aiv infeqcia/SidsiT avadmyofTa mkurnaloba da movla (klinikuri ...
aiv infeqcia/SidsiT avadmyofTa mkurnaloba da movla (klinikuri ... aiv infeqcia/SidsiT avadmyofTa mkurnaloba da movla (klinikuri ...
aiv infeqcia/Sidsis fonze ganviTarebuli histoplazmozis marTvis saxelmwifo standarti (protokoli) 1.daavadebis /nozologiis / sindromis mokle ganmarteba _ aiv infeqcia/Sidsi ewodeba adamianis imunodeficitis virusiT gamowveul infeqciur daavadebas. hispoplazmozis gamomwvevia soko Histoplazma capsulatum inhalaciuri sporebi. 2.kriteriumebi _ o a)damadasturebeli _ aiv infeqcia/Sidsis damadasturebeli kriteriumebia: aiv antisxeulebis arseboba sisxlis SratSi imunoblotingis meTodiT, aiv rnm-is raodenobrivad da/an aiv provirus dnm-is Tvisobrivad aRmoCena sisxlSi polimerizaciis jaWvuri reaqciis meTodiT. histoplazmozis diagnostika dasturdeba sokos kulturiT an qsovilis bioptatis histologiuri gamokvleviT. hispoplazmozis diagnostisTvis unda Catardes sisxlis da kanis testebi, Tumca isini ar aris farTod gamoyenebuli. b)gamomricxavi _ aiv infeqcia/Sidsis gamomricxavi kriteriumebia: aiv antisxeulebis ar arseboba sisxlis SratSi imunofermentuli meTodiT, raodenobrivad aiv rnm-is da/an Tvisobrivad aiv provirus dnm-is ar arseboba sisxlSi polimerizaciis jaWvuri reaqciis meTodiT. histoplazmozis gamomricxavi kriteriumebia sokos ar arseboba qsovilis bioptatis histologiuri gamokvleviT. 3.simptomebi da niSnebi a)damadasturebeli _ aiv infeqcia/Sidss paTognomuri klinikuri niSnebi ar gaaCnia. igi miekuTvneba laboratoriulad sadiagnozo daavadebebs. simptomebidan SeiZleba gamovyoT: gaxangrZlivebuli cxeleba, gaxangrZlivebuli faRaraTi, limfadenopaTia, aramotivirebuli profuzuli oflianoba, Zlieri saerTo sisuste, aramotivirebuli wonaSi kleba (erTi Tvis ganmavlobaSi sxeulis wonis 10% da meti), sxvadasxva gamonayari kansa da lorwovanze, kandidozuri ezofagiti, cns-is atipiuri dazianebebi da sxva. histoplazmiT gamowveuli mwvave daavadeba gripismagvaria da axasiaTebs: cxeleba, anoreqsia, arTralgia, mialgia, mSrali xveleba, tkivili gul-mkerdis areSi. diseminacia imunosupresiul avadmyofSi swrafad viTardeba da axasiaTebs: wonaSi dakleba, oraluri da kanis dazianebuli ubnebi, RviZlis, elenTis da limfuri kvanZebis gadideba. oraluri ubnebisTvis damaxasiaTebelia nekrozuli wylulebi. SesaZlebelia ganviTareds sasis perforacia da rbili qsovilis destruqcia. b)gamomricxavi _ aiv infeqcia/Sidsis gamomricxavi simptomebi ar arsebobs, aiv inficirebuli wlebis ganmavlobaSi SeiZleba Civilebs ar warmoadgendes. histoplazmozis gamomricxavi faqtoria Sesabamisi Civilebisa da simptomebis ar arseboba. 158
