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 kapoSis sarkomis marTvis saxelmwifo standarti (protokoli) 1.daavadebis /nozologiis / sindromis mokle ganmarteba _ aiv infeqcia/Sidsi ewodeba adamianis imunodeficitis virusiT gamowveul infeqciur daavadebas. kapoSis sarkoma avTvisebiani simsivnea, romlis gamomwvevia gamomwvevia me-8 tipis herpes virusi (HHV8 an KSHV). 2.kriteriumebi _ 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. kapoSis sarkomis diagnozi dasturdeba kanis dazianebuli ubnebidan aRebuli bioptatis histologiuri gamokvleviT. 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. kapoSis sarkomis gamomricxavi kriteriumebia kanis dazianebuli ubnebidan aRebul bioptatSi daignozis histologiurad ar dadastureba. 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. kanze elementebi warmodgenilia cisferi an mewamuli feris papulebiT an kvanZebiT, araiSviaTad garSemo arsebuli kanis limfuri SeSupebiT. xSirad ziandeba sasa, filtvebi kuW-nawlavis traqti da limfuri kvanZebi. piris RruSi kapoSis sarkomis elementebi yvelaze xSirad ganlagebulia magar sasaze, iSviaTad enaze, xaxaze, nuSura jirkvlebsa da RrZilebze. isini warmoadgenen mewamuli feris papulebs, romlebic Cveulebriv ar aris mtkivneuli. xandaxan SeiZleba Segvxvdes msxvili elementebic da elementebi kanze. filtvis parenqimis dazianeba atarebs infiltraciul xasiaTs. xSirad viTardeba sunTqvis ukmarisoba. filtvis infiltraciuli dazianebis mqone avadmyofebs arakeTilsaimedo prognozi aqvT da maTSi maRalia sikvdilianoba. b)gamomricxavi _ aiv infeqcia/Sidsis gamomricxavi simptomebi ar arsebobs, aiv inficirebuli wlebis ganmavlobaSi SeiZleba Civilebs ar warmoadgendes. kapoSis sarkomis gamomricxavi faqtoria Sesabamisi Civilebisa da simptomebis ar arseboba. 160
4.diagnostikur _ laboratoriuli testebi da specialistTa konsultaciebi CD3, CD4, CD8 limfocitebis absoluturi ricxvis gansazRvra, aiv virusuli datvirTvis gansazRvra polimerizaciis jaWvuri reaqciis meTodiT, sisxlis saerTo analizi, RviZlis funqciuri sinjebi, Tirkmlis funqciuri sinjebi, kapoSis sarkomiT dazianebuli kanis ubnebis biopsia da histologiuri gamokvleva. 5.kapoSis sarkomis mkurnaloba kapoSis sarkomis mkurnaloba tardeba onkologis mier. lokaluri formis samkurnalod gamoiyeneba sxivuri Terapia. generalizirebuli formis samkurnalod iniSneba citotoqsiuri qimioTerapia. efeqturobis sxvadasxva xarisxiT gamoiyeneba simsivnis sawinaaRmdego preparatebis Semdegi kombinaciebi: liposomuri doksorubiciniT monoTerapia, bleomicini, vinkristini, daunorubicini, vinblastini, etopozidi. calkeuli elementebi SeiZleba moSordes qirurgiulad an lazeris, Txevadi azotis da dasxivebis zemoqmedebiT. demonstrirebuli iyo uSualod kapoSis sarkomatozul kvanZSi bleomicinis Seyvanis efeqturoba. kapoSis sarkoma SesaZloa daeqvemdebaros mxolod arT-s da nel-nela alagdes. 7.gaidlaini, rimelsac 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. 161
- 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 158 and 159: 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 kapoSis sarkomis 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. kapoSis sarkoma avTvisebiani simsivnea, romlis<br />
gamomwvevia gamomwvevia me-8 tipis herpes virusi (HHV8 an KSHV).<br />
2.kriteriumebi _<br />
a)<strong>da</strong>ma<strong>da</strong>sturebeli _ <strong>aiv</strong> <strong>infeqcia</strong>/Sidsis <strong>da</strong>ma<strong>da</strong>sturebeli kriteriumebia:<br />
<strong>aiv</strong> antisxeulebis arseboba sisxlis SratSi imunoblotingis meTodiT,<br />
<strong>aiv</strong> rnm-is raodenobrivad <strong>da</strong>/an <strong>aiv</strong> provirus dnm-is Tvisobrivad aRmoCena<br />
sisxlSi polimerizaciis jaWvuri reaqciis meTodiT. kapoSis sarkomis<br />
diagnozi <strong>da</strong>sturdeba kanis <strong>da</strong>zianebuli ubnebi<strong>da</strong>n aRebuli bioptatis<br />
histologiuri gamokvleviT.<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. kapoSis<br />
sarkomis gamomricxavi kriteriumebia kanis <strong>da</strong>zianebuli ubnebi<strong>da</strong>n<br />
aRebul bioptatSi <strong>da</strong>ignozis histologiurad ar <strong>da</strong><strong>da</strong>stureba.<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. kanze<br />
elementebi warmodgenilia cisferi an mewamuli feris papulebiT an<br />
kvanZebiT, araiSviaTad garSemo arsebuli kanis limfuri SeSupebiT.<br />
xSirad ziandeba sasa, filtvebi kuW-nawlavis traqti <strong>da</strong> limfuri<br />
kvanZebi. piris RruSi kapoSis sarkomis elementebi yvelaze xSirad<br />
ganlagebulia magar sasaze, iSviaTad enaze, xaxaze, nuSura<br />
jirkvlebsa <strong>da</strong> RrZilebze. isini warmoadgenen mewamuli feris<br />
papulebs, romlebic Cveulebriv ar aris mtkivneuli. xan<strong>da</strong>xan SeiZleba<br />
Segvxvdes msxvili elementebic <strong>da</strong> elementebi kanze. filtvis<br />
parenqimis <strong>da</strong>zianeba atarebs infiltraciul xasiaTs. xSirad<br />
viTardeba sunTqvis ukmarisoba. filtvis infiltraciuli <strong>da</strong>zianebis<br />
mqone avadmyofebs arakeTilsaimedo prognozi aqvT <strong>da</strong> maTSi maRalia<br />
sikvdilianoba.<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. kapoSis sarkomis gamomricxavi faqtoria Sesabamisi<br />
Civilebisa <strong>da</strong> simptomebis ar arseboba.<br />
160
Change language