aiv infeqcia/SidsiT avadmyofTa mkurnaloba da movla (klinikuri ...
aiv infeqcia/SidsiT avadmyofTa mkurnaloba da movla (klinikuri ... aiv infeqcia/SidsiT avadmyofTa mkurnaloba da movla (klinikuri ...
i CD4 X X X X X X X X X TSH X X X HCV RNA raodenobri vi (VL) X mkurnalobis efeqturoba HCV RNA Tvisobrivi X X X ‣ antivirusuli mkurnalobis dawyebidan 12 kviraze Tu HCV virusuli datvirTva gaxda aragansazRvradi an Semcirda sul cota 2 log 10 -iT, es niSnavs, rom mkurnalobaze adreuli virusuli pasuxi(EVR) miRebulia da mkurnaloba unda gagrZeldes. ‣ Tu HCV virusuli datvirTva ar Semcirda sul cota 2 log 10 -iT, mkurnaloba unda Sewydes, radgan aseT SemTxvevaSi myari virusuli pasuxis(SVR) ar miReba mosalodnelia daaxloebiT 99-100%-Si.(AII). ‣ zemoT aRniSnuli vrceldeba HCV nebismieri genotipiT avadmyofze. ‣ amis Semdeg mkurnalobis dawyebidan 24 kviraze rekomendebulia HCV RNA –is (Tvisobrivi) gansazRvra da im avadmyofebSi, romlebic am etapze rCebian HCV RNA (+) pozitiuri, mkurnaloba unda Sewydes. (radgan aseT SemTxvevaSi myari virusuli pasuxis(SVR) ar miiReba mosalodnelia daaxloebiT 99-100%-Si.) ‣ mkurnalobis dawyebidan 48 kviraze unda ganisazRvros HCV RNA (Tvisobrivi) da miRebuli Sedegi daafiqsirebs mkurnalobis bolo pasuxs. (EOT) ‣ mkurnalobis damTavrebidan 6 Tvis Semdeg kvlav unda ganisazRvros HCV RNA (Tvisobrivi). negatiuri HCV RNA mianiSnebs myari virusuli pasuxis (SVR) miRebaze, ris Semdegac daavadebis recidivis ganviTareba Zalian iSviaTia. ‣ Semdgomi gamokvleva SesaZloa Catardes 12-24 Tvis Semdeg mkurnalobis damTavrebidan. 7. gaidlaini romelsac eyrdnoba aRniSnuli protokoli aRniSnuli protokoli eyrdnoba 2006 wels janmo-s mier evropis regionisTvis gamocemul gaidlains da klinikur protokolebs “ C hepatitis da aiv infeqcia/Sidsis koinfeqciis marTva” da evropis I konsensus konferenciis: “HBV da HCV infeqciebis marTva HIV koinfeqciiT avadmyofebSi.” (1-2, marti, 2005. parizi, safrangeTi) konsensus dadgenilebas. 196
aiv infeqcia/Sidsis da tuberkulozis koinfeqciis marTvis saxelmwifo standarti (protokoli) 1.ganmarteba – aiv infeqcia/Sidsi ewodeba adamianis imunodeficitis virusiT gamowveul infeqciur daavadebas. tuberkulozis gamomwvevia tuberkulozis mikobaqteria. orive paTogeniT erTdroulad daavadebisas saubaria aiv infeqcia/Sidsis da tuberkuloziT koinfeqciaze. 2.kriteriumebi – a) damadasturebeli – aiv infeqcia/Sidsis damadasturebeli kriteriumebia: aiv antisxeulebis arseboba sisxlis SratSi imunoblotingis meTodiT, aiv rnm-is raodenobrivad da/an aiv provirusis dnm-is Tvisobrivad aRmoCena sisxlSi polimerizaciis jaWvuri reaqciis meTodiT; tuberkuloziT daavadebis damadasturebeli kriteriumia: avadmyofis biologiur masalaSi (maT Soris naxvelis nacxSi) mJavagamZle baqteriebis (mgb) arseboba, biologiur masalaSi kulturaluri meTodiT tuberkulozis mikobaqteriis aRmoCena. b) gamomricxavi – aiv infeqcia/Sidsis gamomricxavi kriteriumebia: Aaiv antisxeulebis ararseboba sisxlis SratSi imunofermentuli meTodiT, raodenobrivad aiv rnm-is da/an Tvisobrivad aiv provirus dnm-is ararseboba sisxlSi polimerizaciis jaWvuri reaqciis meTodiT; tuberkulozis gamomricxavi kriteriumebia: tuberkulozis damaxasiaTebeli klinikuri niSnebisa da simptomebis ar arseboba, biologiur masalaSi (maT Soris naxvelis nacxSi) baqterioskopiiT mgbsa da kulturaluri gamokvleviT tub.mikobaqteriis ar arseboba. 3.simptomebi da niSnebi a)damadasturebeli - aiv infeqcia/Sidss paTognomuri klinikuri niSnebi ar gaaCnia, igi miekuTvneba laboratoriulad sadiagnozo daavadebebs. simptomebidan SesaZloa gamovyoT: gaxangrZlivebuli cxeleba, gaxangrZlivebuli faRaraTi, limfadenopaTia, aramotivirebuli profuzuli oflianoba, Zlieri saerTo sisuste, aramotivirebuli wonaSi kleba (1 Tvis ganmavlobaSi sxeulis wonis 10% an meti), sxvadasxva gamonayari kansa da lorwovanze, kandidozuri ezofagiti, cns-is atipiuri dazianebebi; tuberkulozis damadasturebel simptomebs miekuTvneba: zogadi niSnebi: subfebriliteti, Ramis oflianoba, advilad daRla, saerTo sisuste, Sromis unaris daqveiTeba, taqikardia. tuberkulozis filtvis formis dros zogad simptomatikas emateba: 2 kviris an meti xangrZlivobis xveleba (produqtiuli, mSrali an sisxliani), haeris ukmarisoba, usiamovno SegrZneba an tkivili gulmkerdSi; tuberkulozis filtvgareSe formebis dros ki zogado intoqsikaciis niSnebs emateba ama Tu im organos dazianebisaTvis damaxasiaTebeli lokaluri simptomatika. 197
