{"id":35915,"date":"2023-06-30T18:25:07","date_gmt":"2023-06-30T11:25:07","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=35915"},"modified":"2023-06-30T18:25:07","modified_gmt":"2023-06-30T11:25:07","slug":"hoi-chung-suy-giam-mien-dich-o-nguoi-nhung-loai-virus-chu-yeu-gay-ra-va-nhung-bieu-hien-dien-hinh","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/06\/30\/hoi-chung-suy-giam-mien-dich-o-nguoi-nhung-loai-virus-chu-yeu-gay-ra-va-nhung-bieu-hien-dien-hinh\/","title":{"rendered":"H\u1ed9i ch\u1ee9ng suy gi\u1ea3m mi\u1ec5n d\u1ecbch \u1edf ng\u01b0\u1eddi: Nh\u1eefng lo\u1ea1i virus ch\u1ee7 y\u1ebfu g\u00e2y ra v\u00e0 nh\u1eefng bi\u1ec3u hi\u1ec7n \u0111i\u1ec3n h\u00ecnh."},"content":{"rendered":"<p><strong>H\u1ed9i ch\u1ee9ng suy gi\u1ea3m mi\u1ec5n d\u1ecbch \u1edf ng\u01b0\u1eddi th\u01b0\u1eddng do virus HIV g\u00e2y ra. HIV l\u00e0 m\u1ed9t retrovirus, t\u1ea5n c\u00f4ng v\u00e0o t\u1ebf b\u00e0o CD4 c\u1ee7a h\u1ec7 th\u1ed1ng ph\u00f2ng v\u1ec7 mi\u1ec5n d\u1ecbch c\u1ee7a c\u01a1 th\u1ec3. Nhi\u1ec5m HIV \u0111i\u1ec3n h\u00ecnh c\u00f3 bi\u1ec3u hi\u1ec7n ban \u0111\u1ea7u l\u00e0 h\u1ed9i ch\u1ee9ng nhi\u1ec5m retrovirus c\u1ea5p, chuy\u1ec3n d\u1ea7n sang b\u1ec7nh m\u00e3n t\u00ednh trong nhi\u1ec1u n\u0103mv\u1edbi t\u00ecnh tr\u1ea1ng gi\u1ea3md\u1ea7n t\u1ebf b\u00e0o lympho T CD4 (t\u1ebf b\u00e0o duy tr\u00ec ho\u1ea1t \u0111\u1ed9ng h\u1ec7 mi\u1ec5n d\u1ecbch), v\u00e0 cu\u1ed1i c\u00f9ng h\u1ed9i ch\u1ee9ng suy gi\u1ea3m mi\u1ec5n d\u1ecbch \u1edf ng\u01b0\u1eddi\u00a0 bi\u1ec3u hi\u1ec7n tri\u1ec7u ch\u1ee9ng v\u00e0 \u0111e d\u1ecda t\u00ednh m\u1ea1ng.<\/strong><\/p>\n<p><img decoding=\"async\" loading=\"lazy\" class=\"alignnone wp-image-35916 size-medium\" src=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/06\/OIP-1-300x168.jpg\" alt=\"hoi-chung-suy-giam-mien-dich\" width=\"300\" height=\"168\" srcset=\"http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/06\/OIP-1-300x168.jpg 300w, http:\/\/noithathoaphat.in\/ctv\/wp-content\/uploads\/2023\/06\/OIP-1.jpg 474w\" sizes=\"(max-width: 300px) 100vw, 300px\" \/><\/p>\n<h2>1. T\u1ed5ng quan virus g\u00e2y h\u1ed9i ch\u1ee9ng suy gi\u1ea3m mi\u1ec5n d\u1ecbch \u1edf ng\u01b0\u1eddi<\/h2>\n<p><strong>1. 