Sharuɗɗa Bayyana shawarar CD4 Kulawa na iya kasancewa mai kyau
Tare da ƙara ƙarfin maganin maganin rigakafin zamani (ART) , ba za a ƙara yin amfani da amfani da CD4 ba a matsayin ma'auni na nasarar nasarar ART. Bisa ga umarnin da Ma'aikatar Kiwon Lafiya ta Amurka da Harkokin Kasuwancin (DHHS) ta bayar akan ranar 1 ga Mayu, 2014, ana amfani da nauyin hoto na hoto na musamman don ƙayyade wannan.
Duk da yake wannan yana iya zama wani sauyi mai sauƙi ga wasu, ya yarda da muhimman abubuwa biyu:
- Wannan amsawar immunological mai haƙuri a kan ART (kamar yadda aka auna ta CD4) zai iya zama mai saurin gaske har ma a fuskar fushin maganin hoto.
- Wannan saka idanu na CD4 baya taimakawa wajen yadda ake gudanar da ART a marasa lafiya a farfadowa.
Kafin gabatar da sababbin sababbin tsararru , ba sabawa wasu likitoci su canza ART ba bisa ga rashin lafiyar mai haƙuri don cimma nasarar sake sake sakewa. Wannan yakan haifar da dakushewar farfadowa, sau da yawa duk da ci gaba da kula da kwayar cutar (kamar yadda ma'aunin hoto ya ɗauka) da kuma shekaru da yawa kafin a kira duk waɗannan canje-canje.
Lokacin da aka ba da jagorancin jagorancin, DHHS ya kammala cewa "rashin maganin CD4 mai rashin lafiya a cikin mai haƙuri wanda ke dauke da maganin cututtuka ba shi da wata alama ga gyaran tsarin mulkin (antiretroviral)." Har ila yau ya yarda da cewa iyawar mayar da martani ga rashin lafiya na marasa lafiya sau da yawa yana da damuwa da dalilai da ke ba da damar yin amfani da kwayoyi-ciki har da ƙididdigar CD4 a ƙarshen farfadowa, tsofaffi ko tarihin cutar ta HIV.
A cikin marasa lafiya tare da waɗannan batutuwa, musanya ART wanda ya dogara da ƙididdigar CD4 zai iya yin ƙari fiye da nagarta, ƙara haɗarin maganin miyagun ƙwayoyi ta hanyar canja tsarin ko dai a farkon ko akai-akai.
Yanayin CD4 Counting Monitoring
Bisa ga DHHS, ana amfani da ƙididdigar CD4 mai haƙuri ga ɗaya daga cikin manufofi uku:
- Don taimakawa wajen sanin lokacin da za a fara hotunan ART a cikin kwayar cutar HIV
- Don tsara lokacin da za a fara ko dakatar da farfadowa na prophylactic don ya fi dacewa da ci gaba da kamuwa da ƙwaƙwalwar kamfani (OIs)
- Don bincika ko amsawar immunological mai haƙuri a kan ART ya ishe (an ƙaddamar da karuwar CD4 da kwayoyin 50-150 a cikin shekara ta farko na farfadowa, tare da haɓaka irin wannan a kowace shekara har sai an sami ci gaba a ƙasa)
Ga sababbin marasa lafiya da aka kamu da su a kan ART, ana gwada gwajin CD4 a lokacin shiga cikin kulawa sannan kuma kowace 3-6 watanni.
Ga marasa lafiya wanda aka nuna ART, ana gwada gwajin CD4 watanni uku bayan farawar farfadowa sannan kuma kowane watanni 3-6 bayan haka.
A ƙarshe, ga marasa lafiya da suka kasance a kan ART don akalla shekaru biyu kuma sun ci gaba da ɗaukar nauyin kayan kyamarar cutar bidiyo, an bada shawarar cewa
- An saka idanu CD4 a kowane watanni 12 ga wadanda ke da CD4 lambobi tsakanin 300 da 500 Kwayoyin / ML, kuma;
- Kulawa CD4 yana la'akari da zaɓi na waɗanda ke da ƙididdigar CD4 akan 500 Kwayoyin / ML.
Bugu da ƙari, kula da CD4 ya kamata ya sake ci gaba da marasa lafiya tare da ko dai an sake dawo da su; wani rashin lafiya mai haɗarin HIV; ko duk wani yanayin ko farfadowa wanda zai iya rage yawan CD4 na mutum.
Kulawa da sauran ragowar lymphocyte (misali, CD8, CD19) ba'a bada shawarar tun lokacin gwaje-gwajen duka suna da tsada kuma ba a bada darajar asibiti.
Yanayin karbar kyamarar bidiyo
Ga marasa lafiya wanda aka kamu da kwayar cutar ta HIV, dole ne a gudanar da jarrabawar hoto na hoto a yayin shigarwa. Idan an yi tsammani cewa za a iya jinkirta ART, za a iya gwada gwajin sakewa a wasu lokuta.
Ga marasa lafiya wanda aka nuna ART, ana bukatar yin gwajin maganin hoto da sauri kafin farawar farfadowa (don samar da ma'auni don auna lissafin maganin). Ya kamata a sake maimaita makonni 2 zuwa hudu bayan kafawar ART kuma kowane mako 4 zuwa 8 bayan haka har sai an kawar da nauyin hoto.
Ga marasa lafiya wadanda aka samu nauyin hoto mai ban tsoro, an sake gwada gwajin kowane watanni 3 zuwa 4. Idan an ci gaba da maganin cututtukan hoto a kalla shekaru biyu, za a iya gwada gwaji a kowane watanni shida.
Sources:
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.