Ukubuyiswa kwe-Immune Recovery kuvela kwiMntu ukuya kuMntu
Inani le- CD4 lichazwe, ngokugqithiseleyo, njengendlela yokulinganisa amandla omzimba wokhuseleko lomntu ophila ne-HIV. Luvavanyo olusetyenziselwa kokubili ukubeka phambili ukunyuka kwe-HIV kunye nokuchaza kwangaphambili isiphumo (ukuhlaziya) kwesi sifo.
Ukuqonda i-CD4 Count
Phakathi kwamalungu omzimba wokuphendula omzimba ngamaseli egazi amhlophe awaziwa njenge CD4 T-cell , enenjongo enkulu ukuphulaphula isilumkiso xa izifo ezibangelwa zizifo ezinjenge-HIV zikhoyo.
Okumangalisa kukuba, nazo zifana neeseli ezifanayo ekujoliswe kuzo kwi-HIV. Ngethuba lexesha, ukuba ingashiywanga ingathotyelwa, i-HIV iya kuncipha iiseli ngokuthe ngcembe, ishiye i-immune system ngokuyimpumputhe kwaye ingakwazi ukuzikhusela.
Isibalo se-CD4 sinokuluhlu naluphi na okuya kuthathwa njengesiqhelo kumntu ongakhuselekanga (800-1500 iiseli / mL) apho i-system immune system ithathwa njengongcipheko (ngaphantsi kweeseli 200 / mL). Njengoko inani lehla liya phezulu ukuya ngaphantsi kweeseli ezili-100 / mL, ingozi yentsholongwane ebonakalayo inokunyuka ngokukhawuleza.
Enye yeenjongo zokwelapha i-antiretroviral (ART) kukubuyisela amandla omzimba omntu onesifo se-HIV. Ngokuthintela intsholongwane ukuba iphendule ngokunyanisekileyo, i-ART inceda umzimba uphakamise ukubuyisela kwakhona, ukubuyisela kwakhona inani labantu be-CD4, ngokufanelekileyo kumanqanaba aqhelekileyo.
Kodwa, inyaniso kukuba, akunjalo ngaso sonke isikhathi.
Kwezinye iimeko, ukungaphumeleli ukuvuselela umsebenzi wokuzivikela ngumzimba kubangelwa ukunyanzeliswa kweziyobisi, okubandakanya ukungena ngokungahambelani kunye / okanye ukungalunganga kwimizi.
Ukuba umsebenzi wentsholongwane uvunyelwe ukuqhubeka kwaye umthwalo wegciwane lesandulela ngculaza awubonakali ngokupheleleyo, iiseli ze-CD4 zingaqhubeka zichithwa, ziphazamise iinjongo zonyango.
Kodwa kuthekani ukuba umntu uhambelana ngokupheleleyo kwaye akakwazi ukufumana i-CD4 count? Ngaba oko kuthetha ukuba iziyobisi azisebenzi? Ngaba le nto ibonisa ukuba unyango kufuneka litshintshwe?
Ngokuphindaphindiweyo, impendulo ayikho.
Imiqobo kwi-CD4 T-Cell Recovery
Ekugqibeleni, injongo ye-ART kukukhusela umsebenzi wentsholongwane-ukunciphisa umthamo wentsholongwane kwimeko apho kungekho ntsho longwane ebonakalayo egazini. Oko kusebenza ngokuthe ngqo kwilisi kunye nento enokufezekiswa kubantu abahlala behambelana neyeza.
Ngokwahlukileyo, ukubuyiselwa kweT-cell kuyimpembelelo yokunciphisa i-viral kune-ART ngokwayo. Iziyobisi azikho inxaxheba ngqo kwi-CD4 count ngaphandle kokususa iintsholongwane ezibulala i-T-cell. Oko kuthetha ukuba ukuphulukana kunokungafani ngokugqithiseleyo kumntu ukuya kumntu, kunye nokunye ukukhawuleza ngokukhawuleza kwaye ngokugcwele, ngelixa ezinye zizinzile kumazinga aphantsi kakhulu kwixesha elide.
Esinye sezizathu ezibalulekileyo zezi mpawu yi- CD4 nadir . I-nadir yindlela ephantsi kakhulu ukuba inani le-CD4 liye lahla ngaphambi kokungenelela kwenziwa. I-CD4 nadir ayikwazi nje ukuchaza ubungqina bezifo ezithile, ezifana neengxaki zengqondo ezichaphazelekayo ne-HIV, ngokuthe ngangoko zikwazi ukuqikelela ukuqina komzimba womntu emva kokuba unyango luqala.
Ngokuqhelekileyo, abantu abane-CD4 nedir ephantsi kakhulu (ngaphantsi kweeseli ezili-100 / mL) baya kuba nexesha elinzima kakhulu ukubuyisela ukusebenza komzimba ngaphandle komntu onokuthi, ukunciphisa ukuxhatshazwa kwe-immune (ngaphezu kwama-cell cell / mL).
Yingakho i- ART iphakanyiswa ngoku ngexesha lokuxilongwa kubo bonke abantu abane-HIV. Ngokuqalisa unyango ngaphambi kwexesha elizayo, ithuba lokubuyiswa ngokukhuselana nokuzikhusela komzimba luphucuke kakhulu, njengokuba kunokwenzeka ukufikelela kwimeko eqhelekileyo yokuphila ubomi .
