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If your immune system becomes very damaged, and your CD4 count drops below 200, you are at increased risk of developing AIDS. But even if this happens, modern treatments can help.

Doctors say you have AIDS when you start to get certain infections or types of cancer that don't usually affect healthy people. Doctors call these opportunistic infections. You may have heard of Pneumocystis pneumonia (or PCP for short). This is an infection that affects your lungs. It's the most common infection seen in people with AIDS. It can make it difficult to breathe, or cause a fever and a dry cough.

You get these extra infections because your immune system has become so damaged by HIV that it can no longer fight off the bugs that can make you sick. This normally happens when your CD4 count has fallen to less than 250. Healthy people who aren't infected have CD4 counts of 800 to 1,200. See CD4 count for more.

You may have an opportunistic infection if you get any of the following symptoms:¹

• A bad cough
• Shortness of breath
• Difficult or painful swallowing
• Confusion or forgetfulness
• Diarrhea
• Fever
• Problems seeing clearly
• Nausea, stomach cramps and vomiting
• Weight loss
• Extreme tiredness
• Bad headaches
• Loss of consciousness (coma).

You'll need to be treated for these infections and may need to go to the hospital. See Opportunistic infections and cancer for more.

It's hard to say how long it will be after you're infected with HIV before you start to get infections. On average, it takes someone with HIV who isn't on medication to control the virus 10 years to 12 years to get AIDS.² Getting the right treatment can extend this time to many years, although we aren't sure exactly how long because the treatments have not been around long enough.³

Remember that the way your body deals with the HIV will be different to the way someone else's would. Some people stay healthy for more than 12 years, while others start to get infections just a few years after getting HIV. So it's impossible to say exactly what will happen to you.

If your CD4 count falls below 250, you have a:⁴

• 4 in 10 chance of getting Pneumocystis carinii pneumonia in the next two years
• 2 in 10 chance of getting cytomegalovirus (CMV) infection in the next two years
• 2 in 10 chance of getting MAC infection in the next two years
• 6 in 100 chance of getting toxoplasmosis in the next two years
• 5 in 100 chance of getting cryptococcal meningitis in the next two years.

However, these numbers are from studies that were done before effective combination therapies were available. Newer antiretroviral drugs lower your chances of getting these infections so much that you may never get them.⁵ Today, people with HIV get 80 percent fewer infections than people in the 1980s.⁵

So, if you get the right treatment for HIV, you're much less likely to get infections.

See Opportunistic infections and cancer for more.

If you do develop one of the infections or cancers associated with AIDS you may worry that you'll get sick very quickly. But antiretroviral drugs help people live longer after they get AIDS.⁶

• In 1984 someone with AIDS lived for an average of 11 months after getting their first infection.
• In 1995 someone with AIDS lived for an average of 46 months (just under four years) after getting their first infection.
• We don't have any figures for how long people with AIDS live nowadays. But it's probably much longer than this. Since 1996, people with HIV have been taking a combination of drugs that works very well. It takes some time for doctors to collect figures on how well these drugs are working.

This information is for educational use only, and is not a substitute for prompt professional medical advice. Readers should always consult a physician or other professional for advice and treatment. ©BMJ Publishing Group Limited 2008. All rights reserved.