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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(BII). yvelaze maRali sixSire aRiniSna espaneTSi 26% (33) (BII) <strong>da</strong> sanfranciskoSi<br />
19% (34) (BII). sloveniis monacemebiT rezistentobis sixSire<br />
<strong>da</strong>balia – 3,9% (35) (BII). eqspertebi rekomen<strong>da</strong>cias uweven rezistentobis<br />
testirebas arT <strong>da</strong>wyebamde axaldiagnoz<strong>da</strong>smul pacientebSi (36-38) (BII),<br />
sa<strong>da</strong>c igi xelmisawvdomia, xolo SezRuduli resursebis pirobebSi<br />
rezistentobaze sentineluri (saguSago) ze<strong>da</strong>mxedvelobis <strong>da</strong>wesebas. arT<br />
<strong>da</strong>wyeba SesaZlebelia rezistentobaze testirebis gareSe. ixileT<br />
<strong>da</strong>narTi 3 rezistentobis testirebaze <strong>da</strong>matebiTi informaciisTvis.<br />
4.2 pirveli rigis maarT reJimi<br />
rekomendebulia, rom pirveli rigis arT Seicavdes or<br />
nukleozid/nukleotidis analog revers transkriftazas inhibitors<br />
(nrti anu NRTI) <strong>da</strong> erT ara-nukleozidis analogis revers<br />
transkriptazas inhibitors (anrti anu NNRTI). rekomendebuli<br />
dozebisTvis ixileT <strong>da</strong>narTi 4.<br />
cxrili 9<br />
rekomen<strong>da</strong>ciebi pirveli rigis arT<br />
Sesaxeb<br />
arT reJimi<br />
2 NRTI-s + 1 NNRTI<br />
medikamentebis kombinacia<br />
ZDV + 3TC + (EFV a or NVP)<br />
an<br />
TDF + FTC + (EFV a or NVP)<br />
an<br />
ABC + 3TC + (EFV a or NVP)<br />
a. EFV ganixileba, rogorc upiratesi anrti (AI)<br />
4.2.1. nrti komponenti<br />
- pirveli rigis arT-s ZiriTadi Semadgeneli nawilia ori nrti-s<br />
kombinacia. erT-erTi un<strong>da</strong> iyos lamivudini (3TC) an emtricitabini (FTC)<br />
(39) (AI), xolo meore yvelaze xSirad zidovudinia (ZDV). vinai<strong>da</strong>n<br />
zidovudini pirveli rekomendebuli arv medikamenti iyo, masze uxvi<br />
monacemebia <strong>da</strong>grovili.<br />
- sxva SesaZlo nrti-ebia tenofoviri (TDF) <strong>da</strong> abakaviri (ABC) 3TC–Tan an<br />
FTC–Tan kombinaciaSi. uaxlesi kvlevebi aCveneben TDF/FTC–is kombinaciis<br />
mcire upiratesobas ZDV/3TC–Tan Se<strong>da</strong>rebiT, rodesac gamoiyeneba<br />
efavirenzTan (EFV) kombinaciaSi (40) (AI). aRniSnuli SesaZloa<br />
ganpirobebuli iyos TDF namkurnaleb pacientebSi gverdiTi movlenebis<br />
simciriT. saWiroa <strong>da</strong>matebiTi kvlevebi aRniSnulis <strong>da</strong>sa<strong>da</strong>stureblad.<br />
un<strong>da</strong> aRiniSnos, rom ABC miRebis dros arsebobs saxifaTo<br />
hipersensitiurobis sindromis riski.<br />
- TDF <strong>da</strong> ABC upiratesobaa maTi rezistentobis kargi profili, romelic<br />
saSualebas iZleva momavalSi meti nrti-s kombinaciis gamoyenebas. Tumca<br />
maT aReniSnebaT seriozuli gverdiTi movlenebi <strong>da</strong> efeqturobis<br />
monacemebic mcirea zidovudinTan Se<strong>da</strong>rebiT (41) (CIII).<br />
34
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