AIDS RELATED CANCER
AIDS-Related Cancer The Causes, Symptoms, Types, and Treatment of AIDS-Related Cancer
AIDS-related cancer is a group of cancers that are frequently diagnosed in people with HIV/AIDS. People who do not have HIV or AIDS can certainly develop these types of cancers, however they are only referred as HIV/AIDS-related cancers when diagnosed in someone with HIV or AIDS.
AIDS-related cancer is a group of cancers that are frequently diagnosed in people with HIV/AIDS. People who do not have HIV or AIDS can certainly develop these types of cancers, however they are only referred as HIV/AIDS-related cancers when diagnosed in someone with HIV or AIDS.
Definition of Definition of AIDS-related cancers: Certain cancer types that are more likely to occur in people who are infected with the human immunodeficiency virus (HIV). The most common types are Kaposi sarcoma and non-Hodgkin lymphoma. Other AIDS-related cancers include Hodgkin disease and cancers of the lung, mouth, cervix, and digestive system.
About HIV/AIDS
Acquired immune deficiency syndrome (AIDS) is a disease of the immune system caused by infection with the human immunodeficiency virus (HIV). HIV is transmitted from person to person most commonly in blood and bodily secretions (such as semen). A person with HIV is highly vulnerable to life-threatening conditions, because HIV severely weakens the body’s immune system. When HIV infection causes symptoms and specific disease syndromes, the disease is called AIDS.
About HIV/AIDS-related cancer
People with HIV/AIDS have a high risk of developing certain cancers, such as Kaposi sarcoma, non-Hodgkin lymphoma, and cervical cancer (see below). For people with HIV, these three cancers are often called “AIDS-defining conditions,” meaning that if a person with an HIV infection has one of these cancers it can signify the development of AIDS.
The connection between HIV/AIDS and certain cancers is not completely understood, but the link likely depends on a weakened immune system. Most types of cancer begin when normal cells begin to change and grow uncontrollably, forming a mass called a tumor. A tumor can be benign (noncancerous) or malignant (cancerous, meaning it can spread to other parts of the body). The types of cancer most common for people with HIV/AIDS are described in more detail below.
Kaposi sarcoma
Kaposi sarcoma is a type of skin cancer, which has traditionally occurred in older men of Jewish or Mediterranean descent, young men in Africa, or people who have had organ transplantation. Today, Kaposi sarcoma is found most often in homosexual men with HIV/AIDS and is related to an infection with the human herpesvirus 8 (HHV-8). Kaposi sarcoma in people with HIV is often called epidemic Kaposi sarcoma.
HIV/AIDS-related Kaposi sarcoma causes lesions to arise in more than one area of the body, including the skin, lymph nodes, and organs such as the liver, spleen, lungs, and digestive tract.
Non-Hodgkin lymphoma
Non-Hodgkin lymphoma (NHL) is a cancer of the lymph system. Lymphoma begins when cells in the lymph system change and grow uncontrollably, which may form a tumor. The lymph system is made up of thin tubes that branch to all parts of the body. Its job is to fight infection and disease. The lymph system carries lymph, a colorless fluid containing white blood cells called lymphocytes. Lymphocytes fight germs in the body. Groups of tiny, bean-shaped organs called lymph nodes are located throughout the body at different sites in the lymph system. Lymph nodes are found in clusters in the abdomen, groin, pelvis, underarms, and neck. Other parts of the lymph system include the spleen, which makes lymphocytes and filters blood; the thymus, an organ under the breastbone; and the tonsils, located in the throat.
The most common subtypes of NHL in people with HIV/AIDS are primary central nervous system lymphoma (affecting the brain and spinal fluid), primary effusion lymphoma (causing fluid to build up around the lungs or in the abdomen), or intermediate and high-grade lymphoma.Cervical cancer
Cervical cancer starts in a woman's cervix, the lower, narrow part of the uterus. The uterus holds the growing fetus during pregnancy. The cervix connects the lower part of the uterus to the vagina and, with the vagina, forms the birth canal. Cervical cancer is also called cancer of the cervix.
Women with HIV/AIDS have a higher risk of developing cervical intraepithelial neoplasia (CIN), a precancerous growth of cells in the cervix that may be associated with human papillomavirus (HPV) infection. High-grade CIN can turn into invasive cervical cancer.
