Saukewa daga cikin Mutum zuwa Mutum
An ƙididdige ƙididdiga CD4 , mafi mahimmanci, a matsayin hanyar da za ta auna ƙarfin tsarin tsarin rigakafi na mutumin da ke zaune tare da kwayar cutar HIV. Yana da gwaji da aka yi amfani dashi duka don saka idanu kan cigaba da kamuwa da kwayar cutar ta HIV da kuma hango hangen nesa game da cutar.
Sanin CD4 Count
Daga cikin ɓangarorin maganin da ake yi na rigakafi shi ne ƙwayoyin jini mai tsabta wanda ake kira CD4 T-cell , wanda babban manufar shine a sauti jijjiga lokacin da cututtukan cututtukan cututtuka irin su HIV suke.
Abin ba shakka, su ma sune kwayoyin halitta guda ɗaya wadanda aka yi niyya don kamuwa da cutar ta HIV. Yawan lokaci, idan aka bar shi ba tare da an hana shi ba, HIV zai sassaukar da waɗannan kwayoyin, yana barin tsarin rigakafi da makanta kuma baza su iya kare kanta ba.
Kwanan CD4 yana iya zuwa ko'ina daga abin da za a yi la'akari da al'ada a cikin mutumin da ba a cutar ba (800-1500 Kwayoyin / ML) zuwa inda aka dauke da kwayar cutar ta mutum (a cikin 200 kwayoyin / mL). Yayin da lamarin ya sauko har zuwa ƙananan kwayoyin halitta 100 / mL, haɗarin babban kamuwa da hankulan haɓaka yana ƙara yawan haɓaka.
Ɗaya daga cikin burin maganin maganin rigakafi (ART) shine a mayar da karfi mai karfi na mutum mai cutar HIV. Ta hanyar hana cutar daga sake yin amfani da ita, ART tana taimaka wa jikin ya sake farfado da kansa, ya sake dawo da yawan mutanen CD4, daidai da matakan al'ada.
Amma, gaskiyar ita ce, wannan ba koyaushe ke faruwa ba.
A wasu lokuta, gazawar sake sake yin aiki na rigakafi shine sakamakon kai tsaye na maganin miyagun ƙwayoyi na ƙasa, ciki har da jituwa da / ko kuskure ba daidai ba.
Idan an yarda da aikin bidiyo mai hoto sai ya ci gaba da kamuwa da kwayar cutar HIV ba cikakke ba, watau CD4 za su iya ci gaba da ɓarna, ƙaddamar da manufofin farfadowa.
Amma idan idan mutum ya cika kuma har yanzu ba zai iya samun CD4 ba? Shin yana nufin magunguna ba su aiki ba? Shin wannan nuni ne cewa za a canza magani?
Sau da yawa ba haka ba, amsar ita ce a'a.
Dama ga CD4 T-cell farfadowa da na'ura
Ƙarshe, manufar ART ita ce ta kawar da aikin hoto na hoto-don rage nau'in hoto na kyamara inda babu cutar da aka gano a cikin jini. Wannan shi ne aikin kai tsaye na miyagun ƙwayoyi da kuma wani abu da zai iya cimmawa a cikin mutanen da ke bin hanyar maganin.
Ya bambanta, sakewa na T-cell yana da ƙarin tasirin maganin cututtukan hoto fiye da na ART kanta. Magunguna ba su da wani mataki na kai tsaye a kan CD4 ƙaya ba don cire ƙwayoyin ƙwayoyin da suke kashe tumakin T. Wannan yana nufin cewa farfadowa zai iya bambanta da yawa daga mutum zuwa mutum, tare da sake dawowa da sauri da kuma cikakke, yayin da wasu ke daidaita a matakan da ke ƙasa a kan dogon lokaci.
Ɗaya daga cikin firamare na haifar da wannan sakamako shine CD4 nadir . Nadir kawai shine mafi ƙasƙanci mafi mahimmanci cewa ƙididdigar CD4 ya bar kafin a yi aiki. CDad nadir ba wai kawai iya hango kan yiwuwar wasu cututtuka, irin su cutar kwakwalwar cutar ta HIV , yana iya ganin hangen nesa da lafiyar mutum bayan ya fara farawa.
Kullum magana, mutane da ƙananan CD4 nadir (ƙarƙashin 100 kwayoyin / ML) zasu sami wani lokaci mafi wuyar sake dawo da aikin aiki fiye da mutum wanda yana da, ya ce, ƙaƙƙarfar maye gurbin (fiye da 350 Kwayoyin / ML).
Dalilin da ya sa aka tsara ART yanzu a lokacin ganewar asali ga dukan mutanen da ke dauke da kwayar cutar HIV. Ta hanyar farawa magani a baya fiye da daga baya, damar samun cikakkiyar farfadowa na rigakafi ya fi kyau, kamar yadda zai yiwu a cimma daidaito na rayuwa mai kyau .
