aiv infeqcia/SidsiT avadmyofTa mkurnaloba da movla (klinikuri ...
aiv infeqcia/SidsiT avadmyofTa mkurnaloba da movla (klinikuri ... aiv infeqcia/SidsiT avadmyofTa mkurnaloba da movla (klinikuri ...
imunokomproometirebulebSi kanisa da lorwovanis banaluri daavadebebi mimdinareobs rTulad, aqvs persistuli xasiaTi da rTulia samkurnalod. qvemoT, mokled aris daxasiTebuli kanisa da lorwovanis is daavadebebi, romlebic ufro xSirad viTardeba aiv infeqcia/Sidsis fonze. Sesabamisad, klinicistma qvemoT aRwerili kanis da lorwovanis romelime daavadebis identifikaciisas avadmyofi unda gamoikvlios aiv antisxeulebze. 5. daavadebis diagnozi laboratoriuli diagnostika vinaidan aiv infeqcias paTognomuri klinikuri niSnebi ar gaaCnia, gadamwyveti mis diagnostikaSi laboratoriuli gamokvlevaa. aiv infeqciis laboratoriuli diagnostika sxvadasxva meTodiT xorcieldeba, virusis kultivireba Semdgomi idenTifikaciiT, sisxlsa da sxva biologiur siTxeebSi virusis antigenis da antisxeulebis gansazRvra, virusis genomis gamovlena da sxva. dReisaTvis aiv infeqciis laboratoriuli diagnostikis ZiriTadi saSualebebia sisxlSi aiv sawinaaRmdego antisxeulebis da virusis genetikuri masalis gansazRvra. aiv antisxeulebis gansazRvris meTodebi or jgufad iyofa – pirveladi anu skrininguli da damadasturebeli anu komfirmaciuli. skriningul meTodebs miekuTvneba: aiv antisxeulebis gamovlena imunofermentuli analizis (ifa), imunofluorescenciis, hemaglutinaciis, imunoqromatografiis, mikroprecipitaciis da sxva meTodebiT. gamokvlevis xangrZlivobis mixedviT es meTodebi iyofa Cveulebriv (xangrZlivoba 2-5 saaTi) da swraf/martiv (xangrZlivoba 5-30 wuTi) meTodebad. konfirmaciuli meTodebidan ZiriTadad gamoiyeneba imunoblotingi (Western blot). skriningul meTodebs Soris yvelaze farTod gamoiyeneba aiv antisxeulebis gamovlena ifa da swrafi/martivi meTodebiT, romlebic maRali mgrZnobelobiTa da specifikurobiT xasiaTdeba da amasTan, advilad xelmisawvdomia. maTi saSualebiT aiv antisxeulebi sisxlSi vlindeba inficirebidan 4-8 kviris Semdeg. dadebiTi Sedegis SemTxvevaSi kvleva grZeldeba damadasturebeli anu, konfirmaciuli meTodiT – imunoblotingiT (Western blot). imunoblotingis meTodi saSualebas iZleva ganisazRvros specifikuri antigenebis, anu virusis calkeuli cilebis sawinaaRmdego antisxeulebi. sadReisod yvelaze zusti da maRalmgrZnobiare meTodia virusis genomis (rnm, dnm) gamovlena polimerizaciis jaWvuri reaqciis (PCR) meTodiT. arsebobs virusis genomis gamovlenis alternatiuli meTodebic – bDNA (branched chain DNA) da NASBA (Nucleic Acid Sequence-Based Amplification). Tumca Tavisi mgrZnobelobiTa da specifikurobiT sadReisod isini PCR meTods CamorCeba. bDNA meTodiT xdeba virusis rnm-is moniSnuli monakveTidan 24
signalis amplifikacia komplementuri dnm-iT hibridizaciis gziT. xolo PCR da NASBA meTodebis SemTxvevaSi xdeba virusis moniSnuli rnm-is amplifikacia fermentuli meTodebiT ise, rom gamravlebuli rnm ganisazRvros Cveulebrivi meTodebiT. PCR, romelic 80-ian wlebSi dainerga, didi win gadadgmuli nabijia zogadad infeqciuri daavadebis, maT Soris aiv infeqciis diagnostikaSic. misi saSualebiT xdeba infeqciuri agentis genetikuri masalis amplifikacia da gamovlena im SemTxvevaSic ki, roca misi koncentracia gamosakvlev masalaSi ukiduresad mcirea (1 virusi 100 000 ujredze). PCR meTodi ori saxisaa: Tvisobrivi da raodenobrivi. Tvisobrivi gamoiyeneba aiv infeqciis diagnostikisaTvis adreul stadiaze – sisxlSi antisxeulebis gaCenamde, agreTve ifa da imunoblotingiT saWvo pasuxis miRebis SemTxvevaSi. gansakuTrebiT didia misi diagnostikuri Rirebuleba inficirebuli dedis axalSobilis aiv infeqciis diagnostirebisas. rogorc cnobilia, aiv inficirebuli dedis axalSobils SesaZloa arainficirebis SemTxvevaSic ki aReniSnos aiv antisxeulebis arseboba maTi transplacenturi barieris gavlis gamo. amitom gadamwyveti mniSvneloba axalSobilis aiv infeqciis diagnostikaSi swored PCR meTods eniWeba. raodenobrivi meTodi saSualebas iZleva ganisazRvros e.w. virusuli datvirTva, anu virusis raodenoba 1 ml plazmaSi. virusuli datvirTva saukeTeso markeria daavadebis prognozirebisa da mkurnalobis efeqtianobis Sesafaseblad. 25
