Kana hutachiona hweHIV hwave huripo, huongorori hunoitwa nguva dzose kuti uone hutachiona hwemunhu uye hutachiona hwemuviri mumuviri. Izvi zvinoratidzwa mune izvo zvinozivikanwa seCD4 count yako uye utachiona hwehutachiona .
Chii chinonzi CD4 Count?
Chirwere cheCD4 chimwe chezvidzidzo zvakajairika zvinowanikwa nevanhu vane HIV. Chiyero chinoyera huwandu hweCD4 mubatsiri T-masero muropa-masero ayo haasi chete anokosha pakuita zvirwere zvemuviri asi ndiyo inonyanya kukosha yehutachiona hweHIV.
Sezvo HIV iri zvishoma nezvishoma inoderedza masero aya, muviri unenge usingakwanise kudziviririra pachako kune huwandu hwakawedzera hwezvirwere zvinotarisana.
Chiyero chinoitwa nekutora sampu yeropa, zvinokonzerwa nechiyero chema CD4 masero mu microliter (μL) yeropa. Nhamba yekutanga yekutanga inosimbisa hutachiwana hwehutachiona hwako, asi kuongororwa kwekutevera kunonyatsotitaurira pamusoro
- chikwata chetachiona uye chiyero chekuwedzera kwezvirwere
- mukana wekuti humwe hutachiona hunokura sezvo CD4 masero apera
- kuti uri kupindura zvakadini kurapwa kana nekuchengetedza kana kuvakazve muviri wako
Kazhinji CD4 inowanikwa iri pakati pe500-1,500 masero / μL. Kusiyana neizvi, CD4 nhamba yemasero makumi maviri / μL kana zvishoma inonyatsorongedzerwa seAIDS . Kutsvakurudza kwakaratidza kuti kutanga chirwere ichi kana kuti pasi peyero ichi chinoratidzira kune zvinoratidzirwa zvekugadzirisa zvipatara uye kuderedzwa kwekutarisira hupenyu nemakore gumi nemashanu.
Makambani ekurapa mazano ekuronga akaratidza kuti antiretroviral therapy (ART) inotangwa kune varwere vane CD4 count pasi pe 500 masere / μL kana kuti pane zvirwere zvinorwara neAIDS . Muna 2016, mirayiridzo yakavandudzwa yakatsigira ART kune vose varwere vane HIV, pasinei neCD4 count, nzvimbo, mari, kana nzvimbo yezvirwere.
Nhasi, iyo CD4 count inoshandiswa kufanotaura chiitiko chechipatara zvakanyanya sekuenzanisa simba remuviri rekudzivirira muviri. Nenzira yekuenzanisira, CD4 nadir (iyo yakaderera kupfuura iyo iyo CD4 count inodonha) inofanirwa kupera kwekugara kwenguva refu, ine maitiro akaderera anoratidza kuwedzera kwehutachiwana hwehutachiona hweHIV uye husina hutachiona hweHIV, pamwe chete slower immune recovery.
Chii Chinonzi Viral Moroja?
Kunyange zvazvo CD4 chiverengero chiri chiratidzo chemuviri wekudzivirira muviri uye kuporesa kwehutano, hutachiona hwehutachiona hunenge hunokosha hunokosha apo antiretroviral therapy inotanga.
Utachiona hwehutachiona hunoyera hutachiona hwehutachiwana muropa, hunozivikanwawo se "viral load" yako. Mabazi aya achishandisa teknolojia yekuongorora maitiro-kazhinji, iyo polymerase chain reaction (PCR) kana bDNA (branched DNA) -kuenzanisa nhamba yemavhuthala mashoma mu milliliter (mL) yeropa. Utachiona hweHIV hune hutachiona hunogona kubva pane zvisingaoneki (pasi pekucherechedza mazinga emamiedzo ekuongororwa zvino) kumakumi emamiriyoni.