Acquired immune deficiency syndrome (AIDS) is a disease of the immune system caused by infection with the human immunodeficiency virus (HIV). HIV is transmitted from person to person most commonly in blood and bodily secretions (such as semen). A person with HIV is highly vulnerable to life-threatening conditions, because HIV severely weakens the body’s immune system. When HIV infection causes symptoms and specific disease syndromes, the disease is called AIDS.
About HIV/AIDS-related cancer
People with HIV/AIDS have a high risk of developing certain cancers, such as Kaposi sarcoma, non-Hodgkin lymphoma, and cervical cancer (see below). For people with HIV, these three cancers are often called “AIDS-defining conditions,” meaning that if a person with an HIV infection has one of these cancers it can signify the development of AIDS.
The connection between HIV/AIDS and certain cancers is not completely understood, but the link likely depends on a weakened immune system. Most types of cancer begin when normal cells begin to change and grow uncontrollably, forming a mass called a tumor. A tumor can be benign (noncancerous) or malignant (cancerous, meaning it can spread to other parts of the body). The types of cancer most common for people with HIV/AIDS are described in more detail below.
Kaposi sarcoma
Kaposi sarcoma is a type of skin cancer, which has traditionally occurred in older men of Jewish or Mediterranean descent, young men in Africa, or people who have had organ transplantation. Today, Kaposi sarcoma is found most often in homosexual men with HIV/AIDS and is related to an infection with the human herpesvirus 8 (HHV-8). Kaposi sarcoma in people with HIV is often called epidemic Kaposi sarcoma.
HIV/AIDS-related Kaposi sarcoma causes lesions to arise in more than one area of the body, including the skin, lymph nodes, and organs such as the liver, spleen, lungs, and digestive tract.
Non-Hodgkin lymphoma
Non-Hodgkin lymphoma (NHL) is a cancer of the lymph system. Lymphoma begins when cells in the lymph system change and grow uncontrollably, which may form a tumor. The lymph system is made up of thin tubes that branch to all parts of the body. Its job is to fight infection and disease. The lymph system carries lymph, a colorless fluid containing white blood cells called lymphocytes. Lymphocytes fight germs in the body. Groups of tiny, bean-shaped organs called lymph nodes are located throughout the body at different sites in the lymph system. Lymph nodes are found in clusters in the abdomen, groin, pelvis, underarms, and neck. Other parts of the lymph system include the spleen, which makes lymphocytes and filters blood; the thymus, an organ under the breastbone; and the tonsils, located in the throat.
The most common subtypes of NHL in people with HIV/AIDS are primary central nervous system lymphoma (affecting the brain and spinal fluid), primary effusion lymphoma (causing fluid to build up around the lungs or in the abdomen), or intermediate and high-grade lymphoma.Cervical cancer
Cervical cancer starts in a woman's cervix, the lower, narrow part of the uterus. The uterus holds the growing fetus during pregnancy. The cervix connects the lower part of the uterus to the vagina and, with the vagina, forms the birth canal. Cervical cancer is also called cancer of the cervix.
Women with HIV/AIDS have a higher risk of developing cervical intraepithelial neoplasia (CIN), a precancerous growth of cells in the cervix that may be associated with human papillomavirus (HPV) infection. High-grade CIN can turn into invasive cervical cancer.
HIV weakens your immune system, leaving you vulnerable to certain infections and cancers. The infections are called "opportunistic" because they take the opportunity to attack you when your immune system is weak. The cancers are called "AIDS related" because they appear mostly in people who have advanced, later-stage HIV infection, known as AIDS.
Most people who die of AIDS do not die from the virus itself. They die from opportunistic infections (or "OIs"). Often, people are infected with the OI long before they become infected with HIV. Their functioning immune system keeps the OI under control, so they don't have any symptoms of the infection. Once HIV damages their immune system enough, the OI becomes uncontrolled and makes them sick. If you have HIV, you can take antibiotics to prevent the OI from causing disease. For example, one common opportunistic infection is Pneumocystis jiroveci pneumonia (also called PCP). Most people already have the microbe that causes PCP in their body, but it doesn't make them sick. An HIV-positive person, however, may need to take antibiotics to keep from getting very sick.
Why it's important to get an early diagnosis It is important to catch the early symptoms of OIs and AIDS-related cancers before they take hold in various organs of the body, such as the lungs and brain. The sooner your doctor can diagnose and treat the condition, the more likely you are to make a full recovery. This means you need to keep track of your symptoms and report them to your doctor. Plan on having checkups regularly, at least every 3 months.
