aiv infeqcia/SidsiT avadmyofTa mkurnaloba da movla (klinikuri ...
aiv infeqcia/SidsiT avadmyofTa mkurnaloba da movla (klinikuri ... aiv infeqcia/SidsiT avadmyofTa mkurnaloba da movla (klinikuri ...
4.3. daxocili da inaqtivirebuli vaqcinebi daxocili da inaqtivirebuli vaqcinebi ar warmoadgens safrTxes imunokompromitirebuli pirebisaTvis da, ZiriTadad, gamoiyeneba iseve, rogorc janmrTel populaciaSi. xSirad imunokompromitirebul pacientebSi daxocili da inaqtivirebuli vaqcinis antigenis Sesabamisi imunuri pasuxi imunokompetentur pirebTan SedarebiT naklebad srulyofilia; SesaZloa saWiro gaxdes vaqcinaciis maRali doza an xSiri bustireba, Tumca aRniSnuli modifikaciebis SemTxvevaSic SesaZloa imunuri pasuxi optimalurze susti iyos (DIV). 4.3.1. qoleris vaqcina (WC/rBs) Zveli parenteraluri vaqcina (fenoliT inaqtivirebuli daxocili srulujredovani qoleris vibrioni 01) dabali efeqturobisa da xanmokle dacviTi periodis gamo rekomendebuli ar aris, Tumca zogierT qveyanaSi mainc iwarmoeba. daxocili srulujredovani qoleris vibrionisa da qoleris toqsinis rekombinantuli B fraqciis kombinaciis Semcveli vaqcina (WC/rBs) usafrTxoa orsulobisa da ZuZuTi kvebis periodSic, aseve aiv pozitiur pirebSic. oraluri vaqcinis 2 doza 10-14 dRis SualediT ainducirebs sawyis proteqcias vaqcinirebulTa 86%-Si. saSualod vaqcinacia efeqturia 50- 60%-Si sul mcire 3 wlis ganmavlobaSi. aiv pozitiur pirebSi kombinirebuli vaqcinis (WC/rBs) efeqturobis damadasturebeli specifikuri monacemebi dRemde cnobili ar iyo, Tumca im populaciis magaliTze, romlis 25%-s aiv pozitiuri pirebi warmoadgendnen, mozambikSi Catarebulma uaxlesma kvlevam gamoavlina damaimedebeli Sedegebi. imunitetis xangrZlivoba aiv inficirebulebSi cnobili ar aris. aiv inficirebul mozrdilebSi 100mm 3 -ze naklebi CD4+ ujredebis ricxviT imunizaciis Semdgomi pasuxi SesaZloa iyos susti, xolo im pirebSi, romelTa CD4+ ujredebis ricxvi 100mm 3 -ze metia imunuri pasuxi umjobesdeba ori dozis Semdeg. aRniSnuli monacemebi gviCvenebs vaqcinaciis efeqturobas adreuli an Sualeduri aiv daavadebisas (DIV). vaqcinacia seleqtiurad unda CautardeT im aiv inficirebulebs, romelTac uwevT mogzauroba endemur kerebSi an miekuTvnebian erT-erT risk-jgufs (isini vinc xangrZlivi periodiT mogzauroben, iReben Seumowmebel wyals an arasaTanadod momzadebul sakvebs an cxovroben arasanitarul pirobebSi daavadebis endemur keraSi) (DIV). 116
4.2..2 difTeriis, tetanusisa da yivanaxvelas vaqcinebi (DTP, DTaP, DT, TT, Td 9 ) aiv inficirebul bavSvebSi imunuri statusis miuxedavad DTP da DT vaqcinebi rekomendebulia janmrTeli populaciisaTvis gankuTvnili reJimiT, maT Soris yivanaxvelas araujreduli formis (DTaP) gamoyenebis SemTxvevaSic rogorc bustirebis, aseve pirveli dozirebisaTvis (AI). TT da Td vaqcinebi imunuri statusis miuxedavad SesaZloa gamoyenebul iqnas aiv inficirebul mozrdilebSi janmrTeli populaciisaTvis gankuTvnili reJimiTa da dozirebiT(BII). gansakuTrebuli mniSvneloba unda mieniWos narkotikebis ineqciuri gziT momxmarebelTa vaqcinacias TT da Td vaqcinebiT, raTa nemsebis gacvlis programebis ararsebobis SemTxvevaSi SevZloT tetanusis prevencia. 