Question

The client with AIDS has a CD4 +T-cell count of \(175 \mathrm{cu} \cdot \mathrm{mm} /\) liter. The nurse is aware that: A. He is relatively free of HIV. B. He is at risk for opportunistic infections. C. He is likely to be asymptomatic. D. He is in remission with his disease.

Short answer

A. He is relatively free of HIV. B. He is at risk for opportunistic infections. C. He is likely to be asymptomatic. D. He is in remission with his disease. Answer: B. He is at risk for opportunistic infections.

Step-by-step solution

Understanding CD4 +T-cell count

CD4 +T-cells are a type of white blood cell that plays a significant role in our immune system. They help coordinate the immune response by activating other immune cells and stimulating antibody production. In patients with HIV or AIDS, a lower CD4 +T-cell count indicates a weakened immune system, which makes the individual more susceptible to infections or other health problems. A higher CD4 +T-cell count indicates a stronger immune system.

Evaluating the CD4 +T-cell count

The normal CD4 +T-cell count for a healthy individual ranges from 500 – 1500 cu·mm/liter. A count of 500 cu·mm/liter or lower indicates a weakened immune system and increased risk of infections or other potential health complications. A patient with AIDS, such as the one described, with a CD4 +T-cell count of 175 cu·mm/liter has a weakened immune system that makes them highly vulnerable to infections or other health problems.

Comparing the count to the possible answers

Now let's compare the given CD4 +T-cell count to each of the possible answers: A. "He is relatively free of HIV." This is incorrect, as a CD4 +T-cell count of 175 cu·mm/liter is significantly below the normal range. This suggests the patient is not free of HIV. B. "He is at risk for opportunistic infections." This is correct, as the low CD4 +T-cell count indicates the patient has a weakened immune system and is more susceptible to infections or other health problems. C. "He is likely to be asymptomatic." This is incorrect, as a CD4 +T-cell count of 175 cu·mm/liter is low enough to potentially cause symptoms associated with HIV or AIDS, such as opportunistic infections. D. "He is in remission with his disease." This is incorrect, as the CD4 +T-cell count of 175 cu·mm/liter suggests the patient's immune system is severely compromised and not in a state of remission. Given the analysis above, the correct answer is: B. He is at risk for opportunistic infections.

Key concepts

AIDS

Acquired Immunodeficiency Syndrome (AIDS) is the most advanced stage of HIV infection. It is characterized by a severely weakened immune system which is the result of a prolonged attack by the virus on the body's CD4 +T-cells. When these crucial immune cells drop below a certain threshold—typically less than 200 cells per cubic millimeter of blood—the body becomes more vulnerable to a wide range of infections and diseases that it would normally be able to fend off.

As HIV progresses, without effective treatment, it can lead to AIDS, where the body can no longer defend itself against opportunistic infections, which are infections that take advantage of the weakened immune system. This vulnerability is what makes AIDS a life-threatening condition. Treatments such as antiretroviral therapy (ART) are used to prevent the virus from reproducing and to keep the CD4 count as high as possible, postponing or preventing the onset of AIDS.

Opportunistic Infections

Opportunistic infections are illnesses that occur more frequently and can be more severe in individuals with weakened immune systems, such as those with AIDS. These infections are considered 'opportunistic' because they take advantage of the body's impaired defenses. Common examples include pneumocystis pneumonia (PCP), toxoplasmosis, and certain types of cancers, like Kaposi's sarcoma.

The risk of developing these infections typically increases as the CD4 +T-cell count decreases. A count below 200 cells per cubic millimeter of blood is a specific indicator that an individual with HIV has progressed to AIDS and is at high risk for these infections. Prevention and timely treatment of opportunistic infections are crucial in managing HIV/AIDS and improving the quality of life for affected individuals.

Immune System

The immune system is the body's defense against infectious organisms and other invaders. A key component of this defense system is the CD4 +T-cells, which coordinate the immune response by signaling other cells in the immune system to perform their specific functions, such as attacking and destroying pathogens.

In the context of HIV/AIDS, the virus specifically targets these cells, weakening the overall immune response. This weakening is measured by the depletion of CD4 +T-cells over time. A healthy individual typically has a CD4 count ranging from 500 to 1500 cells per cubic millimeter of blood. A key goal in HIV treatment is to maintain a high CD4 count to ensure a functioning immune system capable of warding off infections.

HIV Symptoms

HIV symptoms can vary widely depending on the stage of the infection. In the early stages, individuals may experience flu-like symptoms such as fever, headache, and fatigue, known as seroconversion illness. As the infection progresses without treatment, more severe symptoms can develop, associated with the fall in CD4 +T-cells and the onset of opportunistic infections.

Symptoms of advanced HIV or AIDS can include prolonged swelling of lymph nodes, weight loss, fever, diarrhea, and cough. Neurological symptoms like confusion and forgetfulness can also be indicative of HIV-related infections affecting the brain. It's important to note that a low CD4 count is typically connected with these more severe symptoms, underscoring the importance of monitoring CD4 levels for those living with HIV.