HIV can cause a dry cough and other symptoms that affect the lungs and respiratory system. A dry cough may occur because HIV reduces the body's ability to fight off infection and other diseases.

However, respiratory problems can have many causes that are not necessarily linked to HIV.

A person with persistent or severe respiratory symptoms should see a doctor to determine the underlying cause. An individual with HIV and new or worsening symptoms should also speak to a doctor.

In this article, we look at the connection between HIV and a dry cough. We also list other common respiratory symptoms that people with HIV may experience.

Woman with a dry cough which may be caused by hivShare on Pinterest
Alongside a dry cough, other symptoms of acute HIV can include fatigue, fever, and a sore throat.

A dry cough can be an early symptom of HIV, or it may indicate that the illness is in the late stage.

In the first 2–4 weeks after contracting HIV, approximately 40–90 percent of people will develop flu-like symptoms. A dry cough may be the only respiratory symptom in the early stages.

Other symptoms of early-stage (acute) HIV are:

A persistent dry cough can also be a symptom of stage 3 HIV, which is sometimes called AIDS. This cough usually gets worse as times goes on.

A dry cough can also indicate pneumonia, a lung infection that is a complication of HIV for some people.

It is important to note that a dry cough is a common complaint. In the absence of other HIV symptoms, it does not suggest that a person has contracted the virus.

A dry cough can also result from:

People at risk of contracting HIV or those with other symptoms of the infection should see a doctor.

Many infections and medical conditions can cause a cough or other breathing difficulties in people with HIV. These include:

Viral and parasitic infections

People with HIV may be prone to viral and parasitic infections.

Those who contract the cytomegalovirus (CMV), for example, may experience lung problems and coughing.

CMV is a common virus, and it does not usually cause problems unless a person has a weakened immune system. This can include people who are HIV-positive, pregnant, or both.

Similarly, the Toxoplasma gondii parasite can cause toxoplasmosis, a condition that leads to lung problems resembling tuberculosis or some types of pneumonia in people with HIV.

Toxoplasma gondii commonly lives in animals and their feces.

Bacterial infections

Several bacterial infections can make their way to the lungs or the respiratory tract and cause inflammation and irritation, leading to a cough.

Bacteria that may cause breathing difficulties in people with HIV are:

  • Haemophilus species
  • Mycobacterium avium complex (MAC)
  • Mycobacterium kansasii
  • Mycobacterium tuberculosis, which causes tuberculosis
  • Pseudomonas aeruginosa
  • Staphylococcus aureus, which causes a staph infection
  • Streptococcus pneumonia

Fungal infections

Fungi that enter the lungs or other parts of the body may cause respiratory problems.

The following fungi are the most common causes of fungal infection in people with HIV:

  • Aspergillus fumigatus
  • Blastomyces dermatitidis
  • Coccidioides immitis
  • Cryptococcus neoformans
  • Histoplasma capsulatum
  • Pneumocystis jirovecii
  • Talaromyces marneffei

Cancer

Some types of cancer are more likely to affect people with HIV, especially in the later stages of the virus' progression.

Some types can cause lung and respiratory symptoms, such as:

  • chest pain
  • a cough
  • coughing up blood
  • difficulty breathing
  • shortness of breath

Cancers that may cause these symptoms include Kaposi sarcoma, non-Hodgkin lymphoma, and lung cancer.

Lung cancer risk is almost three times higher in people with HIV in than those without it.

Other conditions

Several other lung and respiratory conditions can cause problems in people with HIV.

These include:

  • asthma
  • chronic obstructive pulmonary disease, or COPD
  • interstitial lung disease, a group of illnesses that affect the area around the air sacs of the lungs
  • pulmonary arterial hypertension, which is high blood pressure in the arteries between the lungs and heart
  • sarcoidosis, an inflammatory condition affecting the lungs and lymph glands

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Shortness of breath is common among people with an acute HIV infection.

Symptoms that affect breathing may be common in people with HIV, especially if they do not receive treatment. These symptoms can arise from a variety of infections or other complications.

An older study, from 2003, looked at respiratory symptoms among people with HIV. The researchers reported that common symptoms included:

  • shortness of breath
  • a cough
  • phlegm production

These symptoms were more common among people with HIV than those without.

Cigarette smoking, either in the present or the past, was the best predictor of respiratory symptoms among HIV-positive people.

It is essential to note that medications to treat HIV have improved dramatically in the last few decades.

Modern antiretroviral drugs for HIV can effectively manage many symptoms, including a cough, while also preventing progression and transmission of the virus.

A person should see a doctor if they experience persistent or severe respiratory symptoms, including:

  • a dry cough
  • a fever
  • shortness of breath
  • a wet cough (with phlegm)

An individual with HIV should see a doctor as soon as possible if they develop symptoms or if existing symptoms get worse.

Seek immediate medical attention if symptoms include:

  • coughing up blood
  • difficulty breathing
  • severe chest pain

To make a diagnosis, a doctor will perform a physical examination and ask about a person's medical and family histories.

They may also carry out additional tests, such as blood tests or chest X-rays.

The outlook for an HIV-positive person with a dry cough depends on the underlying cause. There are many reasons why someone may have a dry cough or other respiratory symptoms.

In most cases, treatment can control symptoms or address the underlying infection.

For those with HIV, antiretroviral medications can effectively prevent breathing problems and other complications.

Research suggests that people with access to antiretroviral drugs have reduced respiratory symptoms.

To ensure the best outlook, a person should speak to a doctor about any new symptoms and follow the treatment plan they prescribe.