Also, because OIs and AIDS-related cancers tend to occur more commonly in people with lower CD4 counts, it is important to have your CD4 count checked every 3 to 4 months, so that you can begin anti-HIV therapy before your risk of developing an OI or AIDS-related cancer becomes too high.
Common types of illnesses OIs can be caused by viruses, bacteria, fungus, even parasites. Common opportunistic infections are:
Tuberculosis, or TB Pneumocystis jiroveci, or PCP (a type of pneumonia) Wasting syndrome (severe weight loss) Candidiasis, or thrush (yeast infections) Herpes zoster (shingles) HIV dementia (confusion) A common AIDS-related cancer is:
Kaposi sarcoma, or KS What follows are descriptions of some of these illnesses:
Candidiasis (thrush) Candidiasis (or thrush) is a fungal infection of the mouth or lungs. Most people already have the Candida fungus in their body, but the body keeps it in check. Someone whose immune system is weakened is more likely to develop problems.
Some people show no symptoms, but for those who have them, symptoms can include:
white patches on the tongue smooth red areas on the back of the tongue painful areas in the mouth changes in taste sensitivity to spicy foods decreased appetite Treatments for thrush include oral drugs (suspensions) that you swish around in your mouth and swallow. If you are taking drugs for thrush, be sure to:
brush your teeth after each meal; rinse your mouth of all food before using either lozenges or suspension; avoid hurting your mouth: use a soft toothbrush; avoid foods and drinks that are too hot or too spicy. Cervical cancer (for women) Cervical cancer often is caused by the same virus that causes anal and genital warts. The virus is called human papilloma virus (or HPV). Safer sex may help reduce the risk of this infection, but many women who are infected with HPV never had genital warts.
In the early stage, there are often no symptoms. Some women, however, may notice bleeding between their periods or spots of blood after sex. Women should get regular exams with their gynecologist to check for cervical cancer.
Coccidioidomycosis This is a caused by a fungus present in soil in the southwestern United States. Risk of infection is highest in Kern and Tulare counties and the San Joaquin Valley in California.
The fungus is inhaled from dust and dirt carried in the air or wind, rather than passed from person to person. Most people don't have symptoms. Others will feel like they have the flu, sometimes with chest pain and a cough. Infection can lead to meningitis, including headache, fever, and altered mental states.
Treatment with antifungal drugs usually is given for life to prevent the infection from returning. Sometimes surgery is required to remove infected tissue. The seriousness of the disease depends on what part or parts of the body the fungus has infected.
Cryptococcosis This fungus is present in soil, usually where there are bird droppings, particularly those of pigeons. It can be passed through the air or wind. It's important to avoid handling birds, even as pets, and to avoid areas with lots of bird droppings.
The fungus can infect different organs, such as the lung, heart, and central nervous system. Symptoms vary, depending on where the infection occurs. In the lung, for example, symptoms can include:
cough fever malaise shortness of breath This infection is very serious. It can lead to meningitis (swelling in the brain) and pneumonia. Drugs are available for this infection, but they do not cure it.
Cryptosporidiosis This parasite is found in the feces of many animals, including humans. It can contaminate drinking water.
To avoid infection from people, avoid contact with feces (diapers, sex involving direct oral-anal contact). Try to avoid accidentally swallowing water when swimming in pools, rivers, or lakes. Do not drink from streams. Drink bottled water or use filters on tap water (look for "submicron" filters, which will filter out this parasite).
Symptoms of this infection include:
persistent watery diarrhea nausea vomiting abdominal pain cramping loss of appetite weight loss There are not effective drugs against this parasite, but if you are taking anti-HIV drugs, they may help decrease your symptoms or even help rid your body of the parasite. If you are infected with cyptosporidiosis, it's best not to work as a food handler or share a room with someone whose immune system is also weakened.
Cytomegalovirus (CMV) Cytomegalovirus (or CMV) is passed by close contact through sex and through saliva, urine, and other body fluids. It can be passed from mother to child during pregnancy and by breast-feeding. If you are not infected, safer sex may help prevent it.
Most people probably are infected with this virus, though they have no symptoms. In HIV-positive people, the infection can be extremely serious. Symptoms can include:
blind spots in vision, loss of peripheral vision headache, difficulty concentrating, sleepiness mouth ulcers pain in the abdomen, bloody diarrhea fever, fatigue, weight loss shortness of breath lower back pain confusion, apathy, withdrawal, personality changes Drugs are available to keep symptoms of the infection under control. Anti-HIV drugs can improve the condition, too. If you haven't started taking drugs for HIV, it may be best to wait until you have been on treatment for CMV for a few weeks.
