aiv infeqcia/SidsiT avadmyofTa mkurnaloba da movla (klinikuri ...

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ekomendebulia: vaqcina rekomendebulia rutinuli reJimis mixedviT an naCvenebia aiv imunosupresirebulTaTvis. gamoiyeneT Cvenebisas: imunosupresia ukuCvenebis mizezi ar aris; SeiZleba arsebobdes ukuCvenebis sxva mizezi ukunaCvenebia: aiv imunosupresia absoluturi an SedarebiTi ukuCvenebaa vaqcinis gamoyenebisTvis gansaxilvelia: gadawyvetileba vaqcinaciis Sesaxeb damokidebulia konkretul pacientTan daavadebis risksa da vaqcinis efeqturobaze, danarTi 2. aiv asocirebuli imunodeficitis klasifikacia bavSvebSi aiv asocirebuli imunodeficitis klasifikacia klasifikacia CD4 ujredebis maCvenebeli asakis mixedviT 35 >30 >25 >500 saSualo 30-35 25-30 20-25 350-499 Sors wasuli 25-30 20-25 15-20 200-349 mZime
intervaliT. aseT SemTxvevaSi cofis sawinaaRmdego imunoglobulinis gamoyeneba saWiro ar aris. igive wesebi vrceldeba vaqcinirebul pirebze, romelTa maneitralizebeli antisxeulebis titri 0.5 se/ml-Si an metia. adamianis diploidur-ujreduli vaqcina miCneulia oqros standartad. jandacvis msoflio organizaciis mixedviT aucilebelia ujreduli vaqcinis minimum 2.5se-s gamoyeneba TiToeuli dozirebisas. miuxedavad maRali efeqturobisa ujreduli vaqciniT eqspoziciis Semdgom Catarebuli milioni mkurnalobidan erTi SeiZleba aRmoCndes uSedego. analizi gviCvenebs, rom uSedego mkurnaloba, rogorc wesi, dakavSirebulia mniSvnelovan dazianebasTan Tavis an mezobel midamoSi, an arasworad Catarebul mkurnalobasTan. eqspoziciis Semdgomi mkurnalobis sruli kursi nervuli qsovilis vaqcinis gamoyenebiT gulisxmobs 23 ineqciisgan Semdgari imunizaciis gaxangrZlivebul da mtkivneul kurss. amasTan nervuli qsovilis vaqcinebi ujredul vaqcinebTan SedarebiT neklebad efeqturia. amrigad, aRniSnuli vaqcina eqspoziciis Semdgomi imunizaciisaTvis rekomendebuli ar aris. 27 2.5 mlrd adamianze meti cxovrobs cofis endemur arealSi(afrika, azia, samxreT amerika).yovelwliurad saSualod 50 000 adamiani iRupeba cofiT da 10 mln-ze met adamians utardeba eqspoziciis Semdgomi profilaqtika. 5-15 wlis asakis bavsvebi imyofebian maRali riskis qveS. 28 calkeul asakobriv jgufebSi Catarebuli kvlevebis mixedviT daavadebis maRali riski aqvT ganviTarebadi qveynebis cofis endemur areebSi mcxovreb bavSvebs. 29 ZiriTadad rekomendebulia 1 wlis Semdeg damatebiti doza bustirebisTvis; vaqcinacia yovel 5 weliwadSi maRali riskis pirebisTvis; cofis virusis sawinaaRmdego antisxeulebis perioduli gamokvleva (proteqciisaTvis aucilebeli titria >0.5se/ml) gamoyenebuli litraturis CamonaTvali: 1. Onorato IM, Markowitz LE, Oxtoby MJ. Childhood immunization, vaccine-preventable diseases and infection with human immunodeficiency virus. The Pediatric Infectious Disease Journal, 1988, 6:588– 595. 2. Opravil M et al. Poor antibody response after tetanus and pneumococcal vaccination in immunocompromised, HIV-infected patients. Clinical and Experimental Immunology, 1991, 84(2):185–189. 3. Borkowsky W et al. Antibody responses to bacterial toxoids in children infected with human immunodeficiency virus. The Journal of Pediatrics, 1987, 110:563–566. 4. Huang KL et al. Antibody responses after influenza and pneumococcal immunization in HIV-infected homosexual men. JAMA, 1987, 257:2047–2050. 5. Klein RS et al. Responses to pneumococcal vaccine among asymptomatic heterosexual partners of persons with AIDS and intravenous drug users infected with human immunodeficiency virus. Journal of Infectious Diseases, 1989, 160:826–831. 6. TB/HIV: a clinical manual, 2nd ed. Geneva, WHO, 2004. 7. Global Advisory Committee on Vaccine Safety. Safety of BCG vaccination in immunocompromised individuals. Weekly Epidemiological Record, 2003, 32(8):283 (http://www.who.int/wer/2003/en/wer7832. pdf, accessed 25 June 2006). 131
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aiv infeqcia/SidsiT avadmyofTa mkur
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sarCevi klinikuri saxelmZRvanelo-re
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3.2.2.cxeleba aiv inficirebulebSi 3
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aiv infeqcia/Sidsis fonze ganviTare
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done mtkicebulebis siZlieris done (
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1.daavadebis definicia Sidsi abrevi
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Sidsi registrirebulia msoflios 216
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egistrirebul SemTxveevaTa 79% saqar
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adamianis imunodeficitis virusis sa
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aiv rnm-is koncentracia plazmaSi mk
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SeuZlebelia da gadamwyveti misi dia
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persistuli generalizebuli limfadeno
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signalis amplifikacia komplementuri
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• vizitamde rezistentobis testis
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• adamianis papilomavirusi (maxvi
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etinitis identifikaciisTvis, rodesa
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cxrili 8 rekomendaciebi arT dawyebi
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arv medikamentebi arseboben Semdegi
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aCveneben, rom pirveladi rezistento
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- tabletebis Cveneba pacientisTvis
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- aqedan gamomdinare, nrti+anrti re
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igulisxmeba im medikamentebis kombi
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X (arv): testebi, romlebic unda Cat
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maRali mgrZnobeloba abakaviri (ABC
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transaminazebis elevacia anrti (all
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ARV toqsiuroba menejmenti nefrotoqs
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xSiri oportonistuli infeqciebia, ma
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cxrilebis wakiTxvis magaliTi 1. cxr
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damateba2. jandacvis msoflio organi
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damateba 4. ZiriTadi informacia ant
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damateba 5. mkurnalobis reJimis dac
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saerTaSoriso saxeli stavudini (d4T)
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mcire mutacia muSaobs kombinaciaSi.