4.2.3. B tipis hemofilus influencas vaqcina (HiB) 5 wlis asakis zeviT bavSvebs daavadebisadmi asakobrivad ganpirobebuli mgrZnobelobis gaTvaliswinebiT HiB vaqcinacia ar esaWiroebaT. zogierT adamianSi gamomwvevi iwvevs invaziur infeqcias. mikroorganizmis sisxlis nakadSi moxvedris zusti gza ucnobia, Tumca ganmsazRvreli faqtori SeiZleba iyos zemo sasunTqi gzebis winmswrebi virusuli an mikoplazmuri infeqcia. sisxlis nakadis gziT baqteria gadainacvlebs sxeulis sxvadasxva nawilebisaken, ZiriTadad ki tvinis garsebisaken. aiv inficirebuli bavSvebi da mozrdilebi imunosupresiis gamowarmoadgenen HiB daavadebis ganviTarebis maRal risk-jgufs da SesaZloa CautardeT vaqcinacia. 5 wlis asakis zeviT aiv inficirebulebma, romlebic imyofebian HiB daavadebis ganviTarebis riskis qveS, unda miiRon vaqcinis sul mcire erTi doza. imunokompromitirebuli bavSvebis vaqcinacia unda Catardes janmrTeli populaciisaTvis gankuTvnili dozirebiTa da reJimiT. TiToeuli pacientis magaliTze individualurad unda Sefasdes daavadebis ganviTarebis riski da vaqcinaciis mosalodneli efeqturoba, ris mixedviTac gadawydeba imunizaciis sakiTxi. zogierTi monacemis mixedviT aiv negatiur pirebTan SedarebiT aiv inficirebulebSi HiB daavadebis ganviTarebis riski ufro maRalia. 9 DTP: difTeriisa da tetanusis anatoqsini da yivanaxvelas vaqcina; DTaP: difTeriisa da tetanusis anatoqsini da yivanaxvelas araujreduli vaqcina; DT:difTeriisa da tetanusis anatoqsini (pediatriuli gamoyenebisaTvis); TT: tetanusis anatoqsini; Td: tetanusisa da difTeriis anatoqsini (mozrdilebisaTvis). 4.2.4. A hepatitis vaqcina A hepatitis virusiT gamowveuli simptomuri daavadebis ganviTarebis riski pirdapir korelaciaSia asakTan. 6 wlamde asakis bavSvebSi A hepatitis virusiT infeqcia Cveulebriv asimptomuria, simptomuri daavadeba ki ZiriTadad gvxvdeba mozrdilebSi. daavadebis gadatanis Semdeg imuniteti mTeli sicocxlis manZilze narCundeba. dabal-endemur 117
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4.2..2 difTeriis, tetanusisa <strong>da</strong> yivanaxvelas vaqcinebi (DTP,<br />
DTaP, DT, TT, Td 9 )<br />
<strong>aiv</strong> inficirebul bavSvebSi imunuri statusis miuxe<strong>da</strong>vad DTP <strong>da</strong> DT<br />
vaqcinebi rekomendebulia janmrTeli populaciisaTvis gankuTvnili<br />
reJimiT, maT Soris yivanaxvelas araujreduli formis (DTaP) gamoyenebis<br />
SemTxvevaSic rogorc bustirebis, aseve pirveli dozirebisaTvis (AI).<br />
TT <strong>da</strong> Td vaqcinebi imunuri statusis miuxe<strong>da</strong>vad SesaZloa gamoyenebul<br />
iqnas <strong>aiv</strong> inficirebul mozrdilebSi janmrTeli populaciisaTvis<br />
gankuTvnili reJimiTa <strong>da</strong> dozirebiT(BII). gansakuTrebuli mniSvneloba<br />
un<strong>da</strong> mieniWos narkotikebis ineqciuri gziT momxmarebelTa vaqcinacias<br />
