HIV positive & unwell
People infected with HIV still get common colds and viral infections which may be treated at home with simple remedies. The problem for patients is knowing when they should self-treat at home or seek further advice.
If you have a good CD4 count (more than 250 cells per ml within the last 4 months) then you are unlikely to have a severe HIV related condition.
Symptoms that appear gradually over a period of time or do not make you feel ill can normally be discussed with your regular clinic doctor.
This section provides some simple guidelines to help you, but the bottom line is if you are worried about anything then seek further medical advice, for which see below.
It is helpful to keep a thermometer at home so you can record your temperature accurately and a supply of paracetamol or ibuprofen.
Options for seeking further medical advice
- Working hours during the week
- Telephone GP surgery to arrange urgent appointment or speak to GP.
- Phone HIV nurse 020 8934 6220 – they will organise an urgent appointment for you in the clinic or direct you to the appropriate service.
- Phone medical secretaries 020 8934 6845 – they will organise for one of the HIV team to speak to you.
- Evenings and weekends
- Telephone your GP surgery – they will direct you to the out of hours service.
- Phone NHS Direct for advice 0845 4647
- If symptoms are severe attend your local A&E department and take your medicines with you
- Colds, sore throats, cough, feeling flu-like, can usually be self- treated at home with 4 hourly paracetamol or ibuprofen, cough linctus and drinking lots of fluids and keeping warm.
- If these symptoms persist for more than 2 -3 days without getting better then seek further advice, for which see above.
- Vomiting and diarrhoea are usually self limiting conditions. Make sure you drink lots of clear fluids so you don’t become dehydrated. Small frequent sips are best. Don’t worry if you can’t eat for 24 hours. If these symptoms persist for more than 48 hours then seek further medical advice, for which see above. Diarrhoea is a common side effect of kaletra (one of the antiretroviral medicines).
- Headaches are common and some people experience headaches more frequently than others. Normally simple headaches are relieved with paracetamol or ibuprofen. If you get a headache that continues without remission for more than 2-3 days and/or you also feel unwell with a temperature/fevers/ or vomiting then you need to seek medical advice, for which see above.
- Rashes may appear about 10 days after starting a new antiretroviral medicine (particularly efavirenz, nevirapine or kivexa) or PCP prophylaxis with cotrimoxazole or dapsone. Your doctor will probably have warned you about this. If this happens – do not stop the medicine – take antihistamines e.g. piriton 4mg or cetrizine 10mg available from any pharmacy. Seek further medical advice from the Wolverton or at the weekend your GP.
- Shingles is common – a painful rash with blisters that occurs on one side of the body usually affecting the side of the chest or abdomen but can be anywhere. Seek medical advice as you may need treatment, for which see above.
You are more likely to become ill if your CD4 count is less than 200 or you have discontinued your antiretroviral therapy for more than a year. If you become unwell with any of the following symptoms then seek urgent medical advice – if during the evening or weekend attend A&E.
- A persistent fever and night sweats – may also be confusion, difficulty walking, visual disturbance.
- Loss of consciousness or drowsiness.
- Weakness or numbness down one side, droopy face, loss of speech – like a stroke.
- Shortness of breath or difficulty breathing in association with a cough / fever.
- Partial loss of vision in one eye.
- Vomiting / coughing up blood.
- Severe central chest pain.
- Severe abdominal pain.