HIV: CD4 T Cell Count and Opportunistic Infections (Nursing)

00:00 Now, we just touched on opportunistic infections.

00:03 So, you know, this is something that my body should be able to fight off.

00:09 CD4 T cells normally help me do that.

00:12 They're type of lymphocyte or just right in real quick.

00:15 WBC type of white cell called a helper T cells.

00:20 These are the ones that kind of helped other cells mature and do what they're supposed to do.

00:24 So if you knock out the CD4 T-cell level if I just have less than 200 of them available.

00:30 They can't perform this really vitally important function of a healthy immune system.

00:37 Because let's look at their job again, they stimulate the other immune cells to fight infections.

00:42 So these include like the macrophages B lymphocytes the CD8 T-lymphocytes.

00:48 They help these cells do what you need to do.

00:52 Well, my immune system needs these players, but they don't become all they can be your function at the level I need them to to fight off opportunistic infections.

01:03 If I don't have enough CD4 helper cells to help them get there.

01:08 Okay, so that's making sense.

01:09 What we're looking for is the difference between HIV and AIDS.

01:13 Is that clear in your mind? So AIDS is a more advanced HIV infection lots of copies in the bloodstream.

01:21 And now we have a really low CD4 T-cell count.

01:26 Remember normal is yeah the minimum is 500 so somebody with AIDS has a CD4 T-cell count less than 200 and an opportunistic infection.

01:37 So the the reason that I've got a problem here with these three cells because I need them for functioning immune system and with CD4 T-cells down.

01:48 These guys can't function in their roles as effectively.

01:52 That's how HIV weakens the immune system by not only destroying the CD4 T cells.

01:59 It also hijacks the cell and forces it to make copies of itself.

02:04 Okay, are you processing that.

02:06 So we know that the immune system is weak because we don't have the CD4 T cells and then those other cells don't function as well because the helper cells are not there but HIV actually hijacks the cells and forces them to make copies of HIV.

02:23 So you take the cell it's supposed to be helping my immune system, It's hijacked by HIV, now it's making copies of HIV So there's more HIV more HIV.

02:35 Well, you know why that's a bad deal because the more viral load I have, the higher the viral load I have the more problems my immune system is going to have that's really what sets you up for an opportunistic infection because he people don't die from the virus itself.

02:52 But usually what people died from is the opportunistic infection that occurs because the immune system can't fight it off.

02:59 So the virus itself doesn't kill the patient.

03:03 It's usually an opportunistic infection that occurs because my immune system is so weakened by the virus.

03:11 So this is what we're going to be watching out for for our patients with AIDS.

03:15 This is the biggest risk and danger for them.

03:18 Now I'm going to give you some examples of these opportunistic infections cryptococcal meningitis.

03:24 Tuberculosis is strongly associated with AIDS toxoplasmosis, PCP, that's a type of pneumonia that you'll see in AIDS, esophageal candidiasis, that's yeast in the esophagus and there's even certaincancers including kaposi sarcoma.

03:41 So you see what we've got here.

03:44 These are really difficult infections to deal with their difficult on your patient.

03:49 They're difficult to treat because the tools we would normally use require a functioning immune system.

03:57 So again, we're back to that statement what happens if the patient doesn't get treatment, What? how will that disease progressed if the patient isn't able to get treatment.

04:07 Well as HIV to stores more and more of the CD4 T-cells that makes more copies of itself the immune system is getting weaker and weaker.

04:15 And if the person who has HIV isn't taking antiretroviral treatment, it will become harder and harder for them to fight off infections and diseases.

04:26 Okay, so we've got that solid.

04:28 We understand why that happens you're clear on how HIV hijack C cells and it tells the cells to replicate copies of HIV you're clear and how it Takes out the CD4 T-cells which means we have other cells that don't function as effectively and immune system.

04:45 We're all up to that on that but it could take 10 to 15 years for the immune system to be so damaged that it can no longer defend itself at all.

04:54 So this happens over a period of time.

04:57 We have a window or if we can get treatment to a patient we can significantly impact their quality of life, but the rate at which HIV progresses really varies depending on the patient's age, their General Health and their background so we may not have years and years.

05:14 There may be other comorbidities or age or issues that happen quicker than that.

05:20 The point is we have a window.

05:23 So the earlier patients are tested.

05:25 The earlier HIV has identified the quicker and faster we can get them on to treatment.