4.diagnostikur _ laboratoriuli testebi da specialistTa konsultaciebi o CD3, CD4, CD8 limfocitebis absoluturi ricxvis gansazRvra, aiv virusuli datvirTvis gansazRvra polimerizaciis jaWvuri reaqciis meTodiT, sisxlis saerTo analizi, RviZlis funqciuri sinjebi, Tirkmlis funqciuri sinjebi, qsovilis bioptatis histologiuri gamokvleva histoplazmozis diagnostikisTvis. 5. histoplazmozis mkurnaloba antifungaluri agenti dozireba miRebis sixSire amfotericni B 0.7-1 mg/kg erTxel dReSi miRebis gza IV xangrZlivoba 10 dRe sawyis mkurnalobas mohyveba 3 Tviani mkurnaloba imunorekonstituciamde >100 CD4 ujrediT, Sedegi medikamentebiT: o itrakonazoli 200 mg 2X dReSi PO o flukonazoli 200 mg 2X dReSi PO o amfotericini B 1 mg/kg IV kviraSi erTxel. alternatiul reJims warmoadgens itrakonazoli 200 mg samjer dReSi - 3 dRe, Semdeg 200 mg 2X dReSi 12 kvira (sakvebTan erTad). 7.gaidlaini, romelsac eyrdnoba aRniSnuli protokoli aRniSnuli protokoli eyrdnoba jandacvis msoflio organizaciis 2006 wlis gaidlains: “aiv/SidsiT daavadebul mozrdil da mozard pirebSi oportunistuli infeqciebis profilaqtika da mkurnaloba”, aseve protokoli Sejerebulia DHHS, USA-AIS da EACS 2005 wlis oportunistuli infeqciebis mkurnalobis gaidlainebTan. 159
- 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 130 and 131: ekomendebulia: vaqcina rekomendebul
- 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 150 and 151: aiv infeqcia/Sidsis fonze ganviTare
- Page 152 and 153: 6. reabilitacia da dakvirveba monit
- Page 154 and 155: kandidozuri ezofagitis SemTxvevebSi
- Page 156 and 157: aiv infeqcia/Sidsis fonze ganviTare
- Page 160 and 161: aiv infeqcia/Sidsis fonze ganviTare
- Page 162 and 163: aiv infeqcia/Sidsis fonze ganviTare
- Page 164 and 165: aiv infeqcia/Sidsis fonze ganviTare
- Page 166 and 167: aiv infeqcia/Sidsis fonze ganviTare
- 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
- Page 174 and 175: aiv infeqcia/Sidsis fonze ganviTare
- Page 176 and 177: aiv infeqcia/Sidsis fonze ganviTare
- Page 178 and 179: aiv infeqcia/Sidsis fonze ganviTare
- Page 180 and 181: aiv infeqcia/Sidsis fonze ganviTare
- Page 182 and 183: aiv infeqcia/Sidsis fonze ganviTare
- Page 184 and 185: aiv infeqcia/Sidsis fonze ganviTare
- Page 186 and 187: aiv infeqcia/SidsiT avadmyofebSi B
- Page 188 and 189: dinamikaSi dakvirveba CD4≥500/mm
- Page 190 and 191: HBV mkurnalobis efeqturoba HBeAg (+
- Page 192 and 193: ) gamomricxavi - aiv infeqcia/Sidsi
- Page 194 and 195: pegilirebuli interferonis da ribavi
- Page 196 and 197: i CD4 X X X X X X X X X TSH X X X H
- Page 198 and 199: )gamomricxavi - aiv infeqcia/Sidsis
- Page 200 and 201: pirveli rigis antituberkulozuri med
- Page 202: testebi: • sisxlis saerTo analizi
<strong>aiv</strong> <strong>infeqcia</strong>/Sidsis fonze ganviTarebuli histoplazmozis marTvis<br />
saxelmwifo stan<strong>da</strong>rti (protokoli)<br />
1.<strong>da</strong>avadebis /nozologiis / sindromis mokle ganmarteba _ <strong>aiv</strong><br />
<strong>infeqcia</strong>/Sidsi ewodeba a<strong>da</strong>mianis imunodeficitis virusiT gamowveul<br />
infeqciur <strong>da</strong>avadebas. hispoplazmozis gamomwvevia soko Histoplazma<br />
capsulatum inhalaciuri sporebi.<br />
2.kriteriumebi _<br />
o a)<strong>da</strong>ma<strong>da</strong>sturebeli _ <strong>aiv</strong> <strong>infeqcia</strong>/Sidsis <strong>da</strong>ma<strong>da</strong>sturebeli<br />