TT <strong>da</strong> Td vaqcinebiT, raTa nemsebis gacvlis programebis ararsebobis<br />
SemTxvevaSi SevZloT tetanusis prevencia.<br />
4.2.3. B tipis hemofilus influencas vaqcina (HiB)<br />
5 wlis asakis zeviT bavSvebs <strong>da</strong>avadebisadmi asakobrivad ganpirobebuli<br />
mgrZnobelobis gaTvaliswinebiT HiB vaqcinacia ar esaWiroebaT. zogierT<br />
a<strong>da</strong>mianSi gamomwvevi iwvevs invaziur <strong>infeqcia</strong>s. mikroorganizmis sisxlis<br />
nakadSi moxvedris zusti gza ucnobia, Tumca ganmsazRvreli faqtori<br />
SeiZleba iyos zemo sasunTqi gzebis winmswrebi virusuli an<br />
mikoplazmuri <strong>infeqcia</strong>. sisxlis nakadis gziT baqteria ga<strong>da</strong>inacvlebs<br />
sxeulis sxva<strong>da</strong>sxva nawilebisaken, ZiriTa<strong>da</strong>d ki tvinis garsebisaken. <strong>aiv</strong><br />
inficirebuli bavSvebi <strong>da</strong> mozrdilebi imunosupresiis gamowarmoadgenen<br />
HiB <strong>da</strong>avadebis ganviTarebis maRal risk-jgufs <strong>da</strong> SesaZloa CautardeT<br />
vaqcinacia. 5 wlis asakis zeviT <strong>aiv</strong> inficirebulebma, romlebic<br />
imyofebian HiB <strong>da</strong>avadebis ganviTarebis riskis qveS, un<strong>da</strong> miiRon vaqcinis<br />
sul mcire erTi doza. imunokompromitirebuli bavSvebis vaqcinacia un<strong>da</strong><br />
Catardes janmrTeli populaciisaTvis gankuTvnili dozirebiTa <strong>da</strong><br />
reJimiT.<br />
TiToeuli pacientis magaliTze individualurad un<strong>da</strong> Sefasdes<br />
<strong>da</strong>avadebis ganviTarebis riski <strong>da</strong> vaqcinaciis mosalodneli efeqturoba,<br />
ris mixedviTac ga<strong>da</strong>wydeba imunizaciis sakiTxi. zogierTi monacemis<br />
mixedviT <strong>aiv</strong> negatiur pirebTan Se<strong>da</strong>rebiT <strong>aiv</strong> inficirebulebSi HiB<br />
<strong>da</strong>avadebis ganviTarebis riski ufro maRalia.<br />
9 DTP: difTeriisa <strong>da</strong> tetanusis anatoqsini <strong>da</strong> yivanaxvelas vaqcina; DTaP: difTeriisa<br />
<strong>da</strong> tetanusis anatoqsini <strong>da</strong> yivanaxvelas araujreduli vaqcina; DT:difTeriisa <strong>da</strong><br />
tetanusis anatoqsini (pediatriuli gamoyenebisaTvis); TT: tetanusis anatoqsini; Td:<br />
tetanusisa <strong>da</strong> difTeriis anatoqsini (mozrdilebisaTvis).<br />
4.2.4. A hepatitis vaqcina<br />
A hepatitis virusiT gamowveuli simptomuri <strong>da</strong>avadebis ganviTarebis<br />
riski pir<strong>da</strong>pir korelaciaSia asakTan. 6 wlamde asakis bavSvebSi A<br />
hepatitis virusiT <strong>infeqcia</strong> Cveulebriv asimptomuria, simptomuri<br />
<strong>da</strong>avadeba ki ZiriTa<strong>da</strong>d gvxvdeba mozrdilebSi. <strong>da</strong>avadebis ga<strong>da</strong>tanis<br />
Semdeg imuniteti mTeli sicocxlis manZilze narCundeba. <strong>da</strong>bal-endemur<br />
117
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