The Person's Medical Situation
Once the white blood count has dropped, the body becomes a potential target for a number of common and uncommon diseases. As the resistance lowers, a doctor will begin to supplement the immune system with a number of medications that will either prevent or slow down these "opportunistic" diseases. (They are called opportunistic because they take advantage of the opportunity provided by the lowered resistance.)
The most common opportunistic infections are:
Pneumocystis Carinii Pneumonia
(PCP pneumonia, or PCP)
This is a common pneumonia which affects the lungs and interferes with breathing. About 70 percent of the people in the United States carry this weak bacteria in their lungs, but a healthy immune system keeps it from doing damage. For people with HIV infection, a common antibiotic can keep this pneumonia under control. The person will have to make sure to take the medicine on a regular basis as prescribed by the doctor. You cannot catch this type of pneumonia from someone with AIDS.
Kapost's Sarcoma
(Kaposi's cancer or KS)
This is a type of skin cancer that normally appears on the surface-level skin of the lower legs or arms. The cancers look like purple/brown spots and are irregular in shape. These cancer lesions can be treated with chemotherapy and radiation, just like any other cancerous growth. You can’t catch skin cancer from anybody.
Wasting Syndrome
(‘Slim’s’ Disease)
As the immune system loses its strength, germs can invade the digestive system —the stomach and the intestines — and cause them to malfunction. When this happens, the person is not able to hold anything after eating. As a result, the person gets no nutrition and starts to lose weight and body mass. If this condition lasts for a significant period of time, the person may need to be connected to an intravenous unit and receive nutrition through the tube instead of eating. Obviously, the person is going to be very weak until this particular situation is over.
Cyto-Megalo-Virus
(CMV retinitis or CMV)
This infection is caused by a common germ. While it can cause infection in a number of different places in the body, it often affects the eyes of people with HIV. This virus is a fast mover, and persons with HIV who notice any changes in their vision should consult their doctors immediately. This virus can be controlled with medicine.
Candidiasis Candida
(Oral Thrush)
More commonly known as thrush, is a fungus that grows in warm and moist places in the human body. Without the immune system to check it, it can grow fairly large patches of whitish paste-like material. In people with HIV disease, the thrush is generally seen on the tongue and inside the mouth and throat. This infection can be treated with daily doses of medicine.
Herpes
(Herpes Simplex or HSV)
Herpes is a virus. It normally hides itself inside the body’s nerve endings. However, under some circumstances, the virus will move to the surface of the skin and cause a type of eruption. (A cold sore on the lips is caused by a Herpes virus.) In a person with HIV disease, eruptions can occur on different parts of the body. These sores can be very painful, but there is a medication that must be given at the first sign of an eruption that can reduce the effects.
Tuberculosis
(TB)
Tuberculosis is a disease usually found in the lungs. It is caused by bacteria that nestle in the smallest air pockets of the lungs. In healthy people, the body detects these bacteria and releases a coating that covers the bacteria in the lungs and prevents them from reproducing. For individuals with HIV infection and a lowered immune system, the body does not produce the coating and as the bacteria spread over larger surfaces of the lung, the person is not able to take in oxygen from the air. Unless something is done, the person will suffocate. Several medicines can control TB. These medicines not only protect the person carrying the bacteria but also prevent the bacteria from being transmitted to another person. Unfortunately, the person must take several pills a day for six to nine months. Untreated, TB can be transmitted if there is close, prolonged contact in a closed environment with someone who has an active case of the disease.
As might be expected, because the immune system of a person with HIV cannot easily fight off any infections that attack the body, the individual usually takes a large number of medications to make up for the weakened immune system. It is not uncommon for an AIDS patient to be taking at least one, two or even three anti-retrovirus drugs (like AZT) to control the HIV infection. In addition, there are other medicines for each of the diseases mentioned above (and for many more not listed) and these medications sometimes need to be taken several times a day. Therefore, a person with HIV will probably need to have a supply of medicines available during the day that can be taken according to schedule. You, as steward, should be aware that this might be happening.
In addition, persons living with HIV disease or with AIDS need regular visits to doctors or clinics. While these usually can be arranged in advance, sometimes the treatment does not go as expected and the person may need to see a physician unexpectedly. The steward may be asked to mediate scheduling problems.
