aiv infeqcia/SidsiT avadmyofTa mkurnaloba da movla (klinikuri ...
aiv infeqcia/SidsiT avadmyofTa mkurnaloba da movla (klinikuri ...
aiv infeqcia/SidsiT avadmyofTa mkurnaloba da movla (klinikuri ...
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cxrili 8<br />
rekomen<strong>da</strong>ciebi arT <strong>da</strong>wyebis Sesaxeb<br />
janmo <strong>klinikuri</strong> stadia CD4 ricxvi<br />
rekomen<strong>da</strong>cia<br />
1<br />
< 200/mm 3 umkurnaleT<br />
200 - 350/mm 3 ganixileT mkurnalobis<br />
SesaZlebloba b, g<br />
2<br />
< 200/mm 3 umkurnaleT<br />
200 - 350/mm 3 ganixileT mkurnalobis<br />
SesaZlebloba b, g<br />
3 200 - 350/mm 3 umkurnaleT<br />
4 CD4 ricxvisgan<br />
umkurnaleT<br />
<strong>da</strong>moukideblad<br />
a. ix. <strong>da</strong>narTi 2 <strong>klinikuri</strong> stadiebis aRwerilobis Sesaxeb<br />
b. rodesac CD4 ricxvi 350/mm 3 -is mi<strong>da</strong>moSia, <strong>da</strong>iwyeT msjeloba<br />
pacientTan arT <strong>da</strong>wyebis saWiroebis moaxloebis <strong>da</strong> mkurnalobis<br />
sawyisi reJimis Sesaxeb.<br />
g. virusuli <strong>da</strong>tvirTva <strong>da</strong>kavSirebulia CD4 ricxvis klebasTan.<br />
rodesac virusuli <strong>da</strong>tvirTva maRalia (> 100000 asli/ml), maRalia<br />
CD4 ricxvis swrafad klebis albaToba. Sesabamisad, Tu virusuli<br />
<strong>da</strong>tvirTva maRalia <strong>da</strong> CD4 ricxvi 350/mm 3 -ia, rekomendebulia arT<br />
<strong>da</strong>wyeba.<br />
arT <strong>da</strong>wyeba un<strong>da</strong> efuZnebodes CD4 ricxvis orjerad gansazRvras 14 – 28<br />
dRis SualediT, raTa gamoiricxos laboratoriuli Secdoma an ga<strong>da</strong>xris<br />
sxva mizezi (magaliTad, Tanmxlebi <strong>da</strong>avadeba).<br />
4.1.1. virusuli <strong>da</strong>tvirTva<br />
virusuli <strong>da</strong>tvirTva TavisTavad ar aris arT <strong>da</strong>wyebis markeri. Tumca, im<br />
SemTxvevaSi Tu virusuli <strong>da</strong>tvirTva 100 000 asli/ml-ze maRalia (man<br />
SeiZleba 1 milion asli/ml-s miaRwios), SesaZloa adgili hqondes CD4<br />
ricxvis swraf klebas. marTalia virusuli <strong>da</strong>tvirTvis gansazRvra<br />
ZviradRirebulia, mniSvnelovania vicodeT misi mniSvneloba mkurnalobis<br />
<strong>da</strong>wyebamde, raTa SemdgomSi SevafasoT mkurnalobis efeqturoba. Tu<br />
virusuli <strong>da</strong>tvirTva ar aris xelmisawvdomi, maSin CD4 ricxvi <strong>da</strong><br />
<strong>klinikuri</strong> simptomebi sakmarisia mkurnalobis <strong>da</strong>wyebis ga<strong>da</strong>wyvetilebis<br />
misaRebad. polimerizaciis jaWvuri reqciisa (pjr) <strong>da</strong> virusuli<br />
<strong>da</strong>tvirTvis ar arseboba ar un<strong>da</strong> gaxdes mkurnalobis ga<strong>da</strong>debis<br />
kriteriumi.<br />
4.1.2 rezistentobis testi<br />
mosazreba pirveli rigis <strong>mkurnaloba</strong>mde rezistentobis testis Catarebis<br />
Sesaxeb gansxvavebulia. rezistentobaze testireba rekomendebulia im<br />
qveynebSi, sa<strong>da</strong>c maRalia priveladi rezistentoba. evropaSi Catar<strong>da</strong><br />
multicentruli kvleva axaldiagnoz<strong>da</strong>smul <strong>aiv</strong> inficirebulebSi 1996 <strong>da</strong><br />
2002 wlebSi. am jgufSi rezistentobis prevalentobam Seadgina 10% (31)<br />
(BII). aSS 40 qalaqSi Catarebul kvlevaSi rezistentobam 14% Seadgina (32)<br />
33
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