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4.2.5. B hepatitis vaqcina<br />
B hepatitis vaqcina rekomendebulia B virusiT gamowveuli infeqciis<br />
maRali riskis mozrdilebisTvis miuxe<strong>da</strong>vad imunuri <strong>da</strong> <strong>aiv</strong> statusisa<br />
(AI). maRali riskis jgufebia:<br />
• homoseqsuali mamakacebi (MSM);<br />
• mravlobiTi heteroseqsualuri sqesobrivi kontaqtebis mqone pirebi;<br />
• sqesobrivi gziT ga<strong>da</strong>mdebi infeqciebiT pacientebi;<br />
• komerciuli seqs-muSakebi;<br />
• B hepatitis virusis mtarebelTa sqesobrivi partniorebi <strong>da</strong> ojaxis<br />
wevrebi;<br />
• narkotikebis ineqciuri gziT momxmareblebi;<br />
• patimrebi, rogorc mamakacebi, aseve qalebi;<br />
• hemodializze myofi pirebi (miuxe<strong>da</strong>vad imisa, rom B hepatitis vaqcina<br />
aRniSnul kategoriaSi naklebad efeqturia, is mainc rekomendebulia);<br />
• jan<strong>da</strong>cvis muSakebi. 13<br />
B hepatitis vaqcina rekomendebulia yvela axalSobilisTvis<br />
<strong>da</strong>badebisTanave <strong>da</strong> 18 wlamde asakis bavSvebSi, miuxe<strong>da</strong>vad imunuri <strong>da</strong> <strong>aiv</strong><br />
statusisa (AI). miuxe<strong>da</strong>vad imisa iTvaliswinebs Tu ara vaqcinaciis reJimi<br />
erT Tvemde asakis bavSvTa vaqcinacias, maTi efeqturoba erTnairia.<br />
<strong>aiv</strong> inficirebul bavSvebSi vaqcinaciis Semdgomi proteqciis<br />
xangrZlivoba cnobili ar aris, rac Seexeba arainficirebul bavSvebs,<br />
<strong>da</strong>dgenilia, rom vaqcinaciiT ganpirobebuli antisxeulebis done droTa<br />
ganmavlobaSi mcirdeba, Tumca bavSvebSic <strong>da</strong> mozrdilebSic imunuri<br />
mexsiereba srulyofilad narCundeba vaqcinacii<strong>da</strong>n 15 wlis manZilze.<br />
normaluri imunuri sistemis mqone bavSvebsa <strong>da</strong> mozrdilebs ar<br />
esaWiroebaT <strong>da</strong>matebiTi dozebi bustirebisaTvis, arc rutinuli<br />
serologiuri testirebaa naCvenebi. gamonaklisia bavSvebi, romelTa<br />
dedebic HBsAg pozitiurebi arian. isini gamokvleul un<strong>da</strong> iqnen HBsAg-sa<br />
<strong>da</strong> mis sawinaaRmdego antisxeulebze vaqcinaciis mesame dozis Semdeg. Tu<br />
ze<strong>da</strong>piruli antisxeulebis titri 10mIU/ml-ze naklebia, naCvenebia<br />
vaqcinaciis sruli kursis gameoreba. aRniSnul kategoriaSi pasiurad<br />
gadmocemuli dediseuli core antisxeulebi SeiZleba ganisazRvros 24<br />
Tveze maRal asakSic, ris gamoc aRniSnuli testireba ukunaCvenebia.<br />
SesaZlebelia xangrZlivi periodis Semdeg saWiro gaxdes <strong>da</strong>matebiTi<br />
dozebis gamoyeneba bustirebisaTvis (BII). 14<br />
4.2.5.1. B hepatitis vaqcinaciis reJimi <strong>aiv</strong> inficirebul pacientebSi (AI)<br />
<strong>aiv</strong> inficirebuli pacientebs, romelTac ar aReniSnebaT HBV infeqciis<br />
markerebi an arian HBsAg negatiurebi,un<strong>da</strong> CautardeT vaqcinacia.<br />
• B hepatitis vaqcinacia un<strong>da</strong> <strong>da</strong>iwyos gansazRvruli doziT (20µg 0, 1, 2 <strong>da</strong><br />
12 Tveze an 0, 1 <strong>da</strong> 6 Tveze) im pacientebisaTvis, romelTa CD4+<br />
limfocitebis ricxvi >500/mm 3 .<br />
• B hepatitis vaqcinis pediatriuli dozaa 10µg.<br />
• pacientebisaTvis 200-500/mm 3 CD4+ ujredebis ricxviT rekomendebulia<br />
intensiuri reJimi (20µg 0, 1, 2 <strong>da</strong> 12 Tveze).<br />
119
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