aiv infeqcia/SidsiT avadmyofTa mkurnaloba da movla (klinikuri ...
aiv infeqcia/SidsiT avadmyofTa mkurnaloba da movla (klinikuri ... aiv infeqcia/SidsiT avadmyofTa mkurnaloba da movla (klinikuri ...
qimioTerapiiT (mag : B-ALL reJimi) diskusiis Temas warmoadgens da specifikuri rekomendaciebi dRevandeli dRisTvis ar arsebobs (35,36) (Va). o berkitis–tipis limfomebis SemTxvevebSi qimioTerapias Tan unda axldes dasxiveba savaraudo pirveladi keris. o SesaZlebelia ara hojkinis limfomebis mkurnaloba CD4 ujredebis ricxvisgan damoukideblad, Tumca mkurnalobis efeqturobisTvis arT unda dainiSnos ufro adre. qimioTerapiis ganmavlobaSi CD4 ujredebis ricxvi >350 mm3 dakavSirebulia relapsis maRal maCveneblebTan arT gareSe (37) (BII). o intakranilauri limfomebis (metastazebi) sasurvelia Tavis dasxiveba, simsivnis sawinaaRmdego preparatebTan da glukokortikoidebTan erTad (38) (BII). cns-is pirveladi limfomis dros erTaderTi efeqturi mtkicebulebaze dafuZnebuli Terapiaa sxivuri Terapia. dauyonebliv unda daiwyos arT (39,40) (AI). 3.1.12. centraluri nervuli sistemis infeqciebi adamianis imunodeficitis virusis nervul sistemaze pirdapir zemoqmedebas mivyavarT encefalopaTiis, mielopaTiis da periferiuli neiropaTiis ganviTarebamde. aiv infeqcias ukavSireben iseT nevrologiur darRvevebs, rogoricaa o Tavis tvinis nivTierebis atrofia da degeneracia, o Sids-demenciis kompleqsi, o naTxemis atrofia, o vakuoluri mielopaTia, o saxis nervis dambla, o gien-baris sindromi da o sensorul-motoruli periferiuli neiropaTia tkivilis sindromiT. cns-is darRvevebi aseve SeiZleba mogvces baqteriulma, virusulma da sokovanma oportunistulma infeqciebma (mag: kriptokokulma meningitma). 3.1.13. toqsoplazmozi ganviTarebul qveynebSi toqsoplazmozi farTod aris gavrcelebuli. toqsoplazmozi iwvevs Tavis tvinSi mravlobiTi anTebadi ubnebis warmoqmnas. aiv inficirebulebSi toqsoplazmozi ZiriTadad gamovlindeba encefalitis an diseminirebuli daavadebis saxiT. diagnostikaAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA toqsoplazmozze eWvi SeiZleba gamoiTqvas klinikuri suraTis mixedviT: o cnobierebis darRveva o cxeleba o krunCxvebi o Tavis tkivili o kerovani nevrologiuri simptomatika motoruli deficitis, kraniuli nervis parezis, moZraobis SezRudvis, dismetriis, mxedvelobis dakargvis da afaziis CaTvliT. 92
o Tavis tvinis MAC an MRI skanirebiT aRmoCndeba mravlobiTi rgoliseburi kerebi. o Tu es meTodebi ar aris xelmisawvdomi diagnozis dadgenaSi gvexmareba serologiuri testebi toqsoplazmis sawinaaRmdegod gamomuSavebul antisxeulebze (IgG klasis). o cerebraluri toqsoplazmozis mqone pacientebis umravlesobas aReniSneba Toxoplasma gondii-iT gamowveuli infeqciis gadatanis serologiuri niSnebi. o toqsoplazmozze eWvis dros iniSneba sacdeli mkurnaloba o 2 kviris manZilze mkurnalobis araefeqturobis SemTxvevebSi dgeba sakiTxi Tavis tvinis biofsiis Sesaxeb. o diagnozs adasturebs Tavis tvinis qsovilis histologiuri gamokvleva. mkurnalobaA AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA cxrili 15. toqsoplazmozis mkurnaloba (41-43) (AI) preparati doza M miRebis sixSire miRebis gza mkurnalobis xangrZlivoba mkurnaloba pirimetamini 200 mg erTjeradad PO erTjeradad (gajerebiTi doza) Semdeg pirimetamini 25 mg 3-jer dReSi PO 6-8 kvira an 50 mg 2-jer dReSi + foliumis 15 mg dReSi PO 6-8 kvira mJava erTxel + sulfadiazini 1 g 4-jer dReSi PO 6-8 kvira am sqemaSi sulfadiazini SeiZleba Seicvalos: • klindamiciniT 600 mg i/v an PO dReSi 4-jer 6 kvira • azitromiciniT 1200 mg PO dReSi erTxel 6 kvira • klariTromiciniT 1 g PO 2-jer dReSi 6 kvira • atovakvoniT 750 mg PO 4-jer dReSi 6 kvira. • zogierT pacients sWirdeba xangrZlivi mkurnaloba toqsoplazmozis gamo. gadawyvetileba efuZneba klinikur mdgomareobas da ganmeorebiT CAT skanirebas. • meoradi profilaqtika grZeldeba efeqturi reJimis ganaxevrebuli dozebiT manamde sanam CD4 ujredebs ricxvi sami Tvis ganmavlobaSi stabulurad ar moimatebs (200 ujredi da meti). 3.1.14. martivi herpesiT gamowveuli infeqciebi • martivi herpesiT gamowveuli infeqciebi xSiria klinikur praqtikaSi. • herpesis pirvelad epizods xSirad axlavs recidivi. 93
- 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
- Page 78 and 79: o cxeleba o wonaSi kleba o Ramis of
- Page 80 and 81: indikatorebi filtvis darRveuli funq
- Page 82 and 83: o yvelaze xSirad viTardeba diarea,
- Page 84 and 85: o glukokortikoidebis sistematiuri m
- Page 86 and 87: 100 mg/dReSi meore rigis sqemebi am
- Page 88 and 89: o eqspoziciis Sedegad daavadebis ga
- Page 90 and 91: o remisiis miRweva Zalian Znelia da
- Page 94 and 95: • imunodeficitis mqone pacientebS
- Page 96 and 97: an famcikloviri 500 mg 3-jer dReSi
- Page 98 and 99: • berkitis-tipis limfoma; • naz
- Page 100 and 101: 3.2.2. cxeleba aiv inficirebulebSi
- Page 102 and 103: afTozuri wylulebi stomatiti qeiliti
- Page 104 and 105: ganmavlobaSi 2 Tvis manZilze (xelis
- Page 106 and 107: o gamonayari warmodgenilia mravlobi
- Page 108 and 109: 20. Chen XM et al. Cryptosporidiosi
- Page 110 and 111: Tavi IV. aiv infeqcia/SidsiT daavad
- Page 112 and 113: inficirebul bavSvebSi (ramdenadac a
- Page 114 and 115: 8 igulisxmeba piri, romelsac aReniS
- Page 116 and 117: 4.3. daxocili da inaqtivirebuli vaq
- Page 118 and 119: kerebSi A hepatiti erTeuli an mcire
- Page 120 and 121: 13 riski maRalia staJirebis periodS
- Page 122 and 123: ganmavlobaSi, xolo SedarebiT ufro s
- Page 124 and 125: 4.8. tkipismieri encefalitis vaqcin
- Page 126 and 127: CvenebebiTa da doziT, rogorc imunok
- Page 128 and 129: 4.11.2.3. cofis sawinaaRmdego imuno
- Page 130 and 131: ekomendebulia: vaqcina rekomendebul
- Page 132 and 133: 8. United States Centers for Diseas
- Page 134 and 135: aiv infeqcia/Sidsis antiretrovirusu
- Page 136 and 137: 5. mkurnaloba a) rekomendebuli pirv
- Page 138 and 139: aiv infeqcia/SidsiT daavadebuli bav
- Page 140 and 141: joxiseburi TiTebi. Tumca wlebis man
