Risk of Opportunistic Infections in Sickle Cell Patients with HIV: A Review

Sickle cell disease (SCD) and human immunodeficiency virus (HIV) are both associated with significant immune dysregulation, making co-infected individuals highly susceptible to opportunistic infections (OIs). SCD leads to functional asplenia, chronic inflammation, and impaired immune responses, while HIV progressively weakens the immune system through CD4+ T-cell depletion. The interaction between these two conditions exacerbates immune dysfunction, increasing the risk of severe and recurrent infections. Opportunistic infections in SCD-HIV co-infected patients include bacterial pathogens like Streptococcus pneumoniae and Mycobacterium tuberculosis, fungal infections such as Cryptococcus neoformans, viral infections like cytomegalovirus (CMV), and parasitic infections such as Toxoplasma gondii and Plasmodium falciparum. These infections can lead to severe complications, including life-threatening anemia, neurological impairments, and multi-organ failure. Early diagnosis, infection prevention through vaccination and prophylaxis, and appropriate antiretroviral therapy (ART) are critical in mitigating these risks. Keywords: Sickle cell disease, HIV, opportunistic infections, immunocompromised, co-infection