presa
ra unda vicodet shidsis shesaxeb

10:59 17.01.2012 [presa.ge]

shidsze gasuli saukunis 70-iani wlebis dasasruls alaparakdnen. pirveli diagnozi 1981 wels ashsh-shi daisva (tavad termini “shidsic” – “shedzenili imunodeficitis sindromis” abreviatura, igive AIDS – Acquired Immune Deficiency syndrome – amerikelebis mogonilia), xolo 1983 wels pasteris institutis tanamshromelma, mecnierma luk montaniem, aghmoachina virusi, romelic shidss iwvevs da mas dzalze banaluri saxeli – adamianis imunodeficitis virusi (Human immune Deficiency Virus, shemoklebit – HIV) uwoda.

aiv-transformacia

adamianis imunodeficitis gamomwvevi virusis agebuleba warmoudgenlad martivia: garsi cximovani ujredebis ormagi shrisgan shedgeba, saidanac glikoproteinebisgan shemdgari sokos formis warmonaqmnebi izrdeba. virusis shignit rnm-s ori jachvia chaxveuli. aqvea rtuli saxelwodebis cilebi: ukutranskriptaza, integraza da proteaza.

adamianis imunodeficitis virusi organizmshi shechrisas samizned sisxlshi arsebul T-limfocitebs irchevs. es ujredebi imunuri sistemis mdzlavr rgols warmoadgens da organizms garemodan shechrili ucxo mikroorganizmebis ganadgurebashi exmareba. T-limfocitebis zedapirze motavsebulia e.w. CD-4 molekulebi, ris gamoc am ujredebs CD-4-limfocitebsac uwodeben. virusi swored im ujredebs emtereba, romlebic CD-4 molekulebit aris aghchurvili: tavdapirvelad glikoproteinebis “sokoebi” am molekulebs chaebghauchebian, shemdeg virusisa da limfocitis garsebi ertmanets sheerwymian da adamianis imunodeficitis virusis rnm – genetikuri masala – ujredshi aghwevs. T-limfocitebi, romlebic gushagad udganan organizms, am shemtxvevashi udzlurni arian ujredshi shechrili ucxo agentis mimart. metic – mtlianad emorchilebian “agresoris” brdzanebebs.

genetikuri informacia adamianis limfocitebshi dnm-s saxit aris kodirebuli. adamianis imunodeficitis virusma tavi baton-patronad rom igrdznos, rnm dnm-d unda gardaqmnas. amashi mas cila ukutranskriptaza exmareba. axalsintezirebuli dnm limfocitis birtvshi aghwevs, cila integrazas daxmarebit maspindzlis dnm-shi chainergeba da axali virusebis warmoqmnas ubrdzanebs. am dros asparezze mesame cilac – proteazac gamodis da adamianis imunodeficitis virusis shvilobilebis warmoqmnasa da srulyofashi ertveba. ase mravldeba shidsis virusi adamianis organizmshi, ichreba sxva ujredebshi, ipyrobs mat, kvlav mravldeba da a. sh.

sheichreba tu ara virusi organizmshi, iwyeba mwvave infeqciuri procesi, radgan sisxlshi virusebis raodenoba mkvetrad imatebs (amas viremias uwodeben), T-limfocitebis raodenoba ki mteli 20-40%-it iklebs. xshirad (ara yoveltvis) am dros gripismagvari simptomebi ichens tavs. mwvave periodi maleve gaivlis da inficirebidan 1-3 tvis shemdeg organizmshi virusis sawinaaghmdego antisxeulebi gamomushavdeba, shesabamisad, dampyroblebis raodenobac iklebs, xolo CD-4-limfocitebis ricxvi mteli 80-90%-it imatebs. samwuxarod, es sasiketo dzvrebi droebitia da saqmes ver shvelis: organizmshi yoveldghe miliardobit virusi warmoiqmneba. amxela jartan gamklaveba yvelaze mobilizebul imunur sistemasac ki ar dzaludzs...

