Kubwezeretsedwa kwa Mthupi Kumasintha kuchokera kwa Munthu kupita kwa Munthu
CD4 count imatanthauzidwa, mophweka chabe, monga njira zomwe zingayesere mphamvu ya chitetezo cha mthupi cha munthu yemwe ali ndi HIV. Ndiyeso yogwiritsira ntchito poyang'ana momwe chiopsezo cha kachilombo ka HIV kakuyendera komanso kufotokozera zotsatira za matendawa.
Kumvetsetsa CD4 Count
Zina mwa zigawo zomwe zimayambitsa chitetezo cha mthupi ndi maselo apadera a magazi oyera omwe amadziwika ngati CD4 T-maselo , omwe cholinga chake chachikulu ndikumvetsera tcheru pamene tizilombo toyambitsa matenda monga HIV alipo.
Zodabwitsa, ndizo maselo omwewo omwe amayang'aniridwa ndi kachirombo ka HIV. Pakapita nthawi, ngati sichikutsatiridwa, kachilombo ka HIV kachepetsere maselowa, ndipo chitetezo cha mthupi chikhoza kukhala chopanda khungu ndipo pang'onopang'ono sungathe kudziteteza.
CD4 chiwerengero chikhoza kuyenda paliponse kuchokera pa zomwe zingaganizidwe kukhala zachilendo kwa munthu wosatetezeka (800-1500 maselo / mL) kumene malo a chitetezo cha munthu amaonedwa kuti akusokonezeka (pansi pa maselo 200 / mL). Pamene nambala ikugwa mpaka pansi pa maselo 100 / mL, chiwopsezo cha matenda akuluakulu opatsirana chimakula kwambiri.
Chimodzi mwa zolinga za mankhwala ochepetsa kachilombo ka HIV (ART) ndi kubwezeretsa mphamvu ya chitetezo cha mthupi mwa munthu amene ali ndi HIV. Poletsa kuteteza kachilombo ka HIV kuti kasatengeke, ART imathandiza thupi kupitiriza kuchira, kubwezeretsa kachilombo ka CD4, mpaka kumayendedwe abwino.
Koma, zoona ndizakuti, izi sizichitika nthawi zonse.
Nthawi zina, kulephera kubwezeretsanso chitetezo cha mthupi ndi zotsatira zowonongeka kwa mankhwala osokoneza bongo, kuphatikizapo kulephera kugwiritsira ntchito mankhwala osokoneza bongo.
Ngati ntchito ya mavalasi imaloledwa kupitiriza ndipo kachilombo ka HIV sichitha kuoneka, ma CD4 akhoza kupitirizabe kuthetsedwa, kuchepetsa zolinga za mankhwala.
Koma nanga bwanji ngati munthu akutsatira mokwanira ndipo sangathe kuwerengera CD4 yawo? Kodi izi zikutanthauza kuti mankhwalawa sakugwira ntchito? Kodi izi zikusonyeza kuti mankhwala ayenera kusinthidwa?
Nthawi zambiri osati, yankho ndilo ayi.
Zolepheretsa kubwezeretsedwa kwa CD4 T-cell
Chotsatira, cholinga cha ART ndichochotsa mavairasi-kuchepetsa chiwerengero cha tizilombo komwe kulibe kachilombo koyambitsa magazi. Izi ndizochindunji za mankhwala ndi chinthu chomwe chimapezeka mwa anthu omwe amatsatira chithandizo.
Mosiyana, kubwezeretsa T-cell ndizo zotsatira zowonjezera ma ARV kusiyana ndi ART yokha. Mankhwalawa alibe mankhwala enieni pa CD4 count koma kuchotsa mavairasi omwe akupha T-cells. Izi zikutanthauza kuti kuchira kumatha kusiyana kwambiri kuchokera kwa munthu ndi munthu, pomwe ena amatha kubwerera mwamsanga komanso mokwanira, pamene ena amatha kukhazikika m'magulu otsika kwambiri pa nthawi yayitali.
Chinthu chimodzi chomwe chimayambitsa zotsatirazi ndi CD4 nadir . Nthendayo ndi chabe yomwe mtengo wa CD4 umatsikapo asanayambe kuchitapo kanthu. CD4 nadir sichikutha kulosera kuti matenda ena amatha, monga matenda a ubongo okhudzana ndi kachilombo ka HIV , nthawi zambiri amatha kufotokoza kuti mphamvu ya munthu imatha kupulumuka patatha mankhwala.
Kawirikawiri, anthu omwe ali ndi CD4 nadir otsika kwambiri (pansi pa maselo 100 / mL) adzakhala ndi nthawi yovuta kwambiri kubwezeretsa chitetezo cha mthupi kusiyana ndi munthu yemwe ali ndi, kunena kuti, kuteteza thupi kuteteza thupi (pafupifupi 350 maselo / mL).
Ndi chifukwa chake ART ikulimbikitsidwa panthawi yomwe anthu onse omwe ali ndi kachilombo ka HIV amapezeka. Poyamba chithandizo cham'mbuyomu osati kale, mwayi wodzala ndi chitetezo cha mthupi ndi wabwino kwambiri, monga mwayi wokhala ndi moyo wathanzi, wokhala ndi moyo wathanzi .
