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Why did Mr. Hohner develop Kaposi sarcoma, an unusual type of cancer?Mr. Hohner may have developed Kaposi sarcoma due to a weakened immune system, which may have made him susceptible to infection by Kaposi sarcoma-associated herpesvirus (KSHV). The virus may have then infected the cells that line blood and lymphatic vessels (Chakraborty et al., 2020). KSHV often brings genes into such cells, thus causing the cells to divide and live longer than they should(Chakraborty et al., 2020). Besides, the genes also cause the endothelial cells to form new blood cells and increase the production of chemicals that cause inflammation(Chakraborty et al., 2020). The outlined types of changes tend to turn the cells that line blood and lymphatic vessels into cancer cells, explaining why Mr. Hohner developed Kaposi sarcoma.Why is his CD4+ T cell count so low?Mr. Hohner’s CD4+ T cell count may have been low due to the destruction of the Th cells by the human immune-deficiency virus (HIV). The virus may have resulted in cytopathic effects, thus causing lysis or dissolution of the host cells (Mousseau et al., 2019).What is the relationship between his low CD4+ T cell count and Mr. Hohner’s pneumocystis pneumonia?CD4+ T cells are often critical for the resolution of Pneumocystis, as they facilitate memory functions that coordinate host inflammatory responses by recruiting and activating effector cells, which are responsible for the elimination of Pneumocystis jirovecii, a fungus that results in Pneumocystis pneumonia(Qiao et al., 2022). Therefore, a low CD4+ T cell count results in low recruitment and activation of effector cells (Qiao et al., 2022). This implies that effector cells available cannot eliminate Pneumocystis jiroveccii (Qiao et al., 2022). Thus, an individual becomes more susceptible to the infection. The explanation demonstrates why Mr. Hohner developed Pneumocystispneumonia.Given the usual course of HIV infection, how long has Mr. Hohner most likely been HIV positive?Mr. Hohner may have likely been HIV positive for at least 7-10 years. Why did he have HIV infection for so long before it was discovered?It may have taken long before Mr. Hohner was diagnosed with HIV because the virus may not have replicated enough within the Th cells for a diagnostic test to detect.

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