1 Visrus HIV : l\u00e0 m\u1ed9t virus ARN<\/strong><br \/>\nSao ch\u00e9p t\u1eeb ARN th\u00e0nh ADN s\u1eed d\u1ee5ng enzyme sao ch\u00e9p ng\u01b0\u1ee3c<br \/>\n\u2022 ADN \u0111\u01b0\u1ee3c t\u1ea1o ra sau \u0111\u00f3 t\u00edch h\u1ee3p v\u00e0o b\u1ed9 gen c\u1ee7a t\u1ebf b\u00e0o v\u1eadt ch\u1ee7 (lympho b\u00e0o T)<br \/>\n\u2022 Sau \u0111\u00f3 virus HIV (ARN v\u00e0 c\u00e1c protein) ti\u1ebfp t\u1ee5c \u0111\u01b0\u1ee3c t\u1ea1o ra b\u1eb1ng ph\u1ee9c h\u1ee3p ADN n\u00e0y<br \/>\n\u2022 C\u00e1c virus ARN d\u1ec5 m\u1eafc c\u00e1c l\u1ed7i<strong> phi\u00ean m\u00e3<\/strong><\/p>\n<p><strong>1.2 T\u1ebf b\u00e0o T-CD4\u2014m\u1ee5c ti\u00eau c\u1ee7a virus HIV<\/strong><\/p>\n<p>C\u00e1c t\u1ebf b\u00e0o CD4 ch\u00ednh l\u00e0 \u201c\u0111\u1ea1o di\u1ec5n\u201d cho \u0111\u00e1p \u1ee9ng mi\u1ec5n d\u1ecbch<br \/>\n\u2022 HIV g\u1eafn v\u1edbi c\u00e1c th\u1ee5 th\u1ec3 tr\u00ean t\u1ebf b\u00e0o CD4 \u0111\u1ec3 x\u00e2m nh\u1eadp v\u00e0 g\u00e2y nhi\u1ec5m t\u1ebf b\u00e0o n\u00e0y<br \/>\n\u2022 Sau nhi\u1ec5m, s\u1ed1 t\u1ebf b\u00e0o CD4 d\u1ea7n gi\u1ea3m xu\u1ed1ng theo th\u1eddi gian<br \/>\n\u2022 S\u1ed1 l\u01b0\u1ee3ng t\u1ebf b\u00e0o CD4 trong c\u01a1 th\u1ec3 ch\u1ec9 \u0111i\u1ec3m m\u1ee9c \u0111\u1ed9 t\u1ed5n th\u01b0\u01a1ng mi\u1ec5n d\u1ecbch do HIV g\u00e2y ra<br \/>\n\u2022 S\u1ed1 l\u01b0\u1ee3ng t\u1ebf b\u00e0o CD4 c\u00e0ng th\u1ea5p th\u00ec h\u1ec7 mi\u1ec5n d\u1ecbch c\u00e0ng y\u1ebfu.<\/p>\n<p><strong>1.3 T\u1ea3i l\u01b0\u1ee3ng virus HIV<\/strong><\/p>\n<p>T\u1ea3i l\u01b0\u1ee3ng virus l\u00e0 l\u01b0\u1ee3ng HIV trong m\u00e1u (b\u1ea3n sao\/mL)<br \/>\n\u2022 L\u01b0\u1ee3ng HIV trong m\u00e1u ch\u1ec9 \u0111i\u1ec3m m\u1ee9c \u0111\u1ed9 HIV nh\u00e2n l\u00ean v\u00e0 t\u1ed1c \u0111\u1ed9 ph\u00e1 h\u1ee7y t\u1ebf b\u00e0o CD4<br \/>\n\u2022 X\u00e9t nghi\u1ec7m t\u1ea3i l\u01b0\u1ee3ng virus \u0111o l\u01b0\u1eddng l\u01b0\u1ee3ng ARN HIV trong huy\u1ebft t\u01b0\u01a1ng<br \/>\n\u2022 &gt;100,000 \u0111\u01b0\u1ee3c xem l\u00e0 cao \u0111i k\u00e8m v\u1edbi s\u1ef1 ti\u1ebfn tri\u1ec3n nhanh c\u1ee7a t\u00ecnh tr\u1ea1ng HIV<br \/>\n\u2022 &lt;10,000 g\u1eafn v\u1edbi ti\u1ebfn tri\u1ec3n ch\u1eadm h\u01a1n.