Chiitiko chisingaoneki hachirevi kuti hapana hutachiona muropa rako kana iwe "wakanatswa" wehutachiona. (Kutaura zvazviri, pasi pe5% yeHIV mumuviri inogona kuwanika muropa.) Isingaoneki zvinongoreva kuti huwandu hwehutachiwana hwawa pasi pekuedza kuongororwa muropa asi inogona kuonekwa kune imwe nzvimbo, semuviri.
Zvinangwa zveViral Suppression
Chinangwa che antiretroviral therapy ndechokudzivisa zvachose basa rehutachiona kuti zvionekwe zvisingaoneki, iyo, zvakare, inosanganiswa ne
- kunyanya kurapwa kwenguva refu
- njodzi yakaderera yekugadzirwa kwemishonga inopesana nemishonga
- zvirongwa zvekuchirapa zviri nani kuwirirana nekuwedzera hupenyu hwekutarisira,
- kuderedzwa kwehutachiwana hwehutachiwana hwehutachiwana hwehutachiona hwevasikana vasina hutachiona (nzira inonzi inonzi kurapwa sekudzivirira (TasP) .
Kune rumwe rutivi, kuwedzerwa kwehutachiona hwemavirusi kunogona kuva chiratidzo chekurapa kwekurapa , kutadza kushandiswa kwemishonga, kana zvose zviri zviviri.
Zvakakosha kuziva kuti kunyanya kushandiswa kwemishonga kwechikamu chinokwana 95% kunodiwa kuti zvirwere zvipfeko zvisingagoni kuonekwa.
Kuteerera kwakakwana hakungogadziri kukwanisa kukwanisa kuita izvi, kunowedzera mikana yekurapa kusakwanisa kuburikidza nekubvumira kusagadzikana kwehutachiona hwehutachiona kukura. Izvi zvinokonzera-hukama hwehukama ndicho chikonzero chekuteerera kunofanira kugara kuchiongororwa vasati vashandurwa.
Izvozvo zvakati, kuchinja kwehutachiona hwehutachiona (kana kuti "blips") kunogona kuitika kunyange pakati pevaya vane 100% kutevedzera. Izvi zvinowanzotadza uye hazvifaniri kuva chikonzero chemashoko.
Nguva dzose kuongororwa kweCD4 count uye hutachiona hwehutachiona hunokurudzirwa, kazhinji pamwedzi mitatu kusvika kumitanhatu iyo CD4 inogona kuongororwa mumwedzi 6 kana 12 kana iri pakati pe 350 ne500 masero / μL. Varwere vanogona kuchengetedza ma CD4 masero anopfuura 500 masero / μL anogona kuongororwa dzimwe nguva sekurairwa nekurapa chiremba.
Makomborero eViral Control
Maererano nekutsvakurudza kubva kuUk United Collaborative Cohort Yokudzidza (UK CHIC), vanhu vane maitiro asingagoni kuonekwa nehutachiwana avo vakawana CD4 count ye 350 cells / μL kana kupfuura mukati megore rokutanga kurapwa vangangodaro vaine mararamiro ehupenyu husingaperi.
Pamusoro peflip side, kusakwanisa kuwana hutachiona hwekuderedza kuderedza hutariro hwehupenyu nemakore gumi nemana-zvakafanana nekusvuta fodya 40 pazuva.
A retrospective analysis yakagadzirwa muna 2013 neYunivhesiti yeMontreal yakagumisa kuti vanhu vaiva ne "vasingaoneki" mishonga yehutachiona kwemwedzi mitanhatu (kureva, pakati pemakore 50 ne1999 / mL) vaiva nehuwandu hunopfuura 400% hwekukundikana kwe virologic mukati megore kupfuura avo vanogona kuwana hutachiona hwekuvhara.
Kudzidza, kwakarongedza 1 357 varume vane hutachiona hweHIV kubva muna 1999 kusvika muna 2011, zvakaratidza zvakare kuti virologic kusagadzika kweanenge inenge 60% muvanhu vane hutachiona hwehutachiwana hunosvika pakati pe500 ne999 makopi / mL.
Sources:
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