If you are HIV+, you should be aware of a number of diseases that affect the nervous system:

• Toxoplasmosis


• Cryptococcal meningitis


• Peripheral neuropathy

Toxoplasmosis
Toxoplasmosis sounds like something from outer space, but it definitely isn't. Toxoplasmosis is a disease that gets its name from the tiny parasite, Toxoplasma gondii, which causes it. This tiny parasite makes you sick by infecting your brain and nervous system. This parasite can also affect other organ systems. In the lungs, it can cause a pneumonia-like condition called pneumonitis. In the eyes, this parasite can cause lesions and even lead to blindness. Toxoplasmosis is primarily seen in people with HIV with CD4 cell counts below 100.

Sources of Toxoplasma gondii

So, where does this parasite come from? Although the earlier description might remind you of the movie Aliens, the answer to this question is still not outer space. In fact, the answer is much more down to earth. Cats and birds are common sources of this parasite, and you can also find it in undercooked meat, especially pork, lamb, or venison.

The best way to avoid coming into contact with this parasite is to avoid eating rare pork, lamb, or venison and to cook these types of meat until a meat thermometer reads 150°F. You should try to avoid changing litter boxes and cleaning bird cages. If you have to do one of these, be sure to wear rubber gloves and wash your hands thoroughly with soap and water when you are done. If you are HIV+ and you have birds or cats, talk to your vet about getting them tested for the parasite. If they test negative and you always keep your pets indoors, there is no risk of getting this parasite from your pet. If you do have pets, be sure to check out the Pets and HIV section for more information on living with a pet and having HIV.

Symptoms of Toxoplasmosis

The symptoms of toxoplasmosis include:

• Headache
• Fever
• Confusion
• Seizures
• Abnormal behavior
• Coma

If you have one or more of these symptoms, contact your healthcare provider. Your healthcare provider can perform a blood test or may order an MRI scan of your brain to check for possible infection.

Treating Toxoplasmosis

A combination therapy that includes 3 different drugs is used to treat toxoplasmosis. This usually requires taking 10 pills or more a day.

High doses of these drugs are usually taken for 4 to 6 weeks. Provided your CD4 cell count remains above 200 for at least 6 weeks, treatment is continued for about 6 months to ensure that the infection does not return. If your CD4 cell count goes below 200 after stopping treatment, your healthcare provider may require you to restart the medication for toxoplasmosis.

Cryptococcal Meningitis

Cryptococcal meningitis is a condition that is caused by a fungus called Cryptococcus neoformans. Infection with this fungus causes swelling and inflammation in the brain and spinal cord. This inflammation can be extremely dangerous, and if left untreated, death is a certain outcome.

Cryptococcal meningitis is very rare in people with HIV with CD4 cell counts higher than 100, and it is primarily seen in people with HIV with CD4 cell counts lower than 50. However, on very rare occasions, it is seen in people without HIV who are otherwise healthy. The good news is that treatment is available, and it is very effective.

The fungus that causes cryptococcal meningitis is most often found in dust, dirt, and dirt containing bird droppings. You can get cryptococcal meningitis by breathing air containing the disease-causing fungus. For this reason, if you are HIV+, it is wise to avoid areas infested with bird droppings.

Symptoms of Cryptococcal Meningitis

The symptoms of cryptococcal meningitis are very similar to the flu. Sometimes, cryptococcal meningitis can feel like the worst headache you've ever had. A bad headache with confusion, dizziness, or even seizures can also be a sign that you have the disease. Additional symptoms may include any of the following for 3 or more days:

• A fever at or above 100°
• Nausea
• Vomiting
• Body aches, especially in the neck
• Sensitivity to light

If you have any of these symptoms, you should contact your healthcare provider and go to an emergency room right away! Your healthcare provider can find out if you have cryptococcal meningitis by doing a blood test or a spinal tap (removal of fluid from your spinal cord).

Treating Cryptococcal Meningitis

How cryptococcal meningitis is treated depends on how severe the infection is and any previous treatments that you may have received.

• Mild cases—when there are no mental problems, such as dizziness or confusion, your healthcare provider will most probably prescribe an antifungal drug. If your CD4 cell count is low, your healthcare provider may suggest that you continue to take an antifungal drug to prevent you from getting sick again


• Severe cases—for more severe cases of cryptococcal meningitis that involve dizziness or confusion, your healthcare provider will prescribe 2 different drugs. Both of these drugs are taken once a day for about 2 weeks. After this, it is most likely that your healthcare provider will prescribe an antifungal drug, which comes in pill form, for 8 to 10 weeks. For severe cases of cryptococcal meningitis, most healthcare providers will recommend that you take an antifungal drug for the rest of your life to prevent getting the disease again

Peripheral Neuropathy

Peripheral neuropathy is a medical term for damage to the nerves not found in the brain or spinal cord. This condition is a side effect of some anti-HIV medications and can be caused by the HIV virus itself. Symptoms of peripheral neuropathy include a burning sensation, tingling, or numbness in your fingers or toes. Other symptoms may include:

• An electric shock sensation in your fingers and toes
• Soreness or a feeling of deep pain in the muscles of the legs or arms

In the most severe cases, some people with HIV have reported feeling like they have an open wound or pain that makes it difficult to walk.

Unfortunately, currently there is no effective treatment available for peripheral neuropathy. The best solution is to work with your healthcare provider to try to identify the cause of your pain. Some HIV medications are known to increase the risk of peripheral neuropathy, and some evidence suggests that taking 2 or more of these drugs together as part of your anti-HIV treatment can further increase this risk. If you are HIV+ and have peripheral neuropathy, talk to your healthcare provider. You and your healthcare provider may be able to find a solution to ease your pain.