<\/p>\n<p><strong>1.4 X\u00e9t nghi\u1ec7m HIV<\/strong><\/p>\n<p>C\u00f3 hai c\u00e1ch ch\u00ednh \u0111\u1ec3 x\u00e9t nghi\u1ec7m t\u00ecnh tr\u1ea1ng nhi\u1ec5m HIV:<br \/>\n\u2022 X\u00e9t nghi\u1ec7m kh\u00e1ng th\u1ec3<br \/>\n\u2022 N\u1ed3ng \u0111\u1ed9 ARN virus HIV<br \/>\n\u2022 L\u01b0u \u00fd: S\u1ed1 l\u01b0\u1ee3ng t\u1ebf b\u00e0o CD4 kh\u00f4ng kh\u1eb3ng \u0111\u1ecbnh t\u00ecnh tr\u1ea1ng nhi\u1ec5m HIV; nhi\u1ec1u t\u00ecnh tr\u1ea1ng b\u1ec7nh l\u00fd kh\u00e1c c\u00f3 th\u1ec3 g\u00e2y gi\u1ea3m s\u1ed1 l\u01b0\u1ee3ng CD4, do \u0111\u00f3 h\u00e3y x\u00e1c \u0111\u1ecbnh t\u00ecnh tr\u1ea1ng nhi\u1ec5m HIV tr\u01b0\u1edbc khi ki\u1ec3m s\u1ed1 l\u01b0\u1ee3ng t\u1ebf b\u00e0o CD4!<\/p>\n<h2>2. Tri\u1ec7u ch\u1ee9ng nhi\u1ec5m HIV theo t\u00ecnh tr\u1ea1ng suy gi\u1ea3m mi\u1ec5n d\u1ecbch<\/h2>\n<p><strong>2.1 Tri\u1ec7u ch\u1ee9ng nhi\u1ec5m HIV c\u1ea5p<\/strong><\/p>\n<p>Xu\u1ea5t hi\u1ec7n 2-4 tu\u1ea7n sau khi nhi\u1ec5m HIV<br \/>\n\u2022 C\u00e1c tri\u1ec7u ch\u1ee9ng c\u00f3 th\u1ec3 k\u00e9o d\u00e0i t\u1eeb m\u1ed9t v\u00e0i ng\u00e0y \u0111\u1ebfn v\u00e0i tu\u1ea7n<strong><br \/>\n<\/strong>\u2022 \u201cB\u1ec7nh c\u1ea3m d\u01b0\u1eddng nh\u01b0 kh\u00f4ng bao gi\u1edd h\u1ebft\u201d<br \/>\n\u2022 S\u1ed1t v\u00e0 vi\u00eam h\u1ecdng<br \/>\n\u2022 \u0110au c\u01a1\/\u0111au kh\u1edbp<br \/>\n\u2022 H\u1ea1ch to<br \/>\n\u2022 Ph\u00e1t ban: t\u1ed5n th\u01b0\u01a1ng h\u1ed3ng ban d\u00e1t s\u1ea9n 5-10 mm; th\u01b0\u1eddng g\u1eb7p nh\u1ea5t \u1edf m\u1eb7t v\u00e0 th\u00e2n m\u00ecnh; \u0111i\u1ec3n h\u00ecnh th\u00ec kh\u00f4ng ng\u1ee9a<\/p>\n<ul>\n<li>Chuy\u1ec3n \u0111\u1ea3o huy\u1ebft thanh th\u01b0\u1eddng xu\u1ea5t hi\u1ec7n trong v\u00f2ng 4-12 tu\u1ea7n n\u00ean x\u00e9t nghi\u1ec7m t\u00ecm kh\u00e1ng th\u1ec3 HIV th\u01b0\u1eddng \u00e2m<strong> t\u00ednh <\/strong>trong giai \u0111o\u1ea1n n\u00e0y<br \/>\n\u2022 N\u1ebfu nghi nhi\u1ec5m HIV v\u00e0 x\u00e9t nghi\u1ec7m HIV \u00e2m t\u00ednh th\u00ec l\u00e0m l\u1ea1i<strong> x\u00e9t nghi\u1ec7m sau 1 v\u00e0 3 th\u00e1ng<br \/>\n<\/strong>\u2022 X\u00e9t nghi\u1ec7m t\u1ea3i l\u01b0\u1ee3ng virus HIV c\u00f3 th\u1ec3 ch\u1ea9n \u0111o\u00e1n \u0111\u01b0\u1ee3c nhi\u1ec5m HIV c\u1ea5p t\u00ednh.