People whose vision is affected by the virus will have to remain on therapy for life to prevent blindness. Treatment can prevent further loss of vision but cannot reverse existing damage. If you experience any vision problems, tell your provider immediately.
Herpes simplex virus Herpes simplex is caused by a virus. Symptoms include red, painful sores on the mouth ("fever blisters"), genitals, or anal area. Genital herpes is passed through sexual contact. Herpes on the mouth is easily spread through kissing. It can be spread to the genitals through oral sex. The virus can be spread even if you don't have blisters. Safer sex can decrease the risk of infection.
Drugs are available to help herpes blisters heal, but there's no cure. Outbreaks may occur periodically for the rest of your life.
For more information on herpes, call the HELP line in Atlanta at 404-294-6364 or the National Herpes Hotline at 919-361-8488.
Herpes zoster (shingles) Shingles is caused by a virus, the same one that causes chickenpox. People with shingles usually had chickenpox as a child, and the virus is getting becoming again.
Symptoms can include:
painful skin blisters on one side of the face or body some vision loss The skin blisters can be extremely painful. Treatment is available to help the blisters heal, but there is no cure. Bathing them in mild soap and water can help. Antibiotic ointments can help keep the infection from spreading.
Histoplasmosis This infection is caused by a fungus present in the soil contaminated with bat or bird droppings, particularly in eastern and central United States. It gets in the air when the soil is disturbed, such as when people explore caves. It is not passed from person to person.
Symptoms can include:
fever weight loss cough shortness of breath abdominal pain This is an extremely serious disease, and often leads to death. Treatment must be lifelong to prevent the disease from coming back. Even with treatment, the disease may recur.
HIV dementia Sometimes called "HIV encephalopathy" or "AIDS dementia," this disease is caused by HIV invading the brain.
Symptoms can include:
memory loss depressed mood unsteadiness when walking irritability apathy clumsiness shaky hands (poor handwriting) personality changes This condition is less common now that there are drugs available to treat HIV. It may even be prevented by using HIV drugs that cross into the blood.
People who are affected need to have a strong support system. Friends, roommates, or family members can help make sure that HIV medications are taken on time, in the right combination, and at the right dose. If memory is poor, a person can use notes, calendars, and alarms to remember medicines, appointments, and other important events.
HIV wasting syndrome Wasting syndrome refers to unwanted weight loss that is equal to more than 10 percent of their body weight. For a 150-pound man, this means a loss of 15 pounds or more. Weight loss can result in loss of both fat and muscle. Once lost, the weight is difficult to regain.
The condition can be caused by many things: HIV, inflammation, or opportunistic infections. The weight loss may be accompanied by low-grade fever, and sometimes diarrhea. The person may get full easily, or have no appetite at all.
The condition may be preventable, to some degree, by eating a good diet. A "good diet" for an HIV-positive person may not be the low-fat, low-calorie diet recommended for healthy people. Compared with other people, you may need to take in more calories and protein to keep from losing muscle mass. To do this, you can add to your meals:
peanut butter legumes (dried beans and peas) cheeses eggs instant breakfast drinks milkshakes sauces You can also maintain or increase muscle mass through exercise, especially with progressive strength-building exercises. These include resistance and weight-lifting exercise. (For more diet and exercise tips, see the Daily Living section.)
Isosporiasis This condition is caused by a parasite found in feces. It may contaminate food or drinking water. It is most common in tropical and subtropical regions of the United States. To avoid infection, do not drink water from rivers and streams. When appropriate, drink bottled water or use filters on tap water. Cook food thoroughly.
Symptoms can include:
stomach cramps watery diarrhea weight loss (which may be significant) weakness loss of appetite fever Antifungal drugs can treat the infection, but they may need to be taken for a long time to keep the parasite in check.
Most people who die of AIDS do not die from the virus itself. They die from opportunistic infections (or "OIs"). Often, people are infected with the OI long before they become infected with HIV. Their functioning immune system keeps the OI under control, so they don't have any symptoms of the infection. Once HIV damages their immune system enough, the OI becomes uncontrolled and makes them sick. If you have HIV, you can take antibiotics to prevent the OI from causing disease. For example, one common opportunistic infection is Pneumocystis jiroveci pneumonia (also called PCP). Most people already have the microbe that causes PCP in their body, but it doesn't make them sick. An HIV-positive person, however, may need to take antibiotics to keep from getting very sick.