mainc ramden xans cocxlobs adamianis imunodeficitis virusi organizmis garet? amis gasarkvevad mecnierebma araerti cda chaatares. ert-erti cdis dros virusebi dzalze maghali koncentraciit gamoiyenes: mati ricxvi 100 000-jer aghemateboda savaraudo bunebriv raodenobas). tqven warmoidginet, veragma mikroorganizmebma laboratoriashi 1-2 dghe dzlivs gadzles.

mecnieruli daskvna asetia: organizmis garet virusi dzalian cota xans dzlebs da atmosferoshi sul ramdenime wutshi ighupeba. ase rom, tavisi bneli zraxvebis gansaxorcieleblad adamianis imunodeficitis viruss adamiani schirdeba.

mecnierebma ar daizares da isic gaarkvies, ramden xans inarchunebs virusi sicocxlis unars shpricshi. turme yvelaferi sisxlis odenobaze, tavad virusis titrze (sitxis gansazghvrul ulufashi mis raodenobaze) da garemo pirobebze yofila damokidebuli. ert-erti gamokvlevis shedegad aghmoachines, rom adamianis imunodeficitis virusi, romelic shpricshia gamoketili, 48 dghemde cocxlobs, magram mxolod im “bednier” shemtxvevashi, rodesac virusze dabali mudmivi temperatura moqmedebs da misi titric sisxlshi sakmaod maghalia. tu kani shemtxvevit gausterilebeli shpricit gaikawret, romelshic sisxli 3-4 dghis win aighes, didia albatoba, inficirebas gadaurchet – cvalebadi temperaturis pirobebshi virusi shpricshi sicocxlis unars mxolod ramdenime dghe inarchunebs.

HIV/AIDS cifrebshi

mas shemdeg, rac adamianis imunodeficitis virusi aghmoachines anu rac shidsis epidemia daiwyo, 60 milioni adamiani dainficirda aiv-it da 25 milioni gardaicvala aiv/shidsit gamowveuli patologiebit. janmrtelobis msoflio organizaciis 2008 wlis monacemebit, amjamad adamianis imunodeficitis virusit 33,4 milioni kacia inficirebuli da aqedan 2,7 milioni shemtxveva axali aghmochenilia, xolo wlis ganmavlobashi gardacvlilta ricxvma 2 milions miaghwia. 430 000-amde bavshvi aivinficirebuli daibada da sheemata im 2,1 milions, romeltac am mdzime infeqciastan tanaarseboba uxdebat.

yvelaze metad aiv/shidsi afrikis kontinentzea gavrcelebuli. am regionis wilad modis inficirebulta saerto raodenobis 67%, axalgamovlenil shemtxvevata 70% da bavshvebshi axalgamovlenil shemtxvevata mteli 91%.

2009 wlis dekembris monacemebit, sashualo da dabali shemosavlis mqone qveynebshi daaxloebit 5,25 milioni adamiani itarebs antiretrovirusul terapias, rac 2008 wlis machvenebels mteli 30%-it aghemateba. miuxedavad amgvari progresisa, medikamentebit uzrunvelyofis machvenebeli sashualo da dabali shemosavlis mqone qveynebshi metismetad mcirea: 2009 wels inficirebul mozardta mxolod 37%-s da bavshvta mxolod 28%-s chautarda mkurnaloba. saerto jamshi, antiretrovirusuli mkurnaloba msoflios masshtabit daavadebulta 36%-s chautarda, tumca procentuli machvenebeli sxvadasxva regionshi sxvadasxvaa. ase, magalitad: amerikashi aivinficirebulta 50%-s gaumartla, aziashi – 32%-s, xolo evropashi – mxolod 7%-s.

rac sheexeba maghalshemosavlian qveynebs, aq 2009 wels 700 000 adamians chautarda antiretrovirusul mkurnaloba, ris shedegadac terapiagavlilta ricxvma 6 milions miaghwia.

saqartveloshi 2007 wlistvis inficirebis 1472 shemtxveva gaxldat registrirebuli. amatgan 1119 mamakaci iyo, 353 –  qali, mat shoris 4 –  orsuli. inficirebultagan shidsi 614-s ganuvitarda, xolo 307 gardaicvala.