<\/li>\n<\/ul>\n<p><strong>2.2 Giai \u0111o\u1ea1n nhi\u1ec5m kh\u00f4ng tri\u1ec7u ch\u1ee9ng<\/strong><\/p>\n<ul>\n<li>\u0110\u1eb7c \u0111i\u1ec3m l\u00e0 gi\u1ea3m d\u1ea7n s\u1ed1 l\u01b0\u1ee3ng CD4<br \/>\n\u2022 B\u1ec7nh nh\u00e2n c\u00f3 th\u1ec3 kh\u1ecfe m\u1ea1nh trong 5-10 n\u0103m tr\u01b0\u1edbc khi xu\u1ea5t hi\u1ec7n tri\u1ec7u ch\u1ee9ng<br \/>\n\u2022 C\u00f3 th\u1ec3 xu\u1ea5t hi\u1ec7n tri\u1ec7u ch\u1ee9ng khi CD4 &lt; 500 t\u1ebf b\u00e0o\/mm3<br \/>\n\u2022 C\u00e1c NTCH xu\u1ea5t hi\u1ec7n khi CD4 &lt; 200 t\u1ebf b\u00e0o\/mm3<\/li>\n<\/ul>\n<p><strong>2.3 Nhi\u1ec5m HIV c\u00f3 tri\u1ec7u ch\u1ee9ng<\/strong><\/p>\n<ul>\n<li>C\u00e1c t\u00ecnh tr\u1ea1ng c\u00f3 th\u1ec3 g\u1eb7p khi s\u1ed1 l\u01b0\u1ee3ng CD4 200 \u2013 500 bao g\u1ed3m:<br \/>\n\u2022 H\u1ea1ch to to\u00e0n th\u00e2n<br \/>\n\u2022 M\u1ec7t<br \/>\n\u2022 S\u1ed1t ho\u1eb7c ti\u00eau ch\u1ea3y k\u00e9o d\u00e0i &gt; 1 th\u00e1ng<br \/>\n\u2022 B\u1ec7nh Candida mi\u1ec7ng ho\u1eb7c \u00e2m \u0111\u1ea1o<br \/>\n\u2022 Vi\u00eam ph\u1ed5i vi khu\u1ea9n<br \/>\n\u2022 Lao ph\u1ed5i<br \/>\n\u2022 Herpes zoster (Zona)<br \/>\n\u2022 B\u1ec7nh \u00e1c t\u00ednh (ung th\u01b0 c\u1ed5 t\u1eed cung, u lympho).<\/li>\n<li>M\u1ed9t s\u1ed1 b\u1ec7nh nh\u00e2n CD4 &gt; 200 c\u00f3 th\u1ec3 \u1ed1m y\u1ebfu v\u1edbi nhi\u1ec1u tri\u1ec7uch\u1ee9ng<br \/>\n\u2022 M\u1ed9t s\u1ed1 b\u1ec7nh nh\u00e2n c\u00f3 CD4 th\u1ea5p &lt; 200 c\u00f3 th\u1ec3 th\u1ea5y kh\u1ecfe m\u1ea1nh m\u00e0 kh\u00f4ng c\u00f3 tri\u1ec7u ch\u1ee9ng g\u00ec h\u1ebft<br \/>\nT\u1ea5t c\u1ea3 b\u1ec7nh nh\u00e2n \u0111\u1ec1u gi\u1ea3m ch\u1ee9c n\u0103ng mi\u1ec5n d\u1ecbch v\u00e0 c\u00f3 nguy c\u01a1 NTCH khi:<br \/>\n\u2022 Giai \u0111o\u1ea1n l\u00e2m s\u00e0ng 3 ho\u1eb7c 4 theo WHO, ho\u1eb7c<strong><br \/>\n<\/strong>\u2022 CD4 &lt; 200, ho\u1eb7c<strong><br \/>\n<\/strong>\u2022 T\u1ed5ng t\u1ebf b\u00e0o Lympho (Total Leukocyte Count) &lt; 1200.<\/li>\n<\/ul>\n<p><strong>2.4 C\u00e1c y\u1ebfu t\u1ed1 \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn ti\u1ebfn tri\u1ec3n c\u1ee7a b\u1ec7nh<\/strong><\/p>\n<p>T\u0103ng ti\u1ebfn tri\u1ec3n b\u1ec7nh:<br \/>\n\u2022 Tu\u1ed5i cao<br \/>\n\u2022 T\u00ecnh tr\u1ea1ng dinh d\u01b0\u1ee1ng<br \/>\n\u2022 Nhi\u1ec5m tr\u00f9ng c\u01a1 h\u1ed9i (v\u00ed d\u1ee5: lao, giang mai, n\u1ea5m)<br \/>\n\u2022 T\u1ea3i l\u01b0\u1ee3ng virus cao<strong><br \/>\n\u2022 <\/strong>Ti\u00eam ch\u00edch ma t\u00fay<br \/>\n\u2022 Nghi\u1ec7n r\u01b0\u1ee3u<\/p>\n<p>L\u00e0m ch\u1eadm ti\u1ebfn