Dr Ben Chimukangara
5 min read...
The burden of living with chronic infections/conditions is agonizing, and can be alleviated by improving quality of life. Our immune system is very good at stopping pathogens from making us feel sick. However, some pathogens find ways of getting past our immune defense and in some cases cause life-long disease. This includes one of the most researched viruses (not SARS-CoV-2) HIV, that has at least affected everyone globally, in one way or the other.
But why haven’t we found a cure for HIV, or at least a vaccine, given the way medical technology has advanced? Didn’t it take less than a year to develop vaccines for COVID-19?
Well, here is the tricky part when it comes to HIV, the virus changes its form rapidly, making it is difficult to develop effective vaccines against it. Imagine law enforcement agents put out an APB (all-points bulletin) for an individual that is on the run, with a recent picture of that individual attached, but guess what, that individual’s appearance (i.e. face and structure) changes very rapidly, they look like a totally different person an hour later. It will be extremely difficult to find that individual even with latest technology. That’s how quickly HIV changes, making it difficult to keep up with it.
As if that is not enough, HIV gets more crafty in that it actually infects, uses, and destroys cells of the immune system (i.e., CD4 T cells) that are supposed to help us fight off different infections on a daily basis. This makes us vulnerable to pathogens that take advantage of our weakened immune system, and such pathogens are collectively known as opportunistic infections. These include respiratory infections such as Tuberculosis (TB) and Pneumocystis. Many have heard about TB, but Pneumo-what-now? It’s pronounced “Noo-mow-si-stis”, and guess what, we all have been infected by it. Research shows that by the time we celebrate our 3rd birthday, six out of every seven individuals (>85%) would have already been exposed to Pneumocystis.
But what is this Pneumocystis bug we have never heard of?
Just like there are viruses (e.g., HIV and SARS-CoV-2) and bacteria (e.g., TB), there are also fungi, which cause fungal infections. Pneumocystis is a fungal pathogen that is transmitted via respiratory droplets/ particles (similar to how SARS-CoV-2 is transmitted), causing infection of the lungs. Fortunately, our immune systems are able to control Pneumocystis, resulting in asymptomatic infection – meaning you do not develop any symptoms. But here is the catch, in individuals with suppressed immune systems, such as those on non-suppressive HIV treatment, people on high doses of corticosteroids (corticosteroids – weaken the immune system), and people receiving cancer chemotherapy, to name a few, Pneumocystis can cause life-threatening pneumonia (i.e., Pneumocystis pneumonia), and if left untreated can lead to death.
Now that we know a bit more about Pneumocystis, why should we care, and what symptoms should we look out for if we are immunosuppressed?
Pneumocystis pneumonia (PCP) symptoms include fever, cough, chills, shortness of breath, tiredness and chest discomfort, all of which we might have all experienced at some stage in our lives. Now, you are wondering, could it have been Pneumocystis? Most likely not, and more likely COVID-19 in recent times, or both. Due to its non-specific symptoms, diagnosis of Pneumocystis is challenging and there are several reports of people that lost their lives during the recent COVID-19 pandemic, because they were thought to have COVID-19, yet it was Pneumocystis lurking in the shadows. None of us would like to lose a loved one just because we chose not to care.
So, what does this all mean?
This is where one could justify the need for more funding to be directed towards medical research. We need to conduct research to better understand how our immune system interacts with pathogens, as this could provide valuable information for better diagnosis, developing vaccines, and identifying drug targets. This is why Dr Ben Chimukangara has dedicated his life to conducting medical research, specifically in the field of HIV and associated opportunistic infections. His current research focuses on better understanding host immune responses in HIV immunologic non-responders and Pneumocystis infection, using single cell RNA sequencing, which is a very sensitive method for determining changes in individual immune cells that respond to infections.
Life poses so many challenges, the least we should have is a good quality of life. After all, we are humans before we are anything else.
~Ben Chimukangara is a widely published medical research scientist, academic editor, peer reviewer and blogger. He is passionate about simplifying science communication for effective engagement with non-scientific communities.
