Idan an tabbatar da kamuwa da cutar HIV , an yi gwaje-gwaje don tabbatar da matsayin matsayin mutum na rigakafi da kuma matakin aikin hoto a jiki. An bayyana waɗannan a cikin abin da aka sani da ƙidaya CD4 da kayar hoto .
Mene ne kididdigar CD4?
Binciken CD4 yana daya daga cikin gwajin gwajin da aka sani da aka sani ga mutanen da ke dauke da kwayar cutar HIV. Sakamakon gwaji ya ƙunshi nau'i na sakon T4 na CD4 a cikin kwayar jini wanda ba kawai yana da mahimmanci don aiki ba amma yana da manufa ta farko na cutar HIV.
Yayinda kwayar cutar ta kwayar cutar kwayar cutar HIV ta raguwa da wadannan kwayoyin halitta, jikin ya zama kasa da kare kansa ta hanyar yaduwa da dama na cututtuka.
An gwada gwajin ta hanyar daukar samfurin jini, wanda sakamakonsa ya auna yawan adadin CD4 a cikin microliter (μL) na jini. Ƙididdigar ƙididdiga na ƙaddamar da matsayin ku na tsarin rigakafi, yayin da gwaje-gwaje na biyo baya ya sanar da mu game da
- mataki na kamuwa da cuta da kuma yawan ci gaban cutar
- da alama cewa wasu cututtuka za su ci gaba kamar yadda CD4 suka ƙare
- yadda kake amsawa da magani ko dai ta hanyar riƙe ko sake sabunta aikinka na rigakafi
Kwancen CD4 na al'ada a ko'ina tsakanin Kwayoyin 500-1,500 / μL. Bugu da ƙari, ƙididdigar CD4 na kwayoyin 200 / μL ko žasa an haɗa su ne da fasaha kamar cutar AIDS . Bincike ya nuna cewa ƙaddamar da farfadowa a ko a kasa wannan matakin ya dace da sakamakon rashin lafiya da rashin lafiya a cikin tsawon shekaru 15.
Umurnin magani na baya sun bada shawarar a fara samin maganin tayar da kwayar cutar (ART) a marasa lafiya da CD4 a ƙarƙashin kwayoyin 500 ko μL ko a gaban wani cutar rashin lafiya kan cutar AIDS . A shekara ta 2016, shafukan da aka tsara sun amince da ART a duk marasa lafiya marasa lafiya na HIV, ba tare da la'akari da yawan CD4 ba, wuri, samun kudin shiga, ko mataki na cutar.
A yau, ana amfani da ƙididdigar CD4 don hango hasashen cututtukan cututtuka kamar yadda za a auna girman dangin mutum. Misali, CD4 nadir (mafi ƙasƙanci wanda aka ƙididdige CD4) yana da tsinkaye na rashin kwanciyar hankali na dindindin, tare da ƙananan dabi'un da ke nuna yiwuwar ƙwayar cutar HIV da cututtukan HIV ba tare da HIV ba. mai saurin kwakwalwa.
Mene ne Gidajen Damarar Dabba?
Yayinda lambar CD4 ta nuna alamar rashin daidaito da kuma maganin kulawa, ingancin kyakyaran cuta yana da shakka cewa mafi mahimmanci lokacin da maganin antiretroviral ya fara.
Magungunan kyamarar kwayar cutar yana daukar nauyin kwayar cuta a cikin jini, wanda aka fi sani da "nauyin hoto". Labs zai yi amfani da fasahar gwajin kwayoyin-yawanci, maganin maganin polymerase (PCR) ko bDNA (DNA mai haɗawa) - don ƙididdige yawan adadin kwayoyin cutar a cikin milliliter (mL) na jini. Kwayoyin maganin cutar ta HIV za su iya kasancewa daga abin da ba a sani ba (a ƙasa da matakan ganowa na gwaji na yanzu) zuwa dubban miliyoyin.
Wani sakamako wanda ba a iya ganowa ba yana nufin babu kwayar cuta a cikin jininka ko kuma an "yarda" daga kamuwa da cuta. (A gaskiya, kasa da kashi 5 cikin dari na kwayar cutar HIV a cikin jiki za'a iya samuwa a cikin jinin.) Babu shakka yana nufin cewa yawan kwayar cutar ya auku a kasa da ƙwayar gwaji a cikin jini amma ana iya ganowa a wasu wurare, kamar su maniyyi.
Makasudin Ruwayar Bidiyo
Manufar cutar maganin rigakafi shine a rufe dukkan ayyukan aikin kyamara a cikin matakan da ba a iya gani ba, wanda, a gefe guda, yana hade da
- mafi yawan karuwar magani
- ƙananan haɗari ga ci gaba da cutar maganin miyagun ƙwayoyi
- mafi mahimmancin magungunan asibiti da ke haɓakawa ga ƙwarewar rayuwa,
- da rage yawan kwayar cutar ta HIV zuwa wani abokin tarayya marar lafiya (wata hanyar da aka fi sani da magani a matsayin rigakafi (TasP) .