es mxolod oficialurad aghricxuli shemtxvevebia. eqspertebi varaudoben, rom sinamdvileshi inficirebulta ricxvi gacilebit metia – 3000-s acharbebs.

dzveli codna gamogvadgeba

shesadzloa, cifrebi wlidan wlamde icvlebodes, magram dziritadi codna aiv/shidsis shesaxeb (vgulisxmobt prevenciis gzebs, gadacemis meqanizms da a.sh.) ucvleli rcheba. modi, tavdapirvelad gavixsenot, rogor gadaedeba virusi inficirebulisgan janmrtels:

. sqesobrivi gzit. rogorc statistika mowmobs, sqesobrivi gzit aiv-inficirebis albatoba yvelaze maghalia – 70-80%-s sheadgens. es gasagebic aris: virusebi yvelaze didi koncentraciit swored spermasa da sashos sekretshia. am gzit virusis gadacemis safrtxe kidev ufro metia, tu sqesobriv partniors sifilisi, gonorea an romelime sxva veneruli daavadeba aqvs. sqesobrivi gzit gadamdebi daavadeba shidsis virusistvis ertgvar karibches warmoadgens. es imitom, rom veneriuli daavadebebi sasqeso organoebis dawylulebas da antebit cvlilebebs iwvevs, dazianebul ubnebshi ki virusi iolad ichreba. garda amisa, antebis kerashi uxvad arian adamianis imunodeficitis virusis dziritadi samizneebi – T-limfocitebi, romlebic infeqciastan utanasworo brdzolashi swrafad marcxdebian.

qalebi ufro advilad inficirdebian, vidre mamakacebi. ar gegonot, aiv-infeqcia mshvenieri sqesis warmomadgenlebs emterebodes. ubralod, virusi qalis organizmshi ufro iolad ichreba. jer erti, imitom, rom sperma viruss maghali koncentraciit sheicavs, meorec, qalis sasqeso organoebshi, mati taviseburi agebulebis gamo, am veragi mikroorganizmebit ufro didi zedapiri moiteseba.

. saerto shpricit (narkotikebis intravenuri moxmarebisas). am gzit inficireba shedarebit ishviatia – shemtxvevata saerto ricxvis 5-10%-s sheadgens, tumca swored saerto shpricis gamoyenebis bralia, rom narkomanebshi shidsi sakmaod aris gavrcelebuli.

ra vighonot? ra tqma unda, sauketeso gamosavali narkotikebze uaris tqmaa, magram inficirebis risks ertjeradi shpricic amcirebs (cxadia, mxolod mashin, tu mas erti adamiani gamoiyenebs da ara ramdenime).

. uneblie chxvletisas samedicino instrumentebit (shpricit) manipulaciis dros. 1996 wels ashsh-shi daavadebata kontrolis erovnulma centrma 52 aivinficirebuli medicinis mushaki gamoavlina. 45-s infeqcia nemsis chxvletis shedegad sheeyara, danarchens – virusit koncentrirebuli sisxlis dazianebul kanze, tvalshi, piris ghrushi moxvedris shedegad. dainteresebulma mkvlevarebma inficirebis sashualo albatobac gamoiangarishes da daadgines, rom nemsis chxvletisas igi 0,3%-s sheadgens anu 300 “dachxvletilidan” mxolod erti xdeba virusis msxverpli, xolo dazianebul kanze, lorwovan garsebze da tvalshi moxvedrisas albatoba kidev ufro naklebia – mxolod 0,1%.

sazogadod, eqimebis aivinficirebis safrtxe dzalze mcirea (0,01%-ze naklebi), xolo saqartveloshi jer arc erti shemtxveva ar dafiqsirebula.

