Kugadziriswa kweMusana Kunoshandiswa kubva kune Munhu kuenda kune Munhu
Iko CD4 count inotsanangurwa, yakawanda kwazvo, senzira yekuyera nayo simba rekudzivirirwa kwezvirwere zvemuviri wemunhu anogara neHIV. Icho chiyero chinoshandiswa zvose kutarisa kufambira mberi kwehutachiona hweHIV uye kufanotaura zvingangoitika (kufungidzira) kwechirwere.
Kunzwisisa CD4 Count
Pakati pezvikamu zvehutachiona hwemasimba ezvirwere zvinonzi masero machena eropa anozivikanwa seCD4 T-cells , ane chinangwa chikuru ndechokuti tive nekuchenjerera apo zvirwere zvinokonzera zvirwere seHIV zviripo.
Zvinotoshamisa ndezvokuti, iwo masero mamwechete anotarirwa nehutachiona hweHIV. Nokufamba kwenguva, kana isina kutenderwa, HIV inopedza zvishoma nezvishoma masero aya, ichiita kuti maitiro ezvirwere mumuviri aporese mapofu uye zvishoma nezvishoma haakwanise kuzvidzivirira.
Iko CD4 count inogona kuenda chero kupi zvayo kubva kune izvo zvingaonekwa sezvakanaka kune munhu asina kutaridzika (800-1500 masero / mL) kune iyo masimba evanhu anonzi anofungidzirwa (pasi pe200 cells / mL). Sezvo nhamba yacho inodonha kunyange kusvika pasi pe100 masero / mL, njodzi yehutachiona hunokanganisa inowedzera zvishoma nezvishoma.
Chimwe chezvinangwa zve antiretroviral therapy (ART) ndeyekudzorera simba rekudzivirira zvirwere zvemuviri kune munhu ane HIV. Nokudzivirira hutachiona kuti usanyatsogadzirisa, ART inobatsira muviri kuwedzera kupora, kugadzirisa huwandu hweCD4, zvichienderana nemaitiro akaenzana.
Asi, chokwadi ndechokuti, izvozvo hazviiti nguva dzose.
Mune zvimwe zviitiko, kusakwanisa kudzorerazve maitiro ekudzivirira muviri kunokonzera zvakananga zvekudzivirira kwechirwere chemishonga, kusanganisira kusanzwisisana uye / kana kusina kukodzera.
Kana hutachiona huchibvumirwa kuramba huchienda uye hutachiona hweHIV huri husingaoneki, maCD4 anokwanisa kuramba achipera, achideredza zvinangwa zverapi.
Asi zvakadini kana munhu akanyatsotevedzera uye asingakwanisi kuwana CD4 count yake? Izvi zvinoreva kuti madhiragi haashandi here? Izvi zvinoratidza kuti kurapa kunofanira kuchinjwa here?
Kazhinji kakawanda kwete, mhinduro yacho kwete.
Zvipingamupinyi kuCD4 T-Cell Recovery
Pakupedzisira, chinangwa cheART ndechekudzivisa hutachiona hwekuita-kuderedza huwandu hwehutachiona uko kusina hutachiwana hunowanikwa muropa. Icho ndicho chiito chaiyo chechirwere uye chimwe chinhu chinowanzogonekika kune vanhu vanoramba vakagadzirira kurapwa.
Kusiyana neizvi, T-cell kudzorerwa ndiyo inokonzerwa nekuderedza hutachiwana pane yeART pachayo. Mishonga iyi haina maitiro akajeka pane imwe CD4 count kunze kwekubvisa mavairasi ari kuuraya T-seli. Izvozvo zvinoreva kuti kupora kunogona kusiyanisa kubva kumunhu kusvika kune mumwe munhu, pamwe nekugumburwa zvakare pakarepo uye zvizere, asi vamwe vanosimbiswa pamatunhu akadzika zvakanyanya kupfuura kwenguva refu.
Chimwe chinonyanya kukonzera izvi ndeche CD4 nadir . Itadir inongova iyo yakaderera pane iyo CD4 count inodonha vasati vapindira. Iko CD4 nadir haisi kungokwanisa kufanotaura kuti humwe hutano huripo, hwakadai sehutano hunokonzerwa nehutachiona hweHIV , hunogona nguva nenguva kufanotaura kubwinya kwemunhu kunorapwa kwekuzvidzivirira mushure mokunge chirwere chinotanga.
Kazhinji, vanhu vane CD4 nadir yakanyanya kwazvo (pasi pe100 masero / mL) vachave nenguva yakaoma zvikuru kudzorera maitiro ezvirwere kunze kwevanhu vane, vanoti, kunyatsodzivirira zvirwere (kupfuura 350 masero / mL).
Ndokusaka ART ikozvino yakakurudzirwa panguva yekuongororwa kwevanhu vose vane HIV. Nokutanga kurapwa pakutanga pane kupfuura gare gare, mukana wekudzivirirwa kwezvirwere zvekudzivirirwa kwezvirwere zvakanyanya kuvandudzwa, sezvinova mukana wekuwana hupenyu hunotarisirwa, hutariro hupenyu .