qimioTerapiiT (mag : B-ALL reJimi) diskusiis Temas warmoadgens <strong>da</strong><br />
specifikuri rekomen<strong>da</strong>ciebi dRevandeli dRisTvis ar arsebobs<br />
(35,36) (Va).<br />
o berkitis–tipis limfomebis SemTxvevebSi qimioTerapias Tan un<strong>da</strong><br />
axldes <strong>da</strong>sxiveba savaraudo pirveladi keris.<br />
o SesaZlebelia ara hojkinis limfomebis <strong>mkurnaloba</strong> CD4 ujredebis<br />
ricxvisgan <strong>da</strong>moukideblad, Tumca mkurnalobis efeqturobisTvis<br />
arT un<strong>da</strong> <strong>da</strong>iniSnos ufro adre. qimioTerapiis ganmavlobaSi CD4<br />
ujredebis ricxvi >350 mm3 <strong>da</strong>kavSirebulia relapsis maRal<br />
maCveneblebTan arT gareSe (37) (BII).<br />
o intakranilauri limfomebis (metastazebi) sasurvelia Tavis<br />
<strong>da</strong>sxiveba, simsivnis sawinaaRmdego preparatebTan <strong>da</strong><br />
glukokortikoidebTan erTad (38) (BII).<br />
cns-is pirveladi limfomis dros erTaderTi efeqturi mtkicebulebaze<br />
<strong>da</strong>fuZnebuli Terapiaa sxivuri Terapia. <strong>da</strong>uyonebliv un<strong>da</strong> <strong>da</strong>iwyos arT<br />
(39,40) (AI).<br />
3.1.12. centraluri nervuli sistemis infeqciebi<br />
a<strong>da</strong>mianis imunodeficitis virusis nervul sistemaze pir<strong>da</strong>pir<br />
zemoqmedebas mivyavarT encefalopaTiis, mielopaTiis <strong>da</strong> periferiuli<br />
neiropaTiis ganviTarebamde. <strong>aiv</strong> <strong>infeqcia</strong>s ukavSireben iseT nevrologiur<br />
<strong>da</strong>rRvevebs, rogoricaa<br />
o Tavis tvinis nivTierebis atrofia <strong>da</strong> degeneracia,<br />
o Sids-demenciis kompleqsi,<br />
o naTxemis atrofia,<br />
o vakuoluri mielopaTia,<br />
o saxis nervis <strong>da</strong>mbla,<br />
o gien-baris sindromi <strong>da</strong><br />
o sensorul-motoruli periferiuli neiropaTia tkivilis sindromiT.<br />
cns-is <strong>da</strong>rRvevebi aseve SeiZleba mogvces baqteriulma, virusulma <strong>da</strong><br />
sokovanma oportunistulma infeqciebma (mag: kriptokokulma meningitma).<br />
3.1.13. toqsoplazmozi<br />
ganviTarebul qveynebSi toqsoplazmozi farTod aris gavrcelebuli.<br />
toqsoplazmozi iwvevs Tavis tvinSi mravlobiTi anTebadi ubnebis<br />
warmoqmnas. <strong>aiv</strong> inficirebulebSi toqsoplazmozi ZiriTa<strong>da</strong>d<br />
gamovlindeba encefalitis an diseminirebuli <strong>da</strong>avadebis saxiT.<br />
diagnostikaAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA<br />
toqsoplazmozze eWvi SeiZleba gamoiTqvas <strong>klinikuri</strong> suraTis mixedviT:<br />
o cnobierebis <strong>da</strong>rRveva<br />
o cxeleba<br />
o krunCxvebi<br />
o Tavis tkivili<br />
o kerovani nevrologiuri simptomatika motoruli deficitis,<br />
kraniuli nervis parezis, moZraobis SezRudvis, dismetriis,<br />
mxedvelobis <strong>da</strong>kargvis <strong>da</strong> afaziis CaTvliT.<br />
92