Women infected with HIV are susceptible to several conditions that may be more difficult to treat because of the infection. These include the following:

• Vaginal infections, including:
  
• • Yeast infection
  • Bacterial vaginosis
    
    
• Sexually transmitted diseases, including:
  
  
• • Chlamydia
  • Gonorrhea
  • Human papillomavirus (HPV)
  • Trichomoniasis
    
    
• Pelvic inflammatory disease (PID).
  
  
• Menstrual cycle changes, including:
  
• • Amenorrhea (absence of menstrual periods)
    
    
  • Dysfunctional uterine bleeding (heavy or constant bleeding)

Women are also susceptible to conditions that affect any person infected with HIV. These are a result of the damage that HIV inflicts upon a patient’s immune system. Such disorders include:

• Bacterial infections:
  
• • Bacterial pneumonia. Among the most common infections occurring in people living with HIV and AIDS (acquired immune deficiency syndrome), it can be caused by dozens of types of bacteria. Bacterial pneumonia develops on its own or after a person has had an upper respiratory infection such as a cold or the flu.
    
    
  • Mycobacterium avium complex (MAC). An infection caused by a group of bacteria collectively known as mycobacterium avium complex. In many cases, MAC causes an infection of the respiratory tract. But patients with advanced HIV infection and CD4 lymphocyte counts of less than 50 may develop a systemic infection of almost any internal organ, including the bone marrow, liver or spleen. Symptoms of MAC include night sweats, weight loss, stomach pain and diarrhea.
    
    
  • Tuberculosis (TB). This infection is the leading cause of death among people living with AIDS in developing countries. Patients with HIV are more susceptible to TB, and TB increases the rate of AIDS virus replication.
    
    
  • Salmonellosis. A bacterial infection that stems from contaminated food or water. Symptoms include severe diarrhea, fever, chills, abdominal pain and vomiting. Salmonellosis is far more common in people who are HIV-positive.
    
    
  • Bacillary angiomatosis. An infection that appears as purplish to bright red patches on the skin. It often resembles Kaposi’s sarcoma (a type of cancer) and is rarely seen in people who do not have HIV.
    
    
• Viral infections:
  
• • Human papillomavirus (HPV). Among the most common causes of Sexually transmitted diseases, HPV can cause genital warts and other lesions. People with HIV are susceptible to infection with HPV and are more prone to recurrent infections. In women, HPV infection increases the risk of cervical cancer. Infection with HPV and HIV further increases a woman’s risk of aggressive cervical cancer. About half of all women with HPV have no symptoms.
    
    Women who are HIV-positive or have unprotected sex with more than one partner should have an annual Pap smear exam to check for cervical cancer.
    
    
  • Cytomegalovirus (CMV). Common herpes virus transmitted in body fluids such as saliva, blood, urine, semen and breast milk, and from mother to fetus during pregnancy. A healthy immune system inactivates the virus, and it remains dormant in the body. But diseases such as HIV that weaken the immune system can activate the virus, causing damage to the eyes, digestive tract, lungs or other organs.
    
    
  • Viral hepatitis. Viral infection of the liver that manifests as yellowing of the skin and the whites (sclera) of the eyes (jaundice), fatigue, nausea, abdominal pain, loss of appetite and diarrhea. Patients who are HIV-positive and also have hepatitis may see their HIV infection progress more rapidly. They also are more likely to develop liver toxicity from their medication.
    
    
  • Herpes simplex virus (HSV). The virus that causes genital herpes. It is usually transmitted during unprotected anal or vaginal sex. Symptoms include pain or irritated skin in the genital area that progresses to sores that ooze and bleed on the genitals, buttocks and anus. These sores heal and then reappear later. People who have HIV are more likely to experience severe skin infections than those who do not have HIV.
    
    
  • Progressive multifocal leukoencephalopathy (PML). A serious brain infection caused by the human polyomavirus JCV. Symptoms may include speech problems, weakness on one side of the body, loss of vision in one eye or numbness in one arm or leg.
    
    
• Fungal infections:
  
• • Candidiasis. A common HIV-related infection that causes inflammation and a thick white coating on the mucous membranes of the mouth, tongue (thrush), esophagus (Candida esophagitis) or vagina (yeast infection).
    
    
  • Cryptococcal meningitis. Meningitis is an inflammation of the membranes and fluid surrounding the brain and spinal cord (meninges). Cryptococcal meningitis is caused by a fungus found in soil and is the most common central nervous system infection associated with HIV. It is rarely seen in non-HIV patients in the United States.
    
    
• Parasitic infections:
  
• • Pneumocystis carinii pneumonia (PCP). The most common opportunistic infection that occurs with AIDS in the United States, it attacks the lungs and makes it difficult for patients to breathe. Symptoms include a persistent cough, fever and trouble breathing.
    
    
  • Toxoplasmosis. The most common cause of brain lesions in people with advanced HIV infection. Toxoplasmosis is caused by the Toxoplasma gondii parasite. House cats are primarily responsible for spreading this parasite, which passes through their stool. Women who are infected with the parasite can pass the infection on to their babies. Toxoplasmosis often leads to encephalitis, an infection of the brain. Signs and symptoms may include disorientation, seizures and difficulty walking or speaking.
    
    
  • Cryptosporidiosis. Infection caused by an intestinal parasite commonly found in animals. People who have AIDS often experience severe, chronic diarrhea after being infected with this parasite.
    
    
• Cancers:
  
• • Kaposi’s sarcoma. The most common cancer found in HIV-positive people. This tumor of the blood vessel walls is rare in people not infected with HIV. It usually appears as pink, red or purple lesions on the skin or in the mouth. In individuals with darker skin, the lesions may look dark brown or black.
    
    
  • Cervical cancer. Cancer of the cervix, the narrow outer end of the uterus.
    
    
  • Non-Hodgkin’s lymphoma. Cancer that begins in the lymphocytes of the bone marrow, lymph nodes, spleen, digestive tract and skin. Symptoms include a painless swelling of the lymph nodes in the neck, armpit or groin.
    
    
• Wasting syndrome. For years, wasting syndrome was common in HIV-infected people. It causes them to lose at least 10 percent of their body weight while suffering with diarrhea, chronic weakness and fever. Aggressive treatment regimens have reduced, but not eliminated, the incidence of this syndrome.