Ukuxinwa kwe-HIV kunye neT-cell
Ngethuba inani le-CD4 liye lahla ngaphantsi kweeseli ezili-100 / i-mL, isistim somzimba siya kuvezwa kwiminyaka kunye neminyaka emininzi yomonakalo, kokubili ngokubandezela okuqhubekayo okubangelwa usulelo lwe-HIV kunye nokulimala ngokuthe ngqo kwezicubu kunye neeseli yintsholongwane ngokwayo.
Kulo thuba ukuba i-effect ebizwa ngokuba yi- T-cell exhaustion ingenzeka.
I-T-cell exhaustion enye yemiphumo yentsholongwane ekhuselekileyo okanye edeleyo, apho isakhiwo kunye nekhowudi yezofuzo zeeseli ziguqulwa kwinqanaba le-molecular. Ngokuhamba kwexesha, i-T-cell ilahlekelwa amandla okusebenza nokukhusela ukukhula kwesifo.
Ngoxa i-T-cell exhaustion iye yaxhamla ngokukodwa kwi- CD8 T-cell-cell " cells killer" kwii-CD4's "helper" iiseli-ngoku siyazi ukuba ii-CD4 T-cell zingasenokuchaphazeleka.
Yintoni Ndingayenza Ukuphucula Ukubala Kwam CD4?
Imiba yokubuyiselwa kwemisebenzi yokuzivikela komzimba kubantu abane-HIV ininzi kwaye ihluka. Akukho ndlela enye inokuthatha ngaphandle kokuhlala ihambelana ne-ART kunye nokugcina imithwalo engenakubonakalayo yentsholongwane.
Akukho zixhobo okanye i-ejenti (kubandakanywa izongezelelo zondlovu , amayeza athile, amavithamini, okanye oko kuthiwa "ukukhuseleka kwe-immune") enefuthe lokudibanisa kwi-CD4 T-cell reconstitution. Nangona kukho iziphakamiso kunye, akukho cwaningo oluye lwadibanisa nayiphi na into enjalo yomlomo okanye injectable ukuphucula kumaxabiso e-CD4.
Xa kuthethwa ukuba, ukhetho olufanelekileyo lokuphila lunokubaluleka kwimiphumo yempilo yomntu, ingaba unesifo se-HIV okanye cha. Ukusetyenziswa okufanelekileyo , ukutya okunempilo, ukuyeka ukutshaya, nokunciphisa utywala, kwenza bonke bafumane ukubuyiswa okunamandla kubantu abane-HIV, nokuba ngaba i-CD4 count yomuntu ihamba kakuhle phantsi kwezinga eliqhelekileyo.
Ukuba unamatherapy kwaye unomthwalo ophezulu wentsholongwane-nangona uqhubekayo, umsebenzi ophantsi-thetha nogqirha wakho. Ingabonisa ukuba uhlakulela ukunganyangeki kwe-HIV . Kwiimeko ezinjalo, unyango lungadinga ukutshintshwa.
Nangona kunjalo, abantu abaneentsholongwane ezikhuseleyo ngokupheleleyo kunye neengxelo ze-CD4 ezinokuthi akufanele zitshintshe i-ART ngokuxhomekeka ekubeni iya kuphucula iziphumo ze-CD4. Utshintsho kufuneka lwenziwe kuphela xa kwenzeka ukungaphumeleli kwonyango okanye ngenxa yeziphumo zonyango.
Ngendlela efunekayo ukuba ndijonge njani i-CD4 Count yami?
Izikhokelo zamanje zibonisa ukuba izibalo ze-CD4 zihlolwe ngokusekelwe kumandla omntu wokufezekisa nokugcina umthwalo wentsholongwane engabonakaliyo, njengendlela elandelayo:
- Kubantu abatsha baxilongwa, ukuhlolwa kwe-CD4 kufuneka kwenziwe phambi kokuqala i-ART, kuphinda emva kweenyanga ezintathu emva kokuqaliswa kweyeza, emva koko emva kweenyanga ezintathu ukuya kwezi-6-6.
- Kulabo abaye kwi-ART ubuncinane ubuncinane kwiminyaka emibili kwaye baye bafumana imithwalo engapheliyo yintsholongwane, iimvavanyo kufuneka ziphindwe rhoqo emva kweenyanga ezili-12 kubabo abaneengxelo ze-CD4 phakathi kwama-300 ne-500 seli-mL. Kuba abo abane-CD4 babala ngaphezu kweeseli ezili-500 / mL, ukubeka iliso lwe-CD4 kufuneka kuthathelwe ingqalelo ngokuzikhethela.
Imithombo:
Crawford, C; Angelosanto, J .; Kao, C; okqhubekayo. "I-Molecular and Transcriptional Basis ye-CD4 + T cell Dysfunction ngexesha loGawulayo olungapheliyo." Ku khuselwa. NgoFebruwari 20, 2014; 40 (2): 289-302.
Negredo, E .; Massanella, M .; Puig, J .; okqhubekayo. "I-CDdi ye-Nadir T Cell Count njenge-Predictor kunye ne-CD4 T ye-Cell Intrinsic Apoptosis njengeMigangatho yokugqibela ye-CD4 T yokubuyisela i-Cell kwi-Viologically Suppressed HIV-Infected Patients: Impembelelo. Izifo ezithathelwanayo zonyango. 2010; 50 (9): 1300-1308.
ISebe lezeMpilo leSebe lezeMpilo (DHHS). " Izikhokelo zokusetyenziswa kwee-Antiretroviral Agents kwi-HIV-1-abadala nabachaphazelekayo." EBethesda, eMaryland.