Why it's important to get an early diagnosis It is important to catch the early symptoms of OIs and AIDS-related cancers before they take hold in various organs of the body, such as the lungs and brain. The sooner your doctor can diagnose and treat the condition, the more likely you are to make a full recovery. This means you need to keep track of your symptoms and report them to your doctor. Plan on having checkups regularly, at least every 3 months.
Also, because OIs and AIDS-related cancers tend to occur more commonly in people with lower CD4 counts, it is important to have your CD4 count checked every 3 to 4 months, so that you can begin anti-HIV therapy before your risk of developing an OI or AIDS-related cancer becomes too high.
Common types of illnesses OIs can be caused by viruses, bacteria, fungus, even parasites. Common opportunistic infections are:
Tuberculosis, or TB Pneumocystis jiroveci, or PCP (a type of pneumonia) Wasting syndrome (severe weight loss) Candidiasis, or thrush (yeast infections) Herpes zoster (shingles) HIV dementia (confusion) A common AIDS-related cancer is:
Kaposi sarcoma, or KS What follows are descriptions of some of these illnesses:
Candidiasis (thrush) Candidiasis (or thrush) is a fungal infection of the mouth or lungs. Most people already have the Candida fungus in their body, but the body keeps it in check. Someone whose immune system is weakened is more likely to develop problems.
Some people show no symptoms, but for those who have them, symptoms can include:
white patches on the tongue smooth red areas on the back of the tongue painful areas in the mouth changes in taste sensitivity to spicy foods decreased appetite Treatments for thrush include oral drugs (suspensions) that you swish around in your mouth and swallow. If you are taking drugs for thrush, be sure to:
brush your teeth after each meal; rinse your mouth of all food before using either lozenges or suspension; avoid hurting your mouth: use a soft toothbrush; avoid foods and drinks that are too hot or too spicy. Cervical cancer (for women) Cervical cancer often is caused by the same virus that causes anal and genital warts. The virus is called human papilloma virus (or HPV). Safer sex may help reduce the risk of this infection, but many women who are infected with HPV never had genital warts.
In the early stage, there are often no symptoms. Some women, however, may notice bleeding between their periods or spots of blood after sex. Women should get regular exams with their gynecologist to check for cervical cancer.
Coccidioidomycosis This is a caused by a fungus present in soil in the southwestern United States. Risk of infection is highest in Kern and Tulare counties and the San Joaquin Valley in California.
The fungus is inhaled from dust and dirt carried in the air or wind, rather than passed from person to person. Most people don't have symptoms. Others will feel like they have the flu, sometimes with chest pain and a cough. Infection can lead to meningitis, including headache, fever, and altered mental states.
Treatment with antifungal drugs usually is given for life to prevent the infection from returning. Sometimes surgery is required to remove infected tissue. The seriousness of the disease depends on what part or parts of the body the fungus has infected.
Cryptococcosis This fungus is present in soil, usually where there are bird droppings, particularly those of pigeons. It can be passed through the air or wind. It's important to avoid handling birds, even as pets, and to avoid areas with lots of bird droppings.
The fungus can infect different organs, such as the lung, heart, and central nervous system. Symptoms vary, depending on where the infection occurs. In the lung, for example, symptoms can include:
cough fever malaise shortness of breath This infection is very serious. It can lead to meningitis (swelling in the brain) and pneumonia. Drugs are available for this infection, but they do not cure it.
Cryptosporidiosis This parasite is found in the feces of many animals, including humans. It can contaminate drinking water.
To avoid infection from people, avoid contact with feces (diapers, sex involving direct oral-anal contact). Try to avoid accidentally swallowing water when swimming in pools, rivers, or lakes. Do not drink from streams. Drink bottled water or use filters on tap water (look for "submicron" filters, which will filter out this parasite).
Symptoms of this infection include:
persistent watery diarrhea nausea vomiting abdominal pain cramping loss of appetite weight loss There are not effective drugs against this parasite, but if you are taking anti-HIV drugs, they may help decrease your symptoms or even help rid your body of the parasite. If you are infected with cyptosporidiosis, it's best not to work as a food handler or share a room with someone whose immune system is also weakened.
Cytomegalovirus (CMV) Cytomegalovirus (or CMV) is passed by close contact through sex and through saliva, urine, and other body fluids. It can be passed from mother to child during pregnancy and by breast-feeding. If you are not infected, safer sex may help prevent it.