tri\u1ec3n b\u1ec7nh:<br \/>\n\u2022 D\u1ef1 ph\u00f2ng NTCH b\u1eb1ng cotrimoxazole, INH<br \/>\n\u2022 \u0110i\u1ec1u tr\u1ecb kh\u00e1ng HIV<\/p>\n<h2>3. H\u1ec7 th\u1ed1ng ph\u00e2n giai \u0111o\u1ea1n l\u00e2m s\u00e0ng theo WHO<\/h2>\n<p>Ph\u00e2n giai \u0111o\u1ea1n l\u00e2m s\u00e0ng theo WHO c\u00f3 th\u1ec3 d\u00f9ng \u0111\u1ec3:<br \/>\n\u2022 \u01af\u1edbc l\u01b0\u1ee3ng m\u1ee9c \u0111\u1ed9 t\u1ed5n th\u01b0\u01a1ng h\u1ec7 mi\u1ec5n d\u1ecbch c\u1ee7a b\u1ec7nh nh\u00e2n<br \/>\n\u2022 Theo d\u00f5i ti\u1ebfn tri\u1ec3n c\u1ee7a b\u1ec7nh HIV<br \/>\n\u2022 X\u00e1c \u0111\u1ecbnh khi n\u00e0o c\u1ea7n :<br \/>\n\u2013 \u0110i\u1ec1u tr\u1ecb ho\u1eb7c ng\u1eebng d\u1ef1 ph\u00f2ng b\u1eb1ng Cotrimoxazole<em><br \/>\n<\/em>\u2022 Theo d\u00f5i \u0111\u00e1p \u1ee9ng c\u1ee7a b\u1ec7nh nh\u00e2n v\u1edbi \u0111i\u1ec1u tr\u1ecb ARV.<\/p>\n<p>Giai \u0111o\u1ea1n 1: Kh\u00f4ng tri\u1ec7u ch\u1ee9ng<strong><br \/>\n<\/strong>Nh\u1eefng h\u1ed9i ch\u1ee9ng \u0111i\u1ec3n h\u00ecnh\/ph\u1ed5 bi\u1ebfn nh\u1ea5t:<br \/>\n\u2022 Kh\u00f4ng c\u00f3 tri\u1ec7u ch\u1ee9ng<br \/>\n\u2022 H\u1ea1ch to to\u00e0n th\u00e2n dai d\u1eb3ng<\/p>\n<p>Giai \u0111o\u1ea1n 2: Tri\u1ec7u ch\u1ee9ng nh\u1eb9<strong><br \/>\n<\/strong>Nh\u1eefng h\u1ed9i ch\u1ee9ng \u0111i\u1ec3n h\u00ecnh\/ph\u1ed5 bi\u1ebfn nh\u1ea5t:<br \/>\n\u2022 S\u00fat c\u00e2n kh\u00f4ng r\u00f5 nguy\u00ean nh\u00e2n m\u1ee9c \u0111\u1ed9 trung b\u00ecnh (&lt; 10% th\u1ec3 tr\u1ecdng)<br \/>\n\u2022 C\u00e1c nhi\u1ec5m tr\u00f9ng h\u00f4 h\u1ea5p t\u00e1i ph\u00e1t (vi\u00eam xoang, vi\u00eam amidan, vi\u00eam tai gi\u1eefa, vi\u00eam h\u1ecdng)<br \/>\n\u2022 Zona (Herpes zoster)<br \/>\n\u2022 Ph\u00e1t ban s\u1ea9n ng\u1ee9a (PPE)<br \/>\n\u2022 N\u1ea5m m\u00f3ng, vi\u00eam da b\u00e3 nh\u1eddn.<\/p>\n<p>Giai \u0111o\u1ea1n 3: Tri\u1ec7u ch\u1ee9ng ti\u1ebfn tri\u1ec3n<strong><br \/>\n<\/strong>Nh\u1eefng h\u1ed9i ch\u1ee9ng \u0111i\u1ec3n h\u00ecnh\/ph\u1ed5 bi\u1ebfn nh\u1ea5t:<br \/>\n\u2022 Kh\u00f4ng r\u00f5 nguy\u00ean nh\u00e2n (KRNN):<br \/>\n\u2013 S\u00fat c\u00e2n n\u1eb7ng (&gt; 10% tr\u1ecdng l\u01b0\u1ee3ng c\u01a1 th\u1ec3)<br \/>\n\u2013 Ti\u00eau ch\u1ea3y m\u1ea1n t\u00ednh tr\u00ean 1 th\u00e1ng<br \/>\n\u2013 S\u1ed1t dai d\u1eb3ng tr\u00ean 1 th\u00e1ng<br \/>\n\u2022 B\u1ec7nh