aiv infeqcia/SidsiT avadmyofTa mkurnaloba da movla (klinikuri ...
aiv infeqcia/SidsiT avadmyofTa mkurnaloba da movla (klinikuri ... aiv infeqcia/SidsiT avadmyofTa mkurnaloba da movla (klinikuri ...
1.2. fizikaluri gamokvleva fizikaluri gamokvlevisas unda dafiqsirdes arsebuli simptomebi da niSnebi, raTa ganisazRvros cvlilebebi statusSi. sasurvelia vixelmZRvaneloT standartuli istoriiT da gamokvlevis kiTxvariT; ix cxrili 2. cxrili 4. sawyisi fizikaluri gamokvleva garegnuli monacemebi: • simaRle da wona • lipodistrofia • karnovskis indeqsi an zogadi mdgomareobis sxva standartuli Sefaseba sasicocxlo niSnebi: • arteriuli wneva • temperatura • pulsi Tavi • garegnuli monacemebi • kbilebis mdgomareoba • oraluri kandidozi • Tmovani leikoplakia • pirveladi sifilisi • saxis kani gul-mkerdi • suTqva, xveleba, dispnoe • gul-mkerdis forma • emfizemis riskis kontroli sarZeve jirkvlis daTvaliereba (qalebsa da mamakacebSi) karcinomis riskis gasakontroleblad gulis mdgomareoba kardiovaskuluri riskis SefasebisTvis antiretrovirusul mkurnalobaze (8,9) (CIII) an endokarditis riski saineqcio narkomanebSi muclis Rrus da gastrointestinuri sistemis gamokvleva (sawyisi informacia antiretrovirusuli mkurnalobis gverdiTi efeqtebisTvis, gansakuTrebiT qronikuli hepatitis, alkoholuri intoqsikaciis da cirozis SemTxvevebSi) • RviZlisa da elenTis konsistencia, zomebi da forma • nawlavebis muSaoba • muclis sirbile • rigidoba • sisuste, moTenTiloba, disfagia genitaluri da analuri regionis gamokvleva: • martivi herpesi • citomegalovirusi • sifilisi 28
• adamianis papilomavirusi (maxvilwvetiani kondilomebi, analuri karcinoma) (10) (BII), sxva sqesobrivi gziT gadamdebi daavadebebi (sggd) qvemo kidurebi (moZraoba, mobiluroba, lipodistrofia) antiretrovirusuli mkurnalobis gverdiTi efeqtebis gasaTvaliswineblad kani (sxeulis): • gadatanili herpes zosteri • RviZlis daavadebebi • kapoSis sarkoma • seboreuli deramatiti • narkotikis ineqciis adgilebi kanis dazianebebi mag: moyavisfro an muqi laqebi umjobesia avsaxoT fotoebSi, kanis sxva SesaZlo dazianebis gamiricxvis mizniT (moqaveba da gafxaWna) momavali gamokvlevisas limfuri kvanZebi nevrologiuri statusi (neiropaTiis niSnebi) gonebrivi statusi mxedveleobiTi da smeniTi funqcia 1.3. laboratoriuli da sxva gamokvlevebi cxrili 5. laboratoriuli testebi aiv infeqciasTan dakavSirebuli testireba: • aiv serologiuri gamokvleva (tipurad ELISA an swrafi testi), romelsac mohyveba damadasturebeli testi (tipiurad vestern blotingi) (11) (AI); • CD4 ujredebis ricxvi imunodeficitis xarisxis gansazRvrisTvis; orsul qalebSi CD4% (12,13) (AI)da • virusuli datvirTvis testi polimerazuli jaWvuri reaqciis (pjr) meTodiT, virusis replikaciis donis gansazRvrisTvis (AI) a ; testireba sxva infeqciebze (CIII) • testi sifilisze (VDRL); • vaginaluri, asos an analuri Camonafxeki gonoreisa da Chlamydia trachomatis identifikaciisTvis; • testireba toqsoplazmis IgG serologiur testze da informacia infeqciis riskis Sesaxeb Tu serologiis Sedegi uaryofiTia • kriptokokis antigenis titri rodesac CD4 limfocitebis ricxvi < 200 mm3 da saxezea kriptokokozis klinikuri niSnebi • CMV antigenemia (pp65 adreuli antigeni) rodesac CD4 ujredebis ricxvi < 100 mm3 b • serologiuri testi B,C hepatitis virusebze (anti HCV, HBsAg) g ZiriTadi laboratoriuli testebi: o eleqtrolitebi (natriumi, kaliumi) N o RviZlis funqciuri sinjebi (ALT, AST, tute fosfataza, saerTo da arapirdapiri bilirubini) o Tirkmlis funqciebi (Sardovana, kreatinini) 29