kriteriumebia: <strong>aiv</strong> antisxeulebis arseboba sisxlis SratSi<br />
imunoblotingis meTodiT, <strong>aiv</strong> rnm-is raodenobrivad <strong>da</strong>/an <strong>aiv</strong><br />
provirus dnm-is Tvisobrivad aRmoCena sisxlSi polimerizaciis<br />
jaWvuri reaqciis meTodiT. histoplazmozis diagnostika<br />
<strong>da</strong>sturdeba sokos kulturiT an qsovilis bioptatis<br />
histologiuri gamokvleviT. hispoplazmozis diagnostisTvis un<strong>da</strong><br />
Catardes sisxlis <strong>da</strong> kanis testebi, Tumca isini ar aris farTod<br />
gamoyenebuli.<br />
b)gamomricxavi _ <strong>aiv</strong> <strong>infeqcia</strong>/Sidsis gamomricxavi kriteriumebia: <strong>aiv</strong><br />
antisxeulebis ar arseboba sisxlis SratSi imunofermentuli meTodiT,<br />
raodenobrivad <strong>aiv</strong> rnm-is <strong>da</strong>/an Tvisobrivad <strong>aiv</strong> provirus dnm-is ar<br />
arseboba sisxlSi polimerizaciis jaWvuri reaqciis meTodiT.<br />
histoplazmozis gamomricxavi kriteriumebia sokos ar arseboba qsovilis<br />
bioptatis histologiuri gamokvleviT.<br />
3.simptomebi <strong>da</strong> niSnebi<br />
a)<strong>da</strong>ma<strong>da</strong>sturebeli _ <strong>aiv</strong> <strong>infeqcia</strong>/Sidss paTognomuri <strong>klinikuri</strong><br />
niSnebi ar gaaCnia. igi miekuTvneba laboratoriulad sadiagnozo<br />
<strong>da</strong>avadebebs. simptomebi<strong>da</strong>n SeiZleba gamovyoT: gaxangrZlivebuli<br />
cxeleba, gaxangrZlivebuli faRaraTi, limfadenopaTia,<br />
aramotivirebuli profuzuli oflianoba, Zlieri saerTo sisuste,<br />
aramotivirebuli wonaSi kleba (erTi Tvis ganmavlobaSi sxeulis<br />
wonis 10% <strong>da</strong> meti), sxva<strong>da</strong>sxva gamonayari kansa <strong>da</strong> lorwovanze,<br />
kandidozuri ezofagiti, cns-is atipiuri <strong>da</strong>zianebebi <strong>da</strong> sxva.<br />
histoplazmiT gamowveuli mwvave <strong>da</strong>avadeba gripismagvaria <strong>da</strong><br />
axasiaTebs: cxeleba, anoreqsia, arTralgia, mialgia, mSrali xveleba,<br />
tkivili gul-mkerdis areSi. diseminacia imunosupresiul avadmyofSi<br />
swrafad viTardeba <strong>da</strong> axasiaTebs: wonaSi <strong>da</strong>kleba, oraluri <strong>da</strong> kanis<br />
<strong>da</strong>zianebuli ubnebi, RviZlis, elenTis <strong>da</strong> limfuri kvanZebis gadideba.<br />
oraluri ubnebisTvis <strong>da</strong>maxasiaTebelia nekrozuli wylulebi.<br />
SesaZlebelia ganviTareds sasis perforacia <strong>da</strong> rbili qsovilis<br />
destruqcia.<br />
b)gamomricxavi _ <strong>aiv</strong> <strong>infeqcia</strong>/Sidsis gamomricxavi simptomebi ar<br />
arsebobs, <strong>aiv</strong> inficirebuli wlebis ganmavlobaSi SeiZleba Civilebs ar<br />
warmoadgendes. histoplazmozis gamomricxavi faqtoria Sesabamisi<br />
Civilebisa <strong>da</strong> simptomebis ar arseboba.<br />
158
Change language