Pregnancy
If you have HIV and become pregnant, you should contact your HIV clinic. There are two reasons why this is important:
- some anti-HIV medicines can harm babies, so your treatment plan will need to be reviewed, and
- additional medicines may be needed to prevent your baby getting HIV.
Without treatment, there is a one in four chance that your baby will develop HIV. With treatment, the risk drops to a one in a hundred.
In the past, mothers with the HIV virus were normally recommended to have a caesarean section, because it reduced the risk of the virus being passed on to the baby.
Due to advancements in treatment, a normal delivery will not usually increase the risk of transmission for women who have an undetectable viral count and whose HIV is well managed.
You should discuss the risks and benefits associated of each delivery method with the staff at your HIV clinic. However, the final decision about how your baby is delivered is yours, and barring any unforeseen complications that may make a caesarean section necessary, staff will respect that decision.
If you have the HIV virus, you should not breastfeed your baby because the virus can be transmitted through breast milk.
If you or your partner have HIV, fertility treatments are available that will allow you to conceive a child without putting either of you at risk of infection. However, these treatments are often expensive and are not available on the NHS.
Opportunistic infections
If your CD4 count drops below 200, you will be at risk of catching many different types of infection. Infections that can 'take advantage' of a HIV-weakened immune system are known as 'opportunistic infections'. However, if you stick to your HIV therapy, the likelihood of developing an opportunistic infection remains low.
The four main types of opportunistic infections are listed below.
- Bacterial infections, such as pneumonia or tuberculosis (TB).
- Viral infections, such as hepatitis.
- Fungal infections, such as thrush.
- Parasitical infections, such as toxoplasmosis.
People with advanced HIV also have a higher risk of developing some forms of cancer, such as lymphoma (cancer of the lymph system).
Some of the most common opportunistic infections that affect people with HIV are outlined below.
Pneumonia:
Pneumonia is a bacterial infection of the lungs. It can often develop as a complication of other infections, such as a cold or the flu. Left untreated, pneumonia can be fatal because the infection can spread through your blood (sepsis).
Pneumonia can be treated using antibiotics. There is also a vaccine available that can protect you against many of the bacteria that can cause pneumonia. People living with HIV are recommended to receive annual vaccinations.
Tuberculosis (TB):
TB is another bacterial infection of the lung. Globally, it is the leading cause of death for people who are HIV positive. TB can be treated using antibiotics, but there are some strains of bacteria that have developed resistance to this medicine, and these can be more difficult to treat. However, there is a vaccine available which can protect you against some strains of TB.
Hepatitis:
Hepatitis is a viral infection that can cause damage to your liver. This can increase your risk of developing liver cancer. There are three main types of hepatitis: hepatitis A, hepatitis B and hepatitis C.
Vaccines are available for hepatitis A and hepatitis B, but not for hepatitis C. Avoiding sharing needles and using a condom are the best ways to prevent hepatitis.
Candidiasis:
Candidiasis is a fungal infection that is common in people living with HIV. It causes a thick, white coating to appear on the inside of your mouth, your tongue, throat or (in the case of women) the vaginia.
Though rarely serious, candidiasis can be both embarrassing and painful. However, it can be treated with anti-fungal creams.
You should tell the staff at your HIV clinic if you have repeated bouts of candidiasis because it could be a sign of a low CB4 count.
Pneumocystis carinii pneumonia (PCP):
PCP is a bacterial infection of the lungs, which can be life-threatening if it is not treated promptly. Before the advances in anti-HIV medicines, PCP was the leading cause of death among those with HIV in the developed world.
Symptoms of PCP include:
- a persistent dry cough,
- shortness of breath,
- difficulty in breathing, and
- in some cases, fever.
You should report any symptoms of PCP straight away because the condition can suddenly worsen without warning. PCP can be treated with antibiotics and, if your CD4 count drops below 200, you may be given antibiotics to prevent a PCP infection.
Cancer
People with advanced HIV have an increased risk of developing cancer. It is estimated that somebody with untreated late-stage HIV infection is 100 times more likely to develop cancer than somebody without the condition. However, with treatment, the risk of getting cancer is much the same as that of the general population.
The two most common cancers to affect people with HIV are lymphoma and Kaposi's sarcoma. Lymphoma is a cancer of the lymphic system (a network of glands that makes up part of our immune system). Kaposi's sarcoma can cause lesions to grow on your skin, and can also affect your internal organs.
Psychological impact of HIV
Being diagnosed with HIV can be very distressing and feelings of anxiety or depression are common. Your HIV clinic will be able to provide you with counselling so that you can fully discuss your condition and your concerns.
Talking to other people who have HIV may be helpful. Your clinic will be able to provide you with information about local support groups.
