Question

The client with AIDS has a CD4 +T-cell count of 175 cu.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. \(\mathrm{He}\) is in remission with his disease.

Short answer

Answer: B. He is at risk for opportunistic infections.

Step-by-step solution

Understand the role of CD4 +T-cell count in HIV/AIDS

The CD4 +T-cell count is a crucial measure of the immune system's health in people living with HIV/AIDS. Healthy individuals typically have a CD4 count between 500 and 1,200 cu.mm/liter. In people with HIV, a lower CD4 count reflects a weakened immune system, making the person more vulnerable to opportunistic infections.

Evaluate each statement based on CD4 count

We are given a CD4 count of 175 cu.mm/liter. With this knowledge, let's evaluate each statement: A. He is relatively free of HIV. This statement is incorrect. A CD4 count of 175 cu.mm/liter indicates that the immune system is weakened, and the individual is not free of HIV. B. He is at risk for opportunistic infections. This statement is correct. A CD4 count of 175 cu.mm/liter is significantly lower than the normal range, indicating a weakened immune system and increased susceptibility to opportunistic infections. C. He is likely to be asymptomatic. This statement is incorrect. People with HIV are usually asymptomatic during the early stages of the infection when their CD4 count is still relatively high. A significantly lower CD4 count, such as 175 cu.mm/liter, typically indicates that the individual is showing symptoms of HIV-related illnesses. D. He is in remission with his disease. This statement is incorrect. Remission suggests improvement or a lessening of symptoms. A CD4 count of 175 cu.mm/liter shows a weakened immune system and a more advanced stage of the disease, not an improvement in overall health.

Select the correct statement

Based on our evaluation, the correct statement is: B. He is at risk for opportunistic infections. A CD4 +T-cell count of 175 cu.mm/liter indicates a weakened immune system, increasing the person's susceptibility to opportunistic infections.

Key concepts

Opportunistic Infections

Individuals with HIV/AIDS are at an increased risk for infections that the body would normally be able to fend off. These are known as opportunistic infections, and they can become prevalent when the immune system is compromised—a common scenario in advanced HIV infection. When the CD4 +T-cell count falls below 200 cu.mm/liter, as in the textbook exercise where the count was 175 cu.mm/liter, the risk of opportunistic infections rises significantly.

Opportunistic infections can be caused by a variety of pathogens, including bacteria, viruses, fungi, and parasites. Common examples include Pneumocystis pneumonia (PCP), a fungal infection of the lungs, and Kaposi's sarcoma, a type of cancer often seen in individuals with HIV/AIDS. These infections can be life-threatening and require prompt medical attention.

Preventing Opportunistic Infections

• Regular monitoring of the CD4 count
• Prophylactic medications to prevent specific infections
• Maintaining a healthy lifestyle to boost the immune system

Understanding the relationship between the CD4 count and the risk for opportunistic infections is critical for managing the health of people living with HIV/AIDS.

HIV/AIDS Progression

The progression of HIV/AIDS can be monitored through various stages, primarily marked by the CD4 +T-cell count and the presence of particular HIV-related symptoms or illnesses. Initially, after infection with HIV, a person may experience a brief period of flu-like illness, followed by an asymptomatic phase, which can last for several years.

The symptomatic phase begins once the virus has caused substantial damage to the immune system, typically when the CD4 count drops below 500 cu.mm/liter. This decline in immune function can lead to a range of conditions, culminating in the diagnosis of AIDS when the CD4 count falls below 200 cu.mm/liter, as in the example provided with a count of 175 cu.mm/liter.

Understanding the Stages

• Acute HIV Infection: Flu-like symptoms soon after infection
• Clinical Latency: Asymptomatic period with gradual immune decline
• AIDS: Marked by a CD4 count under 200 cu.mm/liter and/or the occurrence of opportunistic infections or AIDS-defining illnesses

Proper management and treatment are essential to slow the progression of HIV/AIDS, ranging from antiretroviral therapy to lifestyle changes.

Immune System Monitoring

Monitoring the immune system's health, particularly through the measurement of CD4 +T-cell count, is a cornerstone in the management of HIV/AIDS. CD4 cells are vital for a robust immune response, and their count gives a clear indication of the immune system's ability to combat infections. As highlighted in the exercise, the CD4 count of 175 cu.mm/liter suggests a significantly weakened immune defense.

Regular monitoring of the CD4 count, along with viral load tests to measure the quantity of HIV in the blood, provides crucial information about the disease's progression and the effectiveness of treatment. Clinicians use this information to adjust treatment regimens, recommend prophylactic medications to prevent opportunistic infections, and counsel patients on ways to support their immune health.

Key Aspects of Immune Monitoring

• Regular CD4 count and viral load testing
• Immediate changes to treatment if the CD4 count drops significantly
• Maintaining open communication with healthcare providers about any new symptoms or health concerns

Effective immune system monitoring enables proactive measures to be taken to protect the health of individuals living with HIV/AIDS.