A gefe guda kuma, karuwa a cikin nauyin hoto na sauri zai iya zama alamar rashin nasarar maganin , maganin miyagun ƙwayoyi, ko duka biyu.
Yana da mahimmanci a lura cewa maganin maganin miyagun ƙwayoyi akalla 95% ana buƙatar don tabbatar da maganin cututtukan hoto zuwa matakan da ba a iya ganewa ba.
Rashin amincewa ba kawai rage ikon mutum na cimma wannan ba, yana kara rashin yiwuwar rashin lafiya ta hanyar barin ciwon maganin ƙwayar cuta don bunkasa. Wannan dangantaka mai tasiri shine dalili da ya kamata a duba adda'a kafin a sauya farfadowa.
Wannan ya ce, rikice-rikice na rikice-rikice na hoto (ko "blips") na iya faruwa ko da a tsakanin waɗanda suke tare da 100% haɗuwa. Wadannan yawanci kadan ne kuma bazai zama dalilin ƙararrawa ba.
Kulawa akai-akai game da adadin CD4 da nauyin hoto na bidiyo ne, yawanci kowane watanni uku zuwa shida bayan haka za'a iya duba CD4 kowane watanni 6 ko 12 idan tsakanin 350 da 500 sel / μL. Ana iya gwada marasa lafiya da za su iya ɗaukar CD4 fiye da 500 Kwayoyin / μL lokaci-lokaci kamar yadda aka umurce su ta hanyar magance likita.
Amfanin Kwayar maganin cututtuka
Bisa ga bincike daga Birtaniya (Collaborative Cohort Studies) (UK CHIC), mutanen da ke dauke da kwayoyin cutar ta kwayoyin cutar da ke dauke da CD4 na 350 kwayoyin halitta / μL ko fiye a cikin shekara na farawa farfadowa na iya samun yanayin rayuwa ta al'ada.
A gefen kwalliya, rashin cin nasara ta maganin cututtukan cututtukan cututtuka ya rage yawan rai ta tsawon shekaru 11 - daidai da shan sigari 40 a kowace rana.
Wani bincike mai zurfi da aka gudanar a shekara ta 2013 da Jami'ar Montreal ta kammala ya kammala cewa mutane da ke da "watanni shida da ke kusa da kwayoyin cutar" ba su da wata mahimmanci (watau 50 zuwa 199 kofe / ML) kusan kusan 400% a cikin shekara fiye da waɗanda suka iya cimma cikakken maganin hoto ko bidiyo mai zagaya yanar gizo da sauri.
Binciken, wanda ya kula da mutane 1,357 masu cutar HIV daga shekarar 1999 zuwa 2011, ya kara nuna cewa akwai kashi 60 cikin 100 na mutane da ke dauke da kwayoyin cutar tazarar 500 zuwa 999 kofe / mL.
Sources:
Ma'aikatar Lafiya ta Amurka da Ayyukan Dan Adam (DHHS). "Sharuɗɗa don Amfani da Ma'aikata marasa lafiya a HIV-Infected Adults and Adolescents." AIDS Update Update. Rockland, MD; Fabrairu 12, 2013: C9-C21.
Mayu, M .; Gompels, M .; da Sabin. C. "Tsarin rai na mutane HIV-1-positive sun fuskanci yanayin da ya dace a kan maganin maganin cutar antiretroviral: Birtaniya ta haɗin Gwiwar Kwalejin HIV." Jaridar Cibiyar AIDS ta Duniya. Nuwamba 11, 2012; 15 (4): 18078.
Baligh, Y. Fleishman, J. Metlay, J. et al. "Ci gaba da maganin cututtuka na kwayar cutar HIV a cikin marasa lafiya da ke fama da kwayar cutar HIV. Littafin Labarai na Ƙungiyar lafiya ta Amirka. Yuli 25, 2012; 308 (4): 339-342.
Laprise, C. de Pokomandy, A .; Baril, J. et al. "Harkokin maganganu na yau da kullum da ke ci gaba da ci gaba da ci gaba da kasancewa a cikin wani ɓangare na marasa lafiya HIV-positive: sakamako daga shekaru 12 na kallo." Cututtuka na cututtuka na asibiti. Nuwamba 2013; 57 (10): 1489-96.
Ƙungiyar Nazarin Binciken Farawa. "Gaddamar da Ingantaccen Harkokin Kwayoyin cuta a Early Early Childhood Infection." New England Journal of Medicine. Yuli 20, 2015; DOI: 10.1056 / NEJMoa1506816.