Kutaya kwa HIV ndi T-cell
Panthawi yomwe CD4 yatsikira m'munsi mwa maselo 100 / mL, chitetezo cha mthupi chidzadziwika kwa zaka zambiri ngakhale zaka zambiri zowonongeka, pokhudzana ndi kutupa kosalekeza komwe kunayambitsidwa ndi kachilombo ka HIV komanso kuvulazidwa kwapadera kwa maselo ndi maselo ndi kachilombo.
Panthawiyi kuti zotsatira zotchedwa T-cell zikhoza kuchitika.
Kutha kwa maselo a T ndi chimodzi mwa zotsatira za matenda aakulu kapena aatali, omwe mawonekedwe ndi ma coding a maselo amasinthidwa pa maselo a maselo. Patapita nthawi, ma T-cells amatha kuteteza komanso kuchepetsa matenda.
Ngakhale kutaya kwa T-cell kwabwera makamaka ndi CD8 T-maselo-omwe amatengedwa ndi "maselo" maselo ku maselo a "CD" a CD4-ife tsopano tikudziwa kuti ma CD4 T-maselo angasokonezedwe.
Kodi Ndingatani Kuti Ndilimbitse Ma CD4 Wanga?
Zifukwa za kubwezeretsa chitetezo cha mthupi mwa anthu omwe ali ndi kachilombo ka HIV ndizochuluka. Palibe njira imodzi yomwe ingatengere ena kupatula kukhalabe ogwirizana ndi ART komanso kusunga zowonongeka.
Palibe mankhwala kapena othandizira (kuphatikizapo zakudya zopatsa thanzi , mankhwala onse, mavitamini, kapena otchedwa "boosters" omwe amachititsa kuti CD4 T-cell reconstitution). Ngakhale zili choncho, palibe phunziro limene lagwiritsira ntchito mankhwalawa pakamwa kapena poyambitsa jekeseni.
Ndizinenedwa kuti, zosankha zabwino zokhudzana ndi moyo zingakhale ndi zofunikira pa zotsatira za thanzi la munthu, kaya ali ndi kachilombo ka HIV kapena ayi. Zochita zoyenera, kudya zakudya zabwino, kusuta fodya, ndi kuchepetsa kumwa mowa kumapereka chakudya cholimba kwa anthu omwe ali ndi kachilombo ka HIV, ngakhale kachilombo ka CD4 kaye kamakhala kochepa kwambiri.
Ngati mukugwirizana ndi mankhwalawa ndipo muli ndi chiwerengero chowopsa cha vutolo-ngakhale chotsatira, chochitika chochepa-funsani dokotala wanu. Zingasonyeze kuti mukukulitsa kukana mankhwala osokoneza bongo . Zikatero, mankhwala angafunikire kusinthidwa.
Komabe, anthu omwe ali ndi kachilombo koyambitsa matendawa komanso ma CD4 omwe amatha kusinthasintha sayenera kusintha ART pogwiritsa ntchito malingaliro akuti idzakweza zotsatira za CD4. Kusintha kumachitika pokhapokha ngati mankhwala akulephera kapena chifukwa cha zotsatira zovulaza.
Kodi Kawirikawiri Ndiyenera Kuwunika Bwanji CD4 Wanga?
Zotsatira zamakono zikusonyeza kuti ziwerengero za CD4 ziyenera kuyang'aniridwa molingana ndi momwe munthu angathe kukhalira ndikusunga chiwerengero cha vutolo chosadziwika, motere:
- Kwa anthu omwe angoyamba kumene kupeza, kuyezetsa CD4 kuyenera kuchitidwa musanayambe ART, kubwereza patapita miyezi itatu chitangidwe, ndipo patatha miyezi 3-6 iliyonse.
- Kwa omwe akhala pa ART kwa zaka zosachepera ziwiri ndipo atakhala ndi mavairasi osadziwika, amayesedwa mobwerezabwereza miyezi 12 kwa iwo omwe ali ndi CD4 pakati pa maselo 300 ndi 500 / ml. Kwa iwo omwe ali ndi CD4 amawerengera maselo oposa 500 / mL, kuyang'anira CD4 kuyenera kuonedwa kuti ndi kotheka.
Zotsatira:
Crawford, C .; Angelosanto, J ;; Kao, C .; et al. "Mayi ndi Matenda a Transcriptal a CD4 + T Cell Dysfunction pa Chronic Infection." Chitetezo chokwanira. February 20, 2014; 40 (2): 289-302.
Negredo, E ;; Massanella, M ;; Nkhumba, J .; et al. "CD4 T Cell Count monga Predictor ndi High CD4 T Cell Intrinsic Apoptosis monga Njira Yotsiriza ya Osauka CD4 T Cell Recovery Mu Virologically Ochepetsa HIV Odwala: Odwala Matenda." Matenda opatsirana pogonana. 2010; 50 (9): 1300-1308.
Dipatimenti ya Zaumoyo ya Umoyo ku United States (DHHS). " Malangizo othandizira kugwiritsira ntchito ma antiretroviral mu HIV-1-Akuluakulu Okhudzidwa ndi Achinyamata." Bethesda, Maryland.