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25. Phillips AN et al. Viral load o
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Suppl 2:S171-176. 73. Altice FL, Mo
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122. Koval CE et al. Immune reconst
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kandidozi dRe yovel dRe - ko-trimoq
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karcinoma (ara SidsTan perikardiuli
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o cxeleba o wonaSi kleba o Ramis of
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Page 84 and 85: o glukokortikoidebis sistematiuri m
Page 86 and 87: 100 mg/dReSi meore rigis sqemebi am
Page 88 and 89: o eqspoziciis Sedegad daavadebis ga
Page 90 and 91: o remisiis miRweva Zalian Znelia da
Page 92 and 93: qimioTerapiiT (mag : B-ALL reJimi)
Page 94 and 95: • imunodeficitis mqone pacientebS
Page 96 and 97: an famcikloviri 500 mg 3-jer dReSi
Page 98 and 99: • berkitis-tipis limfoma; • naz
Page 100 and 101: 3.2.2. cxeleba aiv inficirebulebSi
Page 102 and 103: afTozuri wylulebi stomatiti qeiliti
Page 104 and 105: ganmavlobaSi 2 Tvis manZilze (xelis
Page 106 and 107: o gamonayari warmodgenilia mravlobi
Page 108 and 109: 20. Chen XM et al. Cryptosporidiosi
Page 110 and 111: Tavi IV. aiv infeqcia/SidsiT daavad
Page 112 and 113: inficirebul bavSvebSi (ramdenadac a
Page 114 and 115: 8 igulisxmeba piri, romelsac aReniS
Page 116 and 117: 4.3. daxocili da inaqtivirebuli vaq
Page 118 and 119: kerebSi A hepatiti erTeuli an mcire
Page 120 and 121: 13 riski maRalia staJirebis periodS
Page 122 and 123: ganmavlobaSi, xolo SedarebiT ufro s
Page 124 and 125: 4.8. tkipismieri encefalitis vaqcin
Page 126 and 127: CvenebebiTa da doziT, rogorc imunok
Page 128 and 129: 4.11.2.3. cofis sawinaaRmdego imuno
Page 132 and 133: 8. United States Centers for Diseas
Page 134 and 135: aiv infeqcia/Sidsis antiretrovirusu
Page 136 and 137: 5. mkurnaloba a) rekomendebuli pirv
Page 138 and 139: aiv infeqcia/SidsiT daavadebuli bav
Page 140 and 141: joxiseburi TiTebi. Tumca wlebis man
Page 142 and 143: * saWiroa arv preparatebis bavSvebi
Page 144 and 145: laboratoriuli monacemebis kontroli
Page 146 and 147: Tirkmlis funqciuri sinjebi, gulmker
Page 148 and 149: aiv infeqcia/Sidsis fonze ganviTare
Page 152 and 153: 6. reabilitacia da dakvirveba monit
Page 154 and 155: kandidozuri ezofagitis SemTxvevebSi
Page 168 and 169: martivi herpesvirusuli infeqciis mZ
Page 170 and 171: meTodiT, sisxlis saerTo analizi, Rv
Page 172 and 173: )gamomricxavi _ aiv infeqcia/Sidsis
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aiv infeqcia/SidsiT avadmyofebSi B
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dinamikaSi dakvirveba CD4≥500/mm
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HBV mkurnalobis efeqturoba HBeAg (+
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) gamomricxavi - aiv infeqcia/Sidsi
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pegilirebuli interferonis da ribavi
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i CD4 X X X X X X X X X TSH X X X H
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)gamomricxavi - aiv infeqcia/Sidsis
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pirveli rigis antituberkulozuri med
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testebi: • sisxlis saerTo analizi
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