. vertikaluri gzit anu inficirebuli dedisgan mucladyofnis periodshi. virusis gadacemis albatoba am shemtxvevashi 5-10%-ia. statistikis tanaxmad, yovel wels msoflioshi 700 000 aivinficirebuli bavshvi ibadeba. amjamad saqartveloshi aiv-infeqciaze yvela orsulis gamokvleva ver xerxdeba. tu mkurnalma eqimma inficireba iechva, qali mxolod am shemtxvevashi igzavneba shemdgomi gamokvlevistvis.

. sheumowmebeli sisxlis gadasxmit. rogorc eqspertebi gvarwmuneben, transfuziistvis mxolod da mxolod shemowmebuli sisxli gamoiyeneba. miuxedavad amisa, msoflios masshtabit sisxlis gadasxmit inficirebis ramdenime shemtxvevaa aghricxuli. dasnebovnebis albatoba, statistikuri monacemebit, mxolod 3-5%-ia.

virusi ar gadaecema:

. kocnit. nerwyvshi virusi imdenad mcire koncentraciitaa, rom kocnis shedegad inficireba praqtikulad sheudzlebelia. kocna sashishia mxolod mashin, rodesac nerwyvs didi odenobit sisxli moyveba an piris ghrus lorwovani garsi dazianebulia da masshi virusi iolad aghwevs. igive exeba ofls, shards. sxva fiziologiur sitxeebshi (spermashi, rdzeshi, mit umetes, sisxlsa da tavzurgtvinis sitxeshi) virusi dzalze maghali koncentraciit aris da inficirebis tvalsazrisit sashishia.

. mwerebis kbenit. tavdapirvelad, rodesac virusi is-is iyo aghmoachines, gamoitqva mosazreba, rom misi gadamtanebi shesadzloa “uwyinari” koghoebi, tkipebi da sxva sisxlismwoveli arsebebi yofiliyvnen, magram specialistebi maleve mixvdnen, rom mwerebs aravitari brali ar miudzghvit, radgan kbenisas adamianis organizmshi isini nerwyvs ushveben da ara sisxls. garda amisa, warmoidginet, raoden savalalo mdgomareoba iqneboda msoflioshi, mwerebs rom shidsi gadahqondet – es pawawina arsebebi kacobriobas sul ramdenime weliwadshi gaavlebdnen musrs.

. stomatologiuri manipulaciebis dros;

. manikiur-pedikiuris, tmis shechrisa da parsvis dros;

. analizebis chabarebis dros;

. auzshi, abanosa da saunashi;

. xelis chamortmevit;

. piradi higienis nivtebis (magalitad, pirsaxocis, churchlis) da tansacmlis sashualebit;

. sisxlis gacemisas (ase rom, tu janmrteli brdzandebit, tamamad shegidzliat, shidsit daavadebulis donori gaxdet).

ras unda velodet

sainkubacio periodi anu dro inficirebidan daavadebis pirveli nishnebis gamovlenamde, sxva infeqciuri patologiebisgan gansxvavebit, shidsis shemtxvevashi cvalebadia. faruli periodi sashualod 4-5 wels sheadgens – ar aris gamoricxuli, ufro xanmokle iyos an ufro metad gaxangrdzlivdes, rac shemdeg faqtorebzea damokidebuli:

. ramdenma virusma sheaghwia organizmshi (anu inficireba chxvletit moxda tu transfuziit). tu adamians didi odenobit inficirebuli sisxli gadausxes, virusi organizmshi charbad moxvdeba da, shesabamisad, sainkubacio periodic xanmokle iqneba.

. ra mdgomareobashia maspindzeli organizmis imunuri sistema;

. ramdenad virulenturi (agresiuli) shtami sheichreba organizmshi.

faruli periodis xangrdzlivobis mixedvit aivinficirebulebs yofen swraf progresorebad, sashualo donis progresorebad (rodesac faruli periodi 4-5 weliwads sheadgens) da mudmiv araprogresorebad. ukanasknel kategorias miekutvnebian pirebi, romlebic 1981 wels dainficirdnen da shidsi jer ar ganvitarebiat, tumca shesadzloa, daavadeba xval-zeg chamouyalibdet.

