Developing vaccines is not easy. It requires extensive research and hard work from eminent scientists followed by clinical trials to check the efficacy of vaccines. Millions of people across the globe wait for this vaccine which is a boon for AIDS. A vaccine is a therapeutic approach and the best preventive treatment that can work in preventing this fatal disease called AIDS. Acquired Immunodeficiency Syndrome is a chronic, potentially life-threatening disease caused by HIV that is Human Immunodeficiency Virus. As the entire globe waits for the AIDS vaccine, we at Medicircle are conducting an awareness series on the occasion of World Aids Vaccine Day to educate people about AIDS and preventive measures from eminent expert doctors and medical professionals.

Dr. Laxman Jessani is an infectious diseases specialist in Mumbai and provides care for patients with a broad range of infectious diseases. With more than a decade of experience in the field of medicine, he is currently working at Apollo Hospitals in Navi Mumbai. He has been awarded the prestigious International Infectious Diseases Fellow in the United States and also has been trained at the famous Wayne State University Detroit, USA. He has also received a fellowship from Royal School Public Health in UK. He has more than 25 National and International Index Publications to his credit.

CD4 count is the marker of immunity

Dr. Laxman speaks, “CD4 count is a type of a blood test which we do typically in patients who are suffering from HIV AIDS. This count represents the immunity of the patient. Patients with normal CD4 count is having good immunity and are not suffering from any infection. But as we know that patients who are having HIV, when they go on to develop AIDS that is Acquired Immunodeficiency Syndrome, their immunity wanes off over a period of time. As their immunity wanes off, we need to measure how much immunity is getting waned off. So, to measure that, we do CD4 count. CD4 count is an indirect measure to check the immunity of the patients. Thus, patients with HIV AIDS will have low CD4. And depending on the CD4 count, we categorize the patients as stage I, stage II, and stage III of HIV disease they are having. So, in short, CD4 count is a marker of immunity, the lower the CD4 count, the more severe is the infection, and the more immunocompromised the patient is. So that is why it is important to check CD4 count for patients who are having HIV AIDS.”

CD4 count tells the type of infection patients with HIV will develop

Dr. Laxman says, “patients with HIV AIDS have low immunity and when their immunity is low, they are at higher risk of developing infections. In a normal person, the CD4 count will be anywhere between 1000 to 1500. But patients having HIV, their CD4 count will drop below 500. So, depending on the CD4 count, we can know what type of infection they are going to develop. For example, if the CD4 count is below 200, then they have a risk of developing Pneumocystis jiroveci. If they have CD4 count of less than 100, then they are at risk for developing infections like Toxoplasma, Tuberculosis. And finally, if the count is below 50, then they are at risk for developing infections such as CMV, Cryptococcus Meningitis, and Mycobacterium Avium Complex. Depending on the level of CD4 count, there is various type of infection which they develop, I have just named a few, but there are many more infections which these patients develop as the CD4 count falls.”

AIDS vaccine is the need of the hour

Dr. Laxman tells, “AIDS vaccine is the need of the hour. There is a need to develop an HIV AIDS vaccine. If one takes the AIDS vaccine, we can be pretty sure that the patient will not get HIV AIDS after exposure. But that type of vaccine is still not available, research is going on. The ability of the HIV virus to mutates so frequently is the reason why the AIDS vaccine is still not in circulation. There is another type of AIDS vaccine which is called a functional cure that means if a patient who is having HIV AIDS if takes these vaccines, he does not need to take any treatment for HIV. So, it is a kind of cure. So, there are two types of vaccine, one is for the functional cure and one is basically to prevent HIV infection from occurring. These are the two types of vaccines for which the research is going on and maybe in days to come we will see the results.”

Common symptoms of HIV AIDS

Dr. Laxman explains, “In HIV AIDS, during the initial period i.e incubation period of 5 to 10 years, many patients will not have any symptoms as well. The patient may be completely normal, not having any symptoms. If a patient has developed HIV very recently, they can have flu-like symptoms. For example, they will have a fever, they will have malaise, they will have generalized lymphadenopathy which may subside down over a period of time. So, these are the symptoms of acute HIV syndrome. After the acquired acute infection, the patient goes into an incubation period or latent period, in which the patient does not have any symptoms at all. And later on, after 5 years or so, the patient develops symptoms of HIV like loss of weight, loss of appetite, the patient will have fever, the patient will have enlarged lymph nodes and secondly, as disease progresses, the patient’s immunity goes down. Hence, for specific infections, they will have specific symptoms. For example, if the immunity goes down and the patient is at higher risk for Tuberculosis, he will develop symptoms of tuberculosis like loss of weight, loss of appetite, cough, fever. Similarly, if he develops an infection like Pneumocystis jiroveci, he will develop cough, fever, breathlessness. So, depending on the opportunistic infections which they develop, as the CD4 counts wane off, they get those specific symptoms. Overall HIV patients will definitely have a loss of weight, loss of appetite, low-grade fever, generalized lymphadenopathy, these are some of the common symptoms which all patients of HIV AIDS will have,” mentions Dr. Laxman.

(Edited by Renu Gupta)