Mr. Hohner developed Kaposi Sarcoma (KS), an unusual type of cancer, due to the gradual depletion of CD4 cells. This affected his immune system, which is responsible for protecting the body against diseases. It is this diminished response that made his body more susceptible to infectious pathogens and malignant tumors. According to Gambichler et al. (2020), KS is a “cancer that causes patches of abnormal tissue to grow under the skin, in the lining of the mouth, nose, and throat” (p. 169). The resulting patches are mainly red or purple in color.
CD4+T Cell Count
Mr. Hohner’s low CD4+T cell count is caused by HIV, which acts by destroying the T-cells. According to Chang et al. (2020), the new HIV viruses produced by the body can either cause lysis or induce apoptosis. In addition to this, the infected HIV cells are more susceptible to Tc-mediated lysis. After several weeks following the infection, the individual experiences signs and symptoms of acute HIV syndrome. Since the disease is in an active stage, it will progressively infect mucosal T-cells and dendritic cells. The virus then continues to spread to the lymphoid organs and, in the process, causes a decrease in the number of CD4+T cells.
CD4+T Cell Count and Pneumocystis Pneumonia
There is a direct relationship between Mr. Hohner’s CD4+ cell count and pneumocystis pneumonia (PCP). It is important to note that HIV-infected individuals are at high risk for PCP once their CD4+T cell count falls below 200 (Cillóniz et al., 2019). Opportunistic diseases become more common in such people due to reduced T-cell count. Similarly, the clinical manifestations of PCP in patients with HIV include fever, chest discomfort, and non-productive cough.
Mr. Hohner’s HIV-Positive Period
Based on the objective data, Mr. Hohner is in stage 3 HIV infection. This is a clear indication that the patient has been living with the disease for several years. As evidenced in the laboratory tests, his CD4+T cell count is below 200, specifically 180 cells per micrometer. Cook and Kim (2019) noted that stage three is when a person’s immune system is badly damaged and susceptible to infections. The patient has been living with the disease for a long period because there were no signs of illness and the fact that his partner of 6 years was HIV negative. This implies that Mr. Hohner did not find it necessary to do an HIV-antibody test.
Chang, Y. Y., Chang, C. H., Ku, W. W., Gau, J. P., & Yu, Y. B. (2020). Tumor lysis syndrome as a risk factor for very early mortality in HIV-associated non-Hodgkin’s lymphoma: A 10-year single-center experience. Journal of the Chinese Medical Association, 83(4), 371-376. Web.
Cillóniz, C., Dominedò, C., Álvarez-Martínez, M. J., Moreno, A., García, F., Torres, A., & Miro, J. M. (2019). Pneumocystis pneumonia in the twenty-first century: HIV-infected versus HIV-uninfected patients. Expert Review of Anti-Infective Therapy, 17(10), 787-801. Web.
Cook, M. R., & Kim, C. (2019). Safety and efficacy of immune checkpoint inhibitor therapy in patients with HIV infection and advanced-stage cancer: a systematic review. JAMA Oncology, 5(7), 1049-1054. Web.
Gambichler, T., Koim, S., Wrobel, M., Käfferlein, H. U., Brüning, T., Stockfleth, E., & Lang, K. (2020). Expression of programmed cell death proteins in Kaposi sarcoma and cutaneous angiosarcoma. Journal of Immunotherapy, 43(5), 169-174. Web.