Candida mi\u1ec7ng k\u00e9o d\u00e0i, b\u1ea1ch s\u1ea3n l\u01b0\u1ee1i d\u1ea1ng l\u00f4ng<br \/>\n\u2022 Lao ph\u1ed5i<br \/>\n\u2022 Nhi\u1ec5m khu\u1ea9n n\u1eb7ng (vi\u00eam ph\u1ed5i, m\u1ee7 m\u00e0ng ph\u1ed5i, NT huy\u1ebft\u2026)<br \/>\n\u2022 Thi\u1ebfu m\u00e1u (&lt;8 g \/dl), gi\u1ea3m b\u1ea1ch c\u1ea7u trung t\u00ednh (&lt;0.5 x 109 \/l), ho\u1eb7c gi\u1ea3m ti\u1ec3u c\u1ea7u (&lt;50 x 109 \/l) kh\u00f4ng r\u00f5 nguy\u00ean nh\u00e2n.<\/p>\n<p>Giai \u0111o\u1ea1n 4: Tri\u1ec7u ch\u1ee9ng n\u1eb7ng<strong><br \/>\n<\/strong>\u2022 H\u1ed9i ch\u1ee9ng suy m\u00f2n do HIV: c\u00f3 2 trong 3 tri\u1ec7u ch\u1ee9ng sau:<br \/>\n\u2013 S\u00fat c\u00e2n n\u1eb7ng (&gt; 10% tr\u1ecdng l\u01b0\u1ee3ng c\u01a1 th\u1ec3) KRNN<br \/>\n\u2013 Ti\u00eau ch\u1ea3y m\u1ea1n t\u00ednh tr\u00ean 1 th\u00e1ng KRNN<br \/>\n\u2013 S\u1ed1t dai d\u1eb3ng tr\u00ean 1 th\u00e1ng KRNN<br \/>\n\u2022 Nhi\u1ec5m herpes simplex m\u00e3n t\u00ednh (m\u00f4i mi\u1ec7ng, sinh d\u1ee5c, ho\u1eb7c h\u1eadu m\u00f4n, tr\u1ef1c tr\u00e0ng) k\u00e9o d\u00e0i tr\u00ean 1 th\u00e1ng, hay herpes n\u1ed9i t\u1ea1ng b\u1ea5t k\u1ec3 v\u1ecb tr\u00ed n\u00e0o).<\/p>\n<p>Nh\u1eefng h\u1ed9i ch\u1ee9ng \u0111i\u1ec3n h\u00ecnh\/ph\u1ed5 bi\u1ebfn nh\u1ea5t:<br \/>\n\u2022 Lao ngo\u00e0i ph\u1ed5i<br \/>\n\u2022 Vi\u00eam ph\u1ed5i do Pneumocystis jiroveci (PCP)<br \/>\n\u2022 B\u1ec7nh Candida th\u1ef1c qu\u1ea3n<br \/>\n\u2022 B\u1ec7nh Toxoplasma h\u1ec7 th\u1ea7n kinh trung \u01b0\u01a1ng<br \/>\n\u2022 Vi\u00eam m\u00e0ng n\u00e3o do Cryptococcus neoformans<br \/>\n\u2013 B\u1ec7nh do Penicillium marneffei<br \/>\n\u2022 Vi\u00eam v\u00f5ng m\u1ea1c do Cytomegalovirus (CMV)<br \/>\n\u2022 Vi\u00eam ph\u1ed5i do vi khu\u1ea9n t\u00e1i ph\u00e1t\u2026<\/p>\n<p>C\u00e1c ti\u00eau chu\u1ea9n ch\u1ea9n \u0111o\u00e1n HIV ti\u1ebfn tri\u1ec3n<strong><br \/>\n<\/strong>Nhi\u1ec5m HIV ti\u1ebfn tri\u1ec3n:<strong><br \/>\n<\/strong>\u2022 \u1ede ng\u01b0\u1eddi l\u1edbn, v\u1ecb th\u00e0nh ni\u00ean v\u00e0 tr\u1ebb &gt; 5 tu\u1ed5i: khi CD4 \u2264 200 t\u1ebf b\u00e0o\/mm\u00b3 ho\u1eb7c giai \u0111o\u1ea1n l\u00e2m s\u00e0ng 3 ho\u1eb7c 4<br \/>\n\u2022 T\u1ea5t c\u1ea3 tr\u1ebb &lt; 5 tu\u1ed5i \u0111\u01b0\u1ee3c coi l\u00e0 b\u1ec7nh HIV ti\u1ebfn tri\u1ec3n.