Immune Dysfunction for AIDS

Immune Dysfunction for AIDS

AIDS is typified by deterioration in the immune function resulting in malignancies and opportunistic infections, which eventually result in increased mortality in involved persons. The associated immune dysfunction involves persistent inflammatory state as well as unhealthy elaboration of pro-and ant-inflammatory cytokines (Akase, et al. 2017). Inflammatory cytokines are increased during initial response of the acute HIV infection. It persists throughout the chronic infection despite successful viral infection. An immune deficiency state occurs when HIV infection produces enough reduction in number of CD4+ T lymphocytes, dysregulation of cytokine production and defective function of both the macrophages and T lymphocytes (Akase, et al. 2017). The CD4+ T cells are responsible for the coordination of the immune system. They also regulate immune responses in immunocompetent persons. HIV infection targets the CD+ T cells to render the infected person immune-deficient. It also generates a state of immune disarray.

HIV infection leads to the production of cytokines by cells of the immune system and by infected cells. These cells regulate immune function as well as influence viral replication. Alterations in cytokine levels in the serum of patients with HIV impact the course and progression of the disease by suppressing or enhancing HIV replication. The imbalance in the production of cytokines results in part to immune dysregulation typical characteristics of HIV progression to AIDS. Since CD4+ T cells secrete cytokines and HIV infection to infect CD4+ T-cells, it is expected that the concentration of CD4+ to be low in infected persons (Akase, et al. 2017).

Lower CD+ T cell count is associated with higher serum levels of interleukin. During the HIV infection course, secretion of T-helper type 1, such as interleukin (IL-2) and interferon gamma, are reduced while the production of T-helper type 2 like IL-1, IL-6 and IL-8 are increased (Osuji et al. 2018). T-helper type 2 represents inflammatory cytokines and thus the higher interleukin levels are associated with inflammation. The concentration of interleukins tends to be lower among HIV patients on HAART.  Thus earlier initiation of HAART enables the recovery of CD4+ T cells. HAART suppresses viral republication at varied phases of HIV cycle and improves immunological status. CD+ T-cell responses are profoundly changed in patients with AIDS due to functional abnormalities and cellular depletion (Osuji et al. 2018). Loss of CD+ T cell responses and delayed-type hypersensitivity are predictive of disease progression.

Symptomology of AIDS

AIDS is the most severe stage of HIV infection. Individuals with AIDS have badly compromised immune system that they are at risk of getting a growing number of opportunistic diseases. They have a higher viral load and can be very infectious. Their CD+ T cell count plummets below 200 cell/mm. In acute stage, the symptoms manifest as fevers, sweats, fatigue, swollen glands, chills, and weight loss.

Impact on Daily Living

These symptoms complicate daily living. Living with AIDS can increase the risk of posttraumatic stress, depression, suicide attempts and substance abuse. Some opportunistic diseases can compromise the nervous system, leading to changes in thinking and behavior. Fatigue is severe enough interferes with work, activities of daily living and exercise. They also face difficulties like stigma and prejudice, discrimination in employment and relationships with family, healthcare professional and poor perception of self-image.

References

Osuji, F. et al. (2018). The effects of highly active antiretroviral therapy on the serum levels of pro-inflammatory and anti-inflammatory cytokines in HIV infected subjects. Journal of Biomedical Science, 25(88)

Akase, I. et al. (2017). Immune Dysfunction in HIV: A Possible Role for Pro- and Anti-Inflammatory Cytokines in HIV Staging. Journal of Immunology Research, 2017, ID 4128398. https://doi.org/10.1155/2017/4128398