- Page 1 and 2: aiv infeqcia/SidsiT avadmyofTa mkur
- Page 3 and 4: sarCevi klinikuri saxelmZRvanelo-re
- Page 5 and 6: 3.2.2.cxeleba aiv inficirebulebSi 3
- Page 7 and 8: aiv infeqcia/Sidsis fonze ganviTare
- Page 9 and 10: done mtkicebulebis siZlieris done (
- Page 11 and 12: 1.daavadebis definicia Sidsi abrevi
- Page 13 and 14: Sidsi registrirebulia msoflios 216
- Page 15 and 16: egistrirebul SemTxveevaTa 79% saqar
- Page 17 and 18: adamianis imunodeficitis virusis sa
- Page 19 and 20: aiv rnm-is koncentracia plazmaSi mk
- Page 21 and 22: SeuZlebelia da gadamwyveti misi dia
- Page 23: persistuli generalizebuli limfadeno
- Page 27 and 28: • vizitamde rezistentobis testis
- Page 29 and 30: • adamianis papilomavirusi (maxvi
- Page 31 and 32: etinitis identifikaciisTvis, rodesa
- Page 33 and 34: cxrili 8 rekomendaciebi arT dawyebi
- Page 35 and 36: arv medikamentebi arseboben Semdegi
- Page 37 and 38: aCveneben, rom pirveladi rezistento
- Page 39 and 40: - tabletebis Cveneba pacientisTvis
- Page 41 and 42: - aqedan gamomdinare, nrti+anrti re
- Page 43 and 44: igulisxmeba im medikamentebis kombi
- Page 45 and 46: X (arv): testebi, romlebic unda Cat
- Page 47 and 48: maRali mgrZnobeloba abakaviri (ABC
- Page 49 and 50: transaminazebis elevacia anrti (all
- Page 51 and 52: ARV toqsiuroba menejmenti nefrotoqs
- Page 53 and 54: xSiri oportonistuli infeqciebia, ma
- Page 55 and 56: cxrilebis wakiTxvis magaliTi 1. cxr
- Page 57 and 58: damateba2. jandacvis msoflio organi
- Page 59 and 60: damateba 4. ZiriTadi informacia ant
- Page 62 and 63: damateba 5. mkurnalobis reJimis dac
- Page 64 and 65: saerTaSoriso saxeli stavudini (d4T)
- Page 66 and 67: mcire mutacia muSaobs kombinaciaSi.
- Page 68 and 69: 25. Phillips AN et al. Viral load o
- Page 70 and 71: Suppl 2:S171-176. 73. Altice FL, Mo
- Page 72 and 73: 122. Koval CE et al. Immune reconst
signalis amplifikacia komplementuri dnm-iT hibridizaciis gziT. xolo<br />
PCR <strong>da</strong> NASBA meTodebis SemTxvevaSi xdeba virusis moniSnuli rnm-is<br />
amplifikacia fermentuli meTodebiT ise, rom gamravlebuli rnm<br />
ganisazRvros Cveulebrivi meTodebiT.<br />
PCR, romelic 80-ian wlebSi <strong>da</strong>inerga, didi win ga<strong>da</strong>dgmuli nabijia<br />
zoga<strong>da</strong>d infeqciuri <strong>da</strong>avadebis, maT Soris <strong>aiv</strong> infeqciis diagnostikaSic.<br />
misi saSualebiT xdeba infeqciuri agentis genetikuri masalis<br />
amplifikacia <strong>da</strong> gamovlena im SemTxvevaSic ki, roca misi koncentracia<br />
gamosakvlev masalaSi ukiduresad mcirea (1 virusi 100 000 ujredze).<br />
PCR meTodi ori saxisaa: Tvisobrivi <strong>da</strong> raodenobrivi. Tvisobrivi<br />
gamoiyeneba <strong>aiv</strong> infeqciis diagnostikisaTvis adreul stadiaze – sisxlSi<br />
antisxeulebis gaCenamde, agreTve ifa <strong>da</strong> imunoblotingiT saWvo pasuxis<br />
miRebis SemTxvevaSi. gansakuTrebiT didia misi diagnostikuri<br />
Rirebuleba inficirebuli dedis axalSobilis <strong>aiv</strong> infeqciis<br />
diagnostirebisas. rogorc cnobilia, <strong>aiv</strong> inficirebuli dedis<br />
axalSobils SesaZloa arainficirebis SemTxvevaSic ki aReniSnos <strong>aiv</strong><br />
antisxeulebis arseboba maTi transplacenturi barieris gavlis gamo.<br />
amitom ga<strong>da</strong>mwyveti mniSvneloba axalSobilis <strong>aiv</strong> infeqciis<br />
diagnostikaSi swored PCR meTods eniWeba.<br />
raodenobrivi meTodi saSualebas iZleva ganisazRvros e.w. virusuli<br />
<strong>da</strong>tvirTva, anu virusis raodenoba 1 ml plazmaSi. virusuli <strong>da</strong>tvirTva<br />
saukeTeso markeria <strong>da</strong>avadebis prognozirebisa <strong>da</strong> mkurnalobis<br />
efeqtianobis Sesafaseblad.<br />
25
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