Most people probably are infected with this virus, though they have no symptoms. In HIV-positive people, the infection can be extremely serious. Symptoms can include:
blind spots in vision, loss of peripheral vision headache, difficulty concentrating, sleepiness mouth ulcers pain in the abdomen, bloody diarrhea fever, fatigue, weight loss shortness of breath lower back pain confusion, apathy, withdrawal, personality changes Drugs are available to keep symptoms of the infection under control. Anti-HIV drugs can improve the condition, too. If you haven't started taking drugs for HIV, it may be best to wait until you have been on treatment for CMV for a few weeks.
People whose vision is affected by the virus will have to remain on therapy for life to prevent blindness. Treatment can prevent further loss of vision but cannot reverse existing damage. If you experience any vision problems, tell your provider immediately.
Herpes simplex virus Herpes simplex is caused by a virus. Symptoms include red, painful sores on the mouth ("fever blisters"), genitals, or anal area. Genital herpes is passed through sexual contact. Herpes on the mouth is easily spread through kissing. It can be spread to the genitals through oral sex. The virus can be spread even if you don't have blisters. Safer sex can decrease the risk of infection.
Drugs are available to help herpes blisters heal, but there's no cure. Outbreaks may occur periodically for the rest of your life.
For more information on herpes, call the HELP line in Atlanta at 404-294-6364 or the National Herpes Hotline at 919-361-8488.
Herpes zoster (shingles) Shingles is caused by a virus, the same one that causes chickenpox. People with shingles usually had chickenpox as a child, and the virus is getting becoming again.
Symptoms can include:
painful skin blisters on one side of the face or body some vision loss The skin blisters can be extremely painful. Treatment is available to help the blisters heal, but there is no cure. Bathing them in mild soap and water can help. Antibiotic ointments can help keep the infection from spreading.
Histoplasmosis This infection is caused by a fungus present in the soil contaminated with bat or bird droppings, particularly in eastern and central United States. It gets in the air when the soil is disturbed, such as when people explore caves. It is not passed from person to person.
Symptoms can include:
fever weight loss cough shortness of breath abdominal pain This is an extremely serious disease, and often leads to death. Treatment must be lifelong to prevent the disease from coming back. Even with treatment, the disease may recur.
HIV dementia Sometimes called "HIV encephalopathy" or "AIDS dementia," this disease is caused by HIV invading the brain.
Symptoms can include:
memory loss depressed mood unsteadiness when walking irritability apathy clumsiness shaky hands (poor handwriting) personality changes This condition is less common now that there are drugs available to treat HIV. It may even be prevented by using HIV drugs that cross into the blood.
People who are affected need to have a strong support system. Friends, roommates, or family members can help make sure that HIV medications are taken on time, in the right combination, and at the right dose. If memory is poor, a person can use notes, calendars, and alarms to remember medicines, appointments, and other important events.
HIV wasting syndrome Wasting syndrome refers to unwanted weight loss that is equal to more than 10 percent of their body weight. For a 150-pound man, this means a loss of 15 pounds or more. Weight loss can result in loss of both fat and muscle. Once lost, the weight is difficult to regain.
The condition can be caused by many things: HIV, inflammation, or opportunistic infections. The weight loss may be accompanied by low-grade fever, and sometimes diarrhea. The person may get full easily, or have no appetite at all.
The condition may be preventable, to some degree, by eating a good diet. A "good diet" for an HIV-positive person may not be the low-fat, low-calorie diet recommended for healthy people. Compared with other people, you may need to take in more calories and protein to keep from losing muscle mass. To do this, you can add to your meals:
peanut butter legumes (dried beans and peas) cheeses eggs instant breakfast drinks milkshakes sauces You can also maintain or increase muscle mass through exercise, especially with progressive strength-building exercises. These include resistance and weight-lifting exercise. (For more diet and exercise tips, see the Daily Living section.)
Isosporiasis This condition is caused by a parasite found in feces. It may contaminate food or drinking water. It is most common in tropical and subtropical regions of the United States. To avoid infection, do not drink water from rivers and streams. When appropriate, drink bottled water or use filters on tap water. Cook food thoroughly.
Symptoms can include:
stomach cramps watery diarrhea weight loss (which may be significant) weakness loss of appetite fever Antifungal drugs can treat the infection, but they may need to be taken for a long time to keep the parasite in check.