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- Page 152 and 153: 6. reabilitacia da dakvirveba monit
- Page 154 and 155: kandidozuri ezofagitis SemTxvevebSi
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- Page 168 and 169: martivi herpesvirusuli infeqciis mZ
- Page 170 and 171: meTodiT, sisxlis saerTo analizi, Rv
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- 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
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- Page 200 and 201: pirveli rigis antituberkulozuri med
- Page 202: testebi: • sisxlis saerTo analizi
i<br />
CD4 X X X X X X X X X<br />
TSH X X X<br />
HCV RNA<br />
raodenobri<br />
vi (VL)<br />
X<br />
mkurnalobis<br />
efeqturoba<br />
HCV RNA<br />
Tvisobrivi X X X<br />
‣ antivirusuli mkurnalobis <strong>da</strong>wyebi<strong>da</strong>n 12 kviraze Tu HCV virusuli<br />
<strong>da</strong>tvirTva gax<strong>da</strong> aragansazRvradi an Semcir<strong>da</strong> sul cota 2 log 10 -iT, es<br />
niSnavs, rom <strong>mkurnaloba</strong>ze adreuli virusuli pasuxi(EVR) miRebulia<br />
<strong>da</strong> <strong>mkurnaloba</strong> un<strong>da</strong> gagrZeldes.<br />
‣ Tu HCV virusuli <strong>da</strong>tvirTva ar Semcir<strong>da</strong> sul cota 2 log 10 -iT,<br />
<strong>mkurnaloba</strong> un<strong>da</strong> Sewydes, radgan aseT SemTxvevaSi myari virusuli<br />
pasuxis(SVR) ar miReba mosalodnelia <strong>da</strong>axloebiT 99-100%-Si.(AII).<br />
‣ zemoT aRniSnuli vrceldeba HCV nebismieri genotipiT avadmyofze.<br />
‣ amis Semdeg mkurnalobis <strong>da</strong>wyebi<strong>da</strong>n 24 kviraze rekomendebulia HCV<br />
RNA –is (Tvisobrivi) gansazRvra <strong>da</strong> im avadmyofebSi, romlebic am<br />
etapze rCebian HCV RNA (+) pozitiuri, <strong>mkurnaloba</strong> un<strong>da</strong> Sewydes.<br />
(radgan aseT SemTxvevaSi myari virusuli pasuxis(SVR) ar miiReba<br />
mosalodnelia <strong>da</strong>axloebiT 99-100%-Si.)<br />
‣ mkurnalobis <strong>da</strong>wyebi<strong>da</strong>n 48 kviraze un<strong>da</strong> ganisazRvros HCV RNA<br />
(Tvisobrivi) <strong>da</strong> miRebuli Sedegi <strong>da</strong>afiqsirebs mkurnalobis bolo<br />
pasuxs. (EOT)<br />
‣ mkurnalobis <strong>da</strong>mTavrebi<strong>da</strong>n 6 Tvis Semdeg kvlav un<strong>da</strong> ganisazRvros<br />
HCV RNA (Tvisobrivi). negatiuri HCV RNA mianiSnebs myari virusuli<br />
pasuxis (SVR) miRebaze, ris Semdegac <strong>da</strong>avadebis recidivis ganviTareba<br />
Zalian iSviaTia.<br />
‣ Semdgomi gamokvleva SesaZloa Catardes 12-24 Tvis Semdeg mkurnalobis<br />
<strong>da</strong>mTavrebi<strong>da</strong>n.<br />
7. gaidlaini romelsac eyrdnoba aRniSnuli protokoli<br />
aRniSnuli protokoli eyrdnoba 2006 wels janmo-s mier evropis<br />
regionisTvis gamocemul gaidlains <strong>da</strong> klinikur protokolebs<br />
“ C hepatitis <strong>da</strong> <strong>aiv</strong> <strong>infeqcia</strong>/Sidsis koinfeqciis marTva” <strong>da</strong> evropis I<br />
konsensus konferenciis: “HBV <strong>da</strong> HCV infeqciebis marTva HIV koinfeqciiT<br />
avadmyofebSi.” (1-2, marti, 2005. parizi, safrangeTi) konsensus<br />
<strong>da</strong>dgenilebas.<br />
196
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