<\/p>\n<h2>4. \u0110i\u1ec1u tr\u1ecb ARV<\/h2>\n<p><strong>4.1 M\u1ee5c \u0111\u00edch \u0111i\u1ec1u tr\u1ecb ARV<\/strong><\/p>\n<ul>\n<li>Ng\u0103n ch\u1eb7n t\u1ed1i \u0111a, l\u00e2u d\u00e0i qu\u00e1 tr\u00ecnh nh\u00e2n l\u00ean c\u1ee7a HIV trong c\u01a1 th\u1ec3<\/li>\n<li>Ph\u1ee5c h\u1ed3i ch\u1ee9c n\u0103ng mi\u1ec5n d\u1ecbch =&gt; Gi\u1ea3m nguy c\u01a1 m\u1eafc b\u1ec7nh v\u00e0 t\u1eed vong li\u00ean quan t\u1edbi HIV<\/li>\n<\/ul>\n<p>=&gt; D\u1ef1 ph\u00f2ng l\u00e2y truy\u1ec1n HIV (b\u1ea1n t\u00ecnh\/b\u1ea1n ch\u00edch), t\u1eeb m\u1eb9 sang con.<\/p>\n<p><strong>4.2 Nguy\u00ean t\u1eafc \u0111i\u1ec1u tr\u1ecb ARV<\/strong><\/p>\n<ul>\n<li>\u0110i\u1ec1u tr\u1ecb ARV ngay khi \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n nhi\u1ec5m HIV<\/li>\n<li>Ph\u1ed1i h\u1ee3p \u0111\u00fang c\u00e1ch \u00edt nh\u1ea5t 3 lo\u1ea1i thu\u1ed1c ARV<\/li>\n<li>\u0110\u1ea3m b\u1ea3o tu\u00e2n th\u1ee7 \u0111i\u1ec1u tr\u1ecb h\u00e0ng ng\u00e0y, li\u00ean t\u1ee5c, su\u1ed1t \u0111\u1eddi.<\/li>\n<\/ul>\n<p><strong>4.3 Ti\u00eau chu\u1ea9n \u0111i\u1ec1u tr\u1ecb ARV<\/strong><\/p>\n<ul>\n<li>T\u1ea5t c\u1ea3 ng\u01b0\u1eddi nhi\u1ec5m HIV, kh\u00f4ng ph\u1ee5 thu\u1ed9c giai \u0111o\u1ea1n l\u00e2m s\u00e0ng hay s\u1ed1 l\u01b0\u1ee3ng t\u1ebf b\u00e0o CD4<\/li>\n<li>Tr\u1ebb d\u01b0\u1edbi 18 th\u00e1ng tu\u1ed5i c\u00f3 k\u1ebft qu\u1ea3 x\u00e9t nghi\u1ec7m PCR l\u1ea7n 1 (+) ho\u1eb7c c\u00f3 kh\u00e1ng th\u1ec3 kh\u00e1ng HIV (+) \u0111\u1ed3ng th\u1eddi c\u00f3 bi\u1ec3u hi\u1ec7n b\u1ec7nh l\u00fd HIV n\u1eb7ng.<\/li>\n<\/ul>\n<p><strong>4.4 C\u00e1c nh\u00f3m thu\u1ed1c \u0111i\u1ec1u tr\u1ecb ARV<\/strong><\/p>\n<p>\u1ee8c ch\u1ebf men sao ch\u00e9p ng\u01b0\u1ee3c nucleoside &#8211; NRTIs<\/p>\n<ul>\n<li>Abacavir, or ABC (Ziagen)<\/li>\n<li>Emtricitabine, or FTC (Emtriva)<\/li>\n<li>Lamivudine, or 3TC (Epivir)<\/li>\n<li>Tenofovir alafenamide, or TAF (Vemlidy)<\/li>\n<li>Tenofovir disoproxil fumarate, or TDF (Viread),<\/li>\n<li>Zidovudine or ZDV (Retrovir)<\/li>\n<\/ul>\n<p>\u1ee8c ch\u1ebf men sao ch\u00e9p ng\u01b0\u1ee3c non-ucleoside \u2013 NNRTIs<\/p>\n<ul>\n<li>Delavirdine or DLV (Rescripor)<\/li>\n<li>Doravirine, or DOR (Pifeltro)<\/li>\n<li>Efavirenz or EFV (Sustiva)<\/li>\n<li>Etravirine or ETR (Intelence)<\/li>\n<li>Rilpivirine or RPV (Edurant)<\/li>\n<\/ul>\n<p>\u1ee8c