HIV neT-cell Kukanganiswa
Nenguva iyo CD4 count inodonha kusvika pasi pe100 masero / mL, maitiro ezvirongwa zvezvirwere zvezvirwere zvezvirwere achave akazarurirwa kwemakore uye kunyange makumi emakore ekukuvara, zvose maererano nekurwisana kunoramba kuchikonzerwa nehutachiona hweHIV uye kukuvadzwa zvakananga kwemasukisi nemasero nehutachiwana pachahwo.
Iko panguva ino kuti chiitiko chinonzi T-cell kupera kunogona kuitika.
T-masero ekupera simba ndeimwe yemigumisiro yakaoma kana yakareba yeutachiona, umo sarudzo chaiyo uye coding coding yemasero zvinoshandiswa pamatokisikiti. Nokufamba kwenguva, ma-T-cell anorasikirwa nehutano hwavo hwekuita nekudzivirira zvirwere zvishoma.
Kunyange zvazvo kupera kweT-cell kwave kuchibatanidzwa zvikuru neCD8 T-seli- inonzi "killer" masero kumasero e "helper" eCD4, isu zvino tinoziva kuti CD4 T-seli dzinogonawo kuchinjwa.
Ndingaitei Kuti Ndivandudze CD4 Yangu Count?
Zvikonzero zvekudzorerwa kwezvirwere zvevanhu muHIV zvakasiyana uye zvakasiyana. Hapana nzira imwe chete inogona kutora imwe kunze kwekuti irambe yakabatana neAIDS uye kuchengetedza zvisingaoneki zvehutachiona hwehutachiona.
Pane mishonga kana vamiririri (kusanganisira kuwedzerwa kwezvokudya , zvirongwa zvakakwana, mavhithamini, kana zvinonzi "immune boosters") zvine maitiro ekubatanidza CD4 T-cell reconstitution. Pasinei nemazano kune mamwe mazviri, hapana chidzidzo chakambotanidza chero yakadaro kana murwere injodzi yekuvandudza mune zvinyorwa zveCD4.
Nezvo izvo zvichitaurirwa, kusarudzwa kwehupenyu hwakanaka kunogona kuva nehukuru pamagumisiro ehutano hwemunhu, angave ane HIV kana kuti kwete. Kudzidzira kwakakodzera , kudya kwakanaka, kusvuta kusvuta, uye kuderedzwa kunwa doro kunopa vose kudzorera kwakasimba kune vanhu vane HIV, kunyange kana CD4 inotarisana nemunhu ari pasi pemazinga akaenzana.
Kana iwe uchibvuma kurapa uye uine utachiona hwepamusoro-kunyange huri kuramba huripo, basa rezasi-uchitaura nachiremba wako. Zvinogona kuratidza kuti urikudzivirira hutachiona hweHIV . Mumamiriro ezvinhu akadaro, kurapwa kungada kuchinjwa.
Zvisinei, vanhu vane hutachiwana hwakakwana uye huwandu hunokonzerwa neCD4 haufaniri kushandura ART zvichienderana nekufungidzira kuti ichavandudza zvikamu zveCD4. Shanduko inofanira kuitirwa chete kana chiitiko chekurapa kwechirwere kana sechikonzero chemigumisiro yakaipisisa.
Ndezvipi Zvakanyanya Kufanirwa Ndinoona CD4 Yangu Count?
Nhungamiro yemazuva ano inoratidza kuti nhamba dzeCD4 dzinofanira kuongororwa zvichienderana nekukwanisa kwomunhu kukwanisa uye kuchengetedza simba risingaoneki rehutachiwana, sezvinotevera:
- Kune vanhu vatsva vakaongororwa, kuongorora kweCD4 kunofanira kuitwa musati watanga ART, inodzokorora mwedzi mitatu mushure mekutanga kwerapi, uye mushure memwedzi mitatu nemasere gare gare.
- Kune avo vagara vari paAIDS kwemakore maviri uye vave vakachengetedza, vasingaoneki mavirusi emitoro, miedzo inofanira kudzokororwa kwemwedzi gumi nemaviri kune avo vane CD4 dzinoyera pakati pe 300 ne500 masero / mL. Kune avo vane CD4 dzinopfuura mazana mashanu emamiriyoni / mL, kuongorora CD4 kunofanirwa kuonekwa sekusarudzwa.
Sources:
Crawford, C .; Angelosanto, J .; Kao, C .; et al. "Molecular and Transcriptional Basis of CD4 + T Cell Dysfunction during Chronic Infection." Kusurukirwa. February 20, 2014; 40 (2): 289-302.
Negredo, E ;; Massanella, M .; Puig, J .; et al. "Nadir CD4 T Cell Count se Predictor uye High CD4 T Cell Intrinsic Apoptosis seMagariro ekupedzisira eChirwereka CD4 T Cell Recovery Mukurapa Kwechirwere Chirwere cheAIDS chakakonzerwa nehutachiona hweHIV: Clinical Implications." Clinical Infectious Diseases. 2010; 50 (9): 1300-1308.
Dhipatimendi reUnited Health (Health Services) uye Human Services (DHHS). " Mirayiridzo yeKushandiswa kweAntiretroviral Agents muHIV-1-Vakabatwa Vakuru Nevana Vari Kuyaruka." Bethesda, Maryland.