gaxsovdet: adamiani gadamdebia inficirebis dghidan. adamianis imunodeficitis virusi, sheichreba tu ara organizmshi, aqtiurad iwyebs gamravlebas da xvdeba yvela biologiur sekretshi, yvelaze metad – sisxlshi, tavzurgtvinis sitxeshi, spermashi, naklebad – nerwyvsa da oflshi.

tu aiv-inficirebis shishit (daucveli sqesobrivi kontaqtis, saerto shpricit ineqciis shemdeg) laboratoriuli gamokvlevis chatarebas gadawyvett, gaitvaliswinet: adamianis imunodeficitis virusis aghmochena mxolod mas shemdeg aris shesadzlebeli, rac organizmshi misi sawinaaghmdego antisxeulebi gamomushavdeba, amistvis ki droa sachiro – savaraudo inficirebidan ori tve mainc unda gavides. periods, rodesac virusi jer kidev ar chans, fanjris periods uwodeben.

dabolos: mkurnalobis shemtxvevashi shedegi dzalian kargia. inficirebuls maghalaqtiur kombinirebul antiretrovirusul terapias unishnaven. tu rezistentoba (am shemtxvevashi preparati virusze aghar imoqmedebs) an raime gartuleba ar ganvitarda, aivinficirebuli chveulebriv ganagrdzobs cxovrebas, sazogadoebis aqtiur da srulfasovan wevrad darcheba. xolo tu ar imkurnala, utuod daighupeba.

aivinficirebuli antivirusuli medikamentebis mighebis shemdegac gadamdebia, tumca inficirebis xarisxi am shemtxvevashi gacilebit dabalia. martalia, terapiis shedegad virusi sisxlshi aghar chans, magram organizmshi is samudamod rcheba.

mas shemdeg, rac adamianis imunodeficitis virusi aghmoachines, mecnierebi ganuwyvetliv edzieben gankurnebis sashualebas. somxetis samedicino elitis gancxadebam, rom shidsis wamali aghmoachines, male dakarga fasi. msoflios marto saxeldaxelod shercheuli saxelwodeba “armenikumi” daamaxsovrda.

aivmatareblebi, shidsit daavadebulebi da sruliad samedicino sazogadoeba dghemde elis im bednier dghes, rodesac am veragi daavadebis sawinaaghmdego preparats aghmoachenen. sanugesho jerjerobit is aris, rom mecnierebi gulxeldakrefilebi ar sxedan. ukanaskneli mighwevis shesaxeb axlaxan gadaica safrangetis televiziis 24-e arxit – masachusetsis mtavari hospitlis direqtorma ganacxada: “mecnierebi axlos arian im dghestan, rodesac shidsis sawinaaghmdego wamals gamoigoneben. ukanaskneli dakvirvebis shedegebs tu daveyrdnobit, dzaghlis tavi adamianis organizmis imunuri pasuxis taviseburebashi damarxuli”. aghmochnda, rom 300 aivinficirebulidan erts tavad shesdzlebia virusis datrgunva, rac daavadebis gansazghvrul  etapze “dakonservebis” tolfasia. am procesis mtavari mizezis – savaraudod, romelighac cilis – gamovlena vinme florencia pereiras xelmdzghvanelobit shekrebilma mecnierta jgufma itava ragonis universitetshi. mat tavi mouyares 3500 adamians, romeltagan 2500-s swrafad progresirebadi aiv-infeqcia hqonda, xolo 100-s – rezistentuli forma, rac imas nishnavs, rom imunuri sistemis mdzlavri pasuxis gamo virusi organizmshi aghar mravldeboda. adamianta am ori jgufis imunur sistemas shoris 300-amde sxvaoba aghmoachines, magram dziritadi gansxvaveba mainc me-6 qromosomashi iyo “damarxuli”, sadac genebi HLA-antigenebs warmoqmnidnen. virusis gansakutrebit mdzlavri makontrolebeli aminmjava HLA-B proteinad wodebul fraqciashi aghmoachines. swored mas daabrales virusis kontrolis unari da mecnierta didi nawili mis gasaaqtiureblad mushaobas sheudga.

„aversi.ji“

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