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 marTvis saxelmwifo standarti (protokoli) seboreuli dermatitis 1.daavadebis /nozologiis / sindromis mokle ganmarteba _ aiv infeqcia/Sidsi ewodeba adamianis imunodeficitis virusiT gamowveul infeqciur daavadebas. varaudoben, rom seboreuli dermatitis gamomwvevia soko Pitysporu ovale (aseve cnobilia rogorc Malassezia furfur). elementi warmoadgens wiTeli feris laqas, romelic iqercleba. 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. seboreuli dermatitis diagnozi dasturdeba sokos aRmoCeniT kanis dazianebuli ubnidan anafxeki masalis mikroskopuli gamokvlevisas. 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. seboreuli dermatitis diagnozi gamoiricxeba, Tu kanis dazianebuli ubnidan anafxeki masalis mikroskopuli gamokvlevisas gamomwvevi ar aRmoCndeba. 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. seboreuli dermatitis dros saxezea aqerclili wiTeli feris laqa saxeze, cxviris nestoebis irgvliv, cxvir-tuCis naoWze, warbebze, Tavis Tmian nawilze, gul-mkerdis areSi iRliebSi, tanis zeda nawilsa da sazardulis areSi. b)gamomricxavi _ aiv infeqcia/Sidsis gamomricxavi simptomebi ar arsebobs, aiv inficirebuli wlebis ganmavlobaSi SeiZleba Civilebs ar warmoadgendes. seboreuli dermatitis gamomricxavi faqtoria Sesabamisi Civilebisa da simptomebis ar arseboba. 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, 178
Tirkmlis funqciuri sinjebi, virusuli hepatitis markerebi, dazianebuli kanis anafxekis mikroskopuli gamokvleva, dermatologis konsultacia. 5.seboreuli dermatitis mkurnaloba rekomendebulia dazianebuli ubnebis xSirad dabana qerclis mosaSoreblad, karg Sedegs iZleva selenis sulfidis Semcveli samkurnalo Sampunebis gamoyeneba. SesaZloa yvelaze efeqturi aRmoCndes hidrokortizonis 1%-ani mazis aplikaciebi. aseve karg Sedegs iZleva ketokonazolis 2%-ani kremi. 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. 179
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<strong>aiv</strong> <strong>infeqcia</strong>/Sidsis fonze ganviTarebuli<br />
marTvis saxelmwifo stan<strong>da</strong>rti (protokoli)<br />
seboreuli dermatitis<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. varaudoben, rom seboreuli dermatitis<br />
gamomwvevia soko Pitysporu ovale (aseve cnobilia rogorc Malassezia furfur).<br />
elementi warmoadgens wiTeli feris laqas, romelic iqercleba.<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. seboreuli<br />
dermatitis diagnozi <strong>da</strong>sturdeba sokos aRmoCeniT kanis <strong>da</strong>zianebuli<br />
ubni<strong>da</strong>n anafxeki masalis mikroskopuli gamokvlevisas.<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. seboreuli<br />
dermatitis diagnozi gamoiricxeba, Tu kanis <strong>da</strong>zianebuli ubni<strong>da</strong>n<br />
anafxeki masalis mikroskopuli gamokvlevisas gamomwvevi ar aRmoCndeba.<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> niSnebi<br />
ar gaaCnia. igi miekuTvneba laboratoriulad sadiagnozo <strong>da</strong>avadebebs.<br />
simptomebi<strong>da</strong>n SeiZleba gamovyoT: gaxangrZlivebuli cxeleba,<br />
gaxangrZlivebuli faRaraTi, limfadenopaTia, aramotivirebuli<br />
profuzuli oflianoba, Zlieri saerTo sisuste, aramotivirebuli wonaSi<br />
kleba (erTi Tvis ganmavlobaSi sxeulis wonis 10% <strong>da</strong> meti), sxva<strong>da</strong>sxva<br />
gamonayari kansa <strong>da</strong> lorwovanze, kandidozuri ezofagiti, cns-is<br />
atipiuri <strong>da</strong>zianebebi <strong>da</strong> sxva. seboreuli dermatitis dros saxezea<br />
aqerclili wiTeli feris laqa saxeze, cxviris nestoebis irgvliv,<br />
cxvir-tuCis naoWze, warbebze, Tavis Tmian nawilze, gul-mkerdis areSi<br />
iRliebSi, tanis ze<strong>da</strong> nawilsa <strong>da</strong> sazardulis areSi.<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. seboreuli dermatitis gamomricxavi faqtoria Sesabamisi<br />
Civilebisa <strong>da</strong> simptomebis ar arseboba.<br />
4.diagnostikur _ laboratoriuli testebi <strong>da</strong> specialistTa<br />
konsultaciebi<br />
CD3, CD4, CD8 limfocitebis absoluturi ricxvis gansazRvra, <strong>aiv</strong><br />
virusuli <strong>da</strong>tvirTvis gansazRvra polimerizaciis jaWvuri reaqciis<br />
meTodiT, sisxlis saerTo analizi, RviZlis funqciuri sinjebi,<br />
178
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