Rigar cutar HIV da T-cell
A lokacin da adadin CD4 ya sauke zuwa kasa 100 kwayoyin / mL, tsarin rigakafi zai kasance yana nunawa shekaru kuma har ma shekarun da suka faru na lalacewa, dukansu biyu game da ƙin ciwon da ke ci gaba da cutar ta HIV da kuma ciwon kai tsaye na kyallen takalma da sel da cutar kanta.
Yana da a wannan lokacin cewa wani tasirin da ake kira T-cell extinction zai iya faruwa.
Rashin ƙarancin t-kwayoyin halitta shine daya daga cikin sakamakon cutar mai tsanani ko kwanciyar lokaci, inda tsarin da tsarin kwayoyin halitta ke canzawa a matakin kwayoyin. Fiye da lokaci, ƙwayoyin T suna rasa ikon su na aiki da kuma hana ci gaba da cutar.
Yayinda ƙwayar T-cell ya kasance da dangantaka da CD-T-CD-Tuni - killan "killer" a CD4 na "mataimaki" na CD4-yanzu mun san cewa CD4 T-cell din za'a iya rinjaye shi.
Me zan iya yi don inganta katin CD4 na?
Abubuwan da ake bukata don gyara aikin rigakafi ga mutanen da ke dauke da kwayar cutar HIV suna da yawa kuma sun bambanta. Babu wata hanya guda daya da za ta iya ɗaukar wani abu sai dai don kasancewa da ART kuma don ɗaukar nauyin kayan kyamarar marasa lafiya.
Babu mahadi ko jamiái (ciki har da abubuwan da ake gina jiki , da magunguna, da bitamin, ko abin da ake kira "immune boosters") wanda ke da tasiri a kan CD-T-cell reconstitution. Duk da shawarwari zuwa ga in ba haka ba, babu wani binciken da ya shafi kowane irin maganganun ko maƙasudin ginin don ingantawa cikin ƙididdigar CD4.
Da wannan aka ce, zaɓin salon salon rayuwa mai kyau zai iya zama muhimmi a kan sakamakon lafiyar mutum, ko cutar HIV ko a'a. Daidaitawa mai kyau, cin abinci mai kyau, shan taba, da ragewa cikin shan barasa duk yana bada karfi ga mutanen da ke dauke da kwayar cutar HIV, kodayake yawan CD4 na mutum ya kwashe sosai a ƙasa da matakan al'ada.
Idan kun kasance cikin maganin farfadowa kuma suna da nauyin hoto mai nauyin hoto-har ma da ci gaba, aiki mara kyau-magana da likitanku. Yana iya bayar da shawarar cewa kana bunkasa ƙwayar maganin HIV . A irin waɗannan lokuta, magani yana iya buƙata a canza.
Duk da haka, mutanen da ke dauke da kwayar cuta da ƙin ƙwayar CD4 kada su canza ART dangane da zaton cewa zai inganta sakamakon CD4. Canji ya kamata a yi kawai a yayin rashin nasarar rashin lafiya ko kuma sakamakon sakamakon rashin lafiya.
Yaya Sau Nawa Ya Kamata In Kula Da Kayan CD4 Na?
Sharuɗɗa na yau da kullum sunyi la'akari da ƙididdigar CD4 bisa ga iyawar mutum don cimmawa da kuma adana wani nau'in hoto na kyamararru, kamar haka:
- Ga sababbin mutanen da aka kamu da cutar, dole ne a yi gwajin CD4 kafin fara ART, sake maimaita watanni uku bayan farawar farfadowa, sa'an nan kuma kowane watanni 3-6 bayan haka.
- Ga wadanda suka kasance a kan ART don akalla shekaru biyu kuma sun ci gaba, nauyin kwayoyin cutar bidiyo ba za a iya maimaita su ba a kowane watanni 12 ga wadanda ke da CD4 suna da ƙira tsakanin 300 da 500 Kwayoyin / ML. Ga wadanda suke tare da CD4 suna ƙidayar fiye da 500 / ML, saka idanu CD4 ya kamata a yi la'akari da zaɓi.
Sources:
Crawford, C .; Angelosanto, J. Kao, C .; et al. "Tsarin kwayoyin halitta da rubutu na CD4 + T Cell Dysfunction a lokacin Chronic Infection." Immunity. Fabrairu 20, 2014; 40 (2): 289-302.
Negredo, E; Massanella, M .; Puig, J. et al. "Nadir CD4 T Cell ƙwararru kamar Predictor da kuma CD4 T CD na T Cell Intrinsic Apoptosis a matsayin Final Mechanism na Matalauta CD4 T Cell farfadowa a Virologically magance cutar HIV-Infected marasa lafiya: Abubuwa na Clinical." Cututtuka na cututtuka na asibiti. 2010; 50 (9): 1300-1308.
Ma'aikatar Lafiya ta Amurka da Ayyukan Dan Adam (DHHS). " Sharuɗɗa don Amfani da Ma'aikata marasa lafiya a HIV-1-Infected Adults and Adolescents." Bethesda, Maryland.