ch\u1ebf men Protease-PIs Atazanavir or ATV (Reyataz)<\/p>\n<ul>\n<li>Darunavir or DRV (Prezista)<\/li>\n<li>Lopinavir + ritonavir, or LPV\/r (Kaletra)<\/li>\n<li>Ritonavir or RTV (Norvir)<\/li>\n<li>Tipranavir or TPV (Aptivus)<\/li>\n<li><\/li>\n<\/ul>\n<p>\u1ee8c ch\u1ebf t\u00edch h\u1ee3p &#8211; INSTIs Bictegravir or BIC (k\u1ebft h\u1ee3p v\u1edbi thu\u1ed1c kh\u00e1c nh\u01b0 Biktarvy)<\/p>\n<ul>\n<li>Dolutegravir or DTG (Tivicay)<\/li>\n<li>Elvitegravir or EVG (Vitekta)<\/li>\n<li>Raltegravir or RAL (Isentress)<\/li>\n<\/ul>\n<p>Xem th\u00eam: <a href=\"https:\/\/www.vinmec.com\/vi\/benh\/hiv-2975\/\">Nhi\u1ec5m HIV<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>H\u1ed9i ch\u1ee9ng suy gi\u1ea3m mi\u1ec5n d\u1ecbch \u1edf ng\u01b0\u1eddi th\u01b0\u1eddng do virus HIV g\u00e2y ra. HIV l\u00e0 m\u1ed9t retrovirus, t\u1ea5n c\u00f4ng v\u00e0o t\u1ebf b\u00e0o CD4 c\u1ee7a h\u1ec7 th\u1ed1ng ph\u00f2ng v\u1ec7 mi\u1ec5n d\u1ecbch c\u1ee7a c\u01a1 th\u1ec3. Nhi\u1ec5m HIV \u0111i\u1ec3n h\u00ecnh c\u00f3 bi\u1ec3u hi\u1ec7n ban \u0111\u1ea7u l\u00e0 h\u1ed9i ch\u1ee9ng nhi\u1ec5m retrovirus c\u1ea5p, chuy\u1ec3n d\u1ea7n sang b\u1ec7nh m\u00e3n t\u00ednh [&hellip;]<\/p>\n","protected":false},"author":16,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[22,33],"tags":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v20.4 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>H\u1ed9i ch\u1ee9ng suy gi\u1ea3m mi\u1ec5n d\u1ecbch \u1edf ng\u01b0\u1eddi: Nh\u1eefng lo\u1ea1i virus ch\u1ee7 y\u1ebfu g\u00e2y ra v\u00e0 nh\u1eefng bi\u1ec3u hi\u1ec7n \u0111i\u1ec3n h\u00ecnh. - Vinmec<\/title>\n<meta name=\"description\" content=\"H\u1ed9i ch\u1ee9ng suy gi\u1ea3m mi\u1ec5n d\u1ecbch \u1edf ng\u01b0\u1eddi th\u01b0\u1eddng do virus HIV, m\u1ed9t retrovirus, t\u1ea5n c\u00f4ng v\u00e0o t\u1ebf b\u00e0o CD4 c\u1ee7a h\u1ec7 th\u1ed1ng ph\u00f2ng v\u1ec7 mi\u1ec5n d\u1ecbch c\u1ee7a c\u01a1 th\u1ec3.\" \/>\n<meta name=\"robots\" content=\"noindex, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"H\u1ed9i ch\u1ee9ng suy gi\u1ea3m mi\u1ec5n d\u1ecbch \u1edf ng\u01b0\u1eddi: Nh\u1eefng lo\u1ea1i virus ch\u1ee7 y\u1ebfu g\u00e2y ra v\u00e0 nh\u1eefng bi\u1ec3u hi\u1ec7n \u0111i\u1ec3n h\u00ecnh. - 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