinii pneumonia (PCP) | Fever, dry cough, weight loss, night sweats, difficulty breathing, elevated liver enzymes. | Systemic treatment recommended: Bactrim/Septra, IV & IM pentamidine, dapsone plus trimethoprim, clindamycin plus primaquine, atovaquone, trimetrexate. Prednisone for severe cases. |
| Toxoplasmosis gondii (Toxo) | Encephalitis (brain disease); also fever, pneumonia, severe headaches, confusion, lethargy, altered mental state, dementia, seizures, coma.
| Pyrimethamine plus sulfadiazine, pyrimethamine plus clindamycin. |
| Microsporidiosis; Isosporiasis; E. Intestinalis | Watery diarrhea, abdominal pain, cramping, nausea, vomiting, weight loss, fever. | No proven treatments. Experimental: albendazole sulfoxide, metronidazole, thalidomide, atovaquone. |
| Infection | Symptoms | Treatment |
| OTHER CONDITIONS |
| Wasting syndrome | Rapid severe weight loss, loss of appetite, chronic diarrhea, fever. Tumor necrosis factor and gluthathione levels linked to wasting. Check for other OIs. |
Check for other OIs. Approved: Growth hormone, Megace, Marinol, Serostim, oxandralone. Experimental: thalidomide, steroids. Nutritional supplements, vitamins, weight-bearing exercise. Experimental: Provir for diarrhea. |
| Neuropathy | Tingling "pins and needles" in feet and legs, hands and fingers; numbness, pain. Tip: Check for drug-related toxicity. | Experimental: Nerve growth factor, lamotigrine, amytriptiline, Neurontin, lidocaine patch, B vitamins, nutritional supplements, acupuncture. Non-opiods for mild pain, |
| Idiopathic thrombocytopenia purpura (ITP) | Excessive bleeding from nosebleeds and cuts; easy bruising; small and large red spots on skin. Due to HIV-related low platelet count.
| Prednisone, Win-Rho, AZT, gamma globulin. |
| Infection | Symptoms | Treatment |
| GYNECOLOGICAL |
| Cervical cancer | Cervical lesions and cellular abnormalities caused by sexually transmitted viruses, including herpes and HPV; detected by abnormal Pap smear; confirmed by coloscopy. | Early stage cancer: cryosurgery (freezing), laser electric excision, scraping and cone biopsy of cervix. Invasive cancer: chemotherapy, radiation, hysterectomy, surgical removal of lymph nodes. Experimental: Topical 5-flourouracil for high-grade dysplasia (not for pregnant women). |
| Human Papilloma Virus; genital warts | Genital warts can be felt if external; internal requires exam. HPV linked to cancers of anus, penis, vagina, cervix. | Aldera, podophylllin, Alferon-N, Imiquimod topical cream for warts. Cyosurgery, laser then monitor: HPV can recur. Experimental: Topical 5-flourouracil, antisense compounds, HPV peptide vaccines, DFMO after lesion removal. |
| Pelvic Inflammatory Disease (PID) | Vaginal discharge, pain, internal ulcers, ectopic pregnancy, linked to chlamydia; screening, early detection critical. | Ceftriaxone plus tetracycline or doxycycline or erythromycin (if pregnant or allergic). |
| Infection | Symptoms | Treatment |
| VIRAL INFECTIONS |
| Cytomegalovirus (CMV) | Fever common; affects different parts of body. In eyes: Blurry vision. In esophagus: pain, ulcers, difficulty swallowing. In colon and gut: Diarrhea, abdominal pain, wasting. In lungs: pneumonia. | Approved: Ganciclovir (DHPG) IV or intraocular implants; foscarnet (saline hyperhydration recommended to prevent kidney toxicity), cidofovir plus probenecid (monitor renal toxicity and eye pressure). Formivirsen intraocular injection (Vitravene) for patients failing other therapies. Experimental: GEM 132, valganciclovir. |
| CMV Neurological Disorders | Infections of the central nervous system, encephalitis (brain disease), dementia, apathy, delirium, confusion, lethargy. | Standard CMV retinitis treatment suboptimal. Promising: aggressive ganciclovir-foscarnet combination. |
| Progressive Multifocal Leukoencephalopathy (PML) |  Neurological problems: gross dementia, paralysis, loss of all senses in late-stage disease. | No proven treatments. Initiate HAART. Experimental: cidofovir, camptothecin derivatives (topotecan, etc.). Experimental: alpha interferon. |
| Hairy leukoplakia | White, raised patches in mouth and on tongue. Also skin rash, thirst, light-headedness, nausea. May be confused with thrush.
| Acyclovir, ganciclovir, famciclovir. |
| Herpes (Herpes Simplex Virus I and II); Shingles (Herpes Zoster) | Ulcers, painful blisters and/or itching on lips (caused by herpes simplex I), anus and/or genitals (caused by herpes simplex II). Shingles on body caused by herpes zoster. | Approved: acyclovir, oral Famvir (famciclovir) for recurrent herpes, foscarnt for acyclovir-resistant HSV. Experimental: trifluridine (TFT), cidofovir, topical penciclovir. |
| Hepatitis-A, B, and C | Liver infections, fever. Chronic progressive disease is seen for B and C. Co-infection with hepatitis C has been linked to higher HIV viral loads. | Vaccine for hepatitis A and B. No treatment for A. For B: Alpha interferon (INF), Famvir-3TC; experimental: Preveon, FTC/DAPD, L-FMAU. For C: INF-ribavirin (Rebetron) should not be used by pregnnt women; Experimental: once-weekly pegylated INF (with or w/o Ribavirin), beta-INF, Il-12. |
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