Aids and Multiple Sclerosis

AIDS and Multiple Sclerosis
Name
Institution

Acquired Immunodeficiency Syndrome
HIV infections incrementally overwhelm a patient’s immune system to limit its ability to defend against otherwise defensible infections (opportunistic infections). HIV infections’ attack on CD4 T cells is a pathological process that allows opportunistic infections to thrive. Active CD4 T cells infected productively, undergo apoptosis, and the death pathway spreads to the bystander CD4 cells that die through pyroptosis. Pyroptosis causes the death of over ninety-five percent of the CD4 cells via the caspase 1 pathway and the release of interleukin 1β that sequesters more CD4 cells for productive infection (Gaiha & Brass, 2014).
Consequently, such abrasive CD4 cells death reduces their count. If they get lower than two hundred cells per cubic millimeter, a host of opportunistic infections complicate the HIV infection worsening the patient’s prognosis. These include candidiasis, cryptococcosis, herpes simplex, and Pneumocystis carinii pneumonia (PCP) (as in the case study) among others (Chu & Selwyn, 2015).
The push by the US Public Health Service to monitor CD4 counts every three to six months is to determine the level of immunosuppression of HIV patients that justifies the initiation or discontinuance of prophylactic interventions for opportunistic infections (Myers et al., 2016). This cyclic procedure has sometimes been deemed unnecessary when anti-retroviral therapy has already suppressed the viral load.

Multiple Sclerosis
Cerebrospinal Fluid (CSF) analysis in the diagnosis of multiple sclerosis (MS) is valuable as it indicates the immune and inflammation aspects of the disease that supplement imaging techniques in the diagnosis. An elevated immunoglobulin G composition (IgG index) and the presence of oligoclonal IgG bands are the hallmarks of this disease (McDonald et al., 2001). These features are present in the patient’s results proving to be a classic in the diagnosis of multiple sclerosis.
Latency is the distance between an excitatory or inhibitory stimulus and the peak of its wave in milliseconds (Akay, 2012). The demyelination of nerves that occurs with multiple sclerosis interferes with the conduction of stimulus; hence, prolonging their latency. This feature can be tested on optic nerves with the pattern visual evoked potential.

References
Akay, A. (2012). Evoked Potentials. In Electrophysiology-From Plants to Heart. InTech.
Chu, C., & Selwyn, P. A. (2011). Complications of HIV infection: a systems-based approach. Am Fam Physician, 83(4), 395-406.
Gaiha, G. D., & Brass, A. L. (2014). The Fiery Side of HIV–Induced T Cell Death. Science, 343(6169), 383-384.
McDonald, W. I., Compston, A., Edan, G., Goodkin, D., Hartung, H. P., Lublin, F. D., … & Sandberg‐Wollheim, M. (2001). Recommended diagnostic criteria for multiple sclerosis: guidelines from the International Panel on the diagnosis of multiple sclerosis. Annals of Neurology: Official Journal of the American Neurological Association and the Child Neurology Society, 50(1), 121-127.
Myers, J. E., Xia, Q., Torian, L. V., Irvine, M., Harriman, G., Sepkowitz, K. A., & Shepard, C. W. (2016). CD4 Count Monitoring Frequency and Risk of CD4 Count Dropping Below 200 cells/mm3 Among Stable HIV-Infected Patients in New York City, 2007-2013. JAIDS Journal of Acquired Immune Deficiency Syndromes.