- 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 and 24: persistuli generalizebuli limfadeno
- Page 25 and 26: signalis amplifikacia komplementuri
- Page 27: • vizitamde rezistentobis testis
- 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
- Page 74 and 75: kandidozi dRe yovel dRe - ko-trimoq
- Page 76 and 77: karcinoma (ara SidsTan perikardiuli
• a<strong>da</strong>mianis papilomavirusi (maxvilwvetiani kondilomebi, analuri<br />
karcinoma) (10) (BII), sxva sqesobrivi gziT ga<strong>da</strong>mdebi <strong>da</strong>avadebebi<br />
(sggd)<br />
qvemo kidurebi (moZraoba, mobiluroba, lipodistrofia)<br />
antiretrovirusuli mkurnalobis gverdiTi efeqtebis<br />
gasaTvaliswineblad<br />
kani (sxeulis):<br />
• ga<strong>da</strong>tanili herpes zosteri<br />
• RviZlis <strong>da</strong>avadebebi<br />
• kapoSis sarkoma<br />
• seboreuli deramatiti<br />
• narkotikis ineqciis adgilebi<br />
kanis <strong>da</strong>zianebebi mag: moyavisfro an muqi laqebi umjobesia avsaxoT<br />
fotoebSi, kanis sxva SesaZlo <strong>da</strong>zianebis gamiricxvis mizniT (moqaveba <strong>da</strong><br />
gafxaWna) momavali gamokvlevisas<br />
limfuri kvanZebi<br />
nevrologiuri statusi (neiropaTiis niSnebi)<br />
gonebrivi statusi<br />
mxedveleobiTi <strong>da</strong> smeniTi funqcia<br />
1.3. laboratoriuli <strong>da</strong> sxva gamokvlevebi<br />
cxrili 5. laboratoriuli testebi<br />
<strong>aiv</strong> <strong>infeqcia</strong>sTan <strong>da</strong>kavSirebuli testireba:<br />
• <strong>aiv</strong> serologiuri gamokvleva (tipurad ELISA an swrafi testi),<br />
romelsac mohyveba <strong>da</strong>ma<strong>da</strong>sturebeli testi (tipiurad vestern<br />
blotingi) (11) (AI);<br />
• CD4 ujredebis ricxvi imunodeficitis xarisxis gansazRvrisTvis;<br />
orsul qalebSi CD4% (12,13) (AI)<strong>da</strong><br />
• virusuli <strong>da</strong>tvirTvis testi polimerazuli jaWvuri reaqciis (pjr)<br />
meTodiT, virusis replikaciis donis gansazRvrisTvis (AI) a ;<br />
testireba sxva infeqciebze (CIII)<br />
• testi sifilisze (VDRL);<br />
• vaginaluri, asos an analuri Camonafxeki gonoreisa <strong>da</strong> Chlamydia<br />
trachomatis identifikaciisTvis;<br />
• testireba toqsoplazmis IgG serologiur testze <strong>da</strong> informacia<br />
infeqciis riskis Sesaxeb Tu serologiis Sedegi uaryofiTia<br />
• kriptokokis antigenis titri rodesac CD4 limfocitebis ricxvi <<br />
200 mm3 <strong>da</strong> saxezea kriptokokozis <strong>klinikuri</strong> niSnebi<br />
• CMV antigenemia (pp65 adreuli antigeni) rodesac CD4 ujredebis<br />
ricxvi < 100 mm3 b<br />
• serologiuri testi B,C hepatitis virusebze (anti HCV, HBsAg) g<br />
ZiriTadi laboratoriuli testebi:<br />
o eleqtrolitebi (natriumi, kaliumi) N<br />
o RviZlis funqciuri sinjebi (ALT, AST, tute fosfataza,<br />
saerTo <strong>da</strong> arapir<strong>da</strong>piri bilirubini)<br />
o Tirkmlis funqciebi (Sardovana, kreatinini)<br />
29
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