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Metody leczenia

Leczeniem og�lno�wiatowej pandemii HIV/AIDS od samego pocz�tku zaj�li si� najwybitniejsi specjali�ci chor�b zaka�nych. Pomimo tego, i� do tej pory nie uda�o si� odnale�� skutecznego lekarstwa, kt�re upora�oby si� z t� wyniszczaj�c� chorob�, zrobiono ogromne post�py i dzi�ki najnowszym lekom uda�o si� wyd�u�y� �ycie osobom chorym a� o ponad trzydzie�ci lat (przy stosowaniu terapii aretro).

HIV jest niezwykle podst�pnym wirusem, bowiem przez ca�y okres „pobytu” w ludzkim organizmie ulega r�nym mutacjom – z tego te� powodu nie uda�o si� jeszcze wyprodukowa� skutecznego leku, aczkolwiek zosta�y opracowane preparaty zapobiegaj�ce si� jego namna�aniu. Na dzie� dzisiejszy jedn� z najpopularniejszych i tym samym najskuteczniejszych terapii antyretrowirusowych jest HAART polegaj�ca na umiej�tnym zastosowaniu r�norodnych lek�w. Oczywi�cie przyjmowanie jednego leku przez ca�y okres trwania choroby jest wykluczone, bowiem po pewnym czasie HIV uodparnia si� na sk�adniki zawarte w danych preparatach, dlatego te� farmakoterapia jest prowadzona przy u�yciu r�nych medykament�w.

Niestety zapobieganie mutacjom wirusa HIV tudzie� terapia antyretrowirusowa opatrzona jest ci�kimi skutkami ubocznymi, kt�re r�wnie� wyniszczaj� organizm – nerki, serce i w�trob�. Najcz�stszymi niepo��danymi skutkami leczenia s� wymioty, biegunka, gor�czka, spadek wagi, bezsenno��, zgaga, zm�czenie, zapalenie w�troby, anemia – znaczny spadek wagi etc. Nie mniej jednak organizm po pewnym czasie reaguje na przyjmowane regularnie leki, kt�re odbudowuj� uk�ad immunologiczny przez zwi�kszenie liczby atakowanych przez wirus HIV limfocyt�w CD4. O ile norm� jest CD4 w granicach 500-1500, o tyle w�r�d os�b seropozytywnych nawet i wynik 400 nie jest uwa�any za z�y. Przy spadku CD4 poni�ej 200-250 rozpoczyna si� choroba AIDS objawiaj�ca si� zaka�eniami oportunistycznymi.

Leczenie antyretrowirusowe wprowadza si�, gdy:

- liczba kom�rek CD4 spada poni�ej 200/mm³
- wiremia (ilo�� wirusa zawarta w mililitrze krwi) wynosi powy�ej 100�000 kopii
u chorego pojawia si� jedna z wielu chor�b wska�nikowych-oportunistycznych

Podzia� lek�w antyretrowirusowych (nazwy handlowe)

Nukleozydowe inhibitory odwrotnej transkryptazy (NRTI) :

- Retrovir
- Videx
- Zerit
- Epivir
- Ziagen
- Emtriva

Nukleotydowe inhibitory odwrotnej transkryptazy (NtRTI) :

- Viread

Nienukleozydowe inhibitory odwrotnej transkryptazy (NNRTI) :

- Stocrin
- Viramune
- Intelence

Inhibitory proteazy HIV (PI) :

- Crixivan
- Norvir
- Viracept
- Kaletra
- Reyataz
- Telzir
- Aptivus
- Prezista

Inhibitory fuzji:

- Fuzeon

Inhibitory CCR5 (blokery koreceptora) :

- Celsentri

Najpopularniejsze, cz�sto stosowane leki z�o�one:

- Combivir
- Trizivir
- Kivexa
- Truvada
- Atripla

Efekty leczenia antyretrowirusowego

Leczenie farmakologiczne ma za zadanie zmniejszy� poziom wiremii i zwi�kszy� poziom CD4. Terapia tzw. aretro zwalnia szybki post�p rozwoju zaka�enia HIV/AIDS odtwarzaj�c funkcje uk�adu odporno�ciowego. Stosunkowo cz�sto zdarzaj� si� przypadki, �e pacjent trafia na oddzia� szpitalny z wiremi� rz�du 500�000 oraz CD4 wynosz�cym 0-5 i wychodzi ca�o z opresji odzyskuj�c si�y i regeneruj�c sw�j organizm. Nie mniej jednak bywa i tak, �e szybko post�puj�ce choroby oportunistyczne AIDS s� ju� w takim stadium zaawansowania, �e �adna terapia nie skutkuje i cz�owiek umiera.

Dlatego te� niezwykle wa�ne jest wykonywanie test�w przesiewowych na obecno�� wirusa HIV, bowiem w przypadku wyniku dodatniego tylko zmiana trybu �ycia oraz podj�cie leczenia zapewni cz�owiekowi d�ugie i normalne �ycie – �ycie, a� do samej �mierci…..
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