{"id":2802,"date":"2016-05-27T17:31:36","date_gmt":"2016-05-27T10:31:36","guid":{"rendered":"http:\/\/hotboyxamtro.vn\/?p=2802"},"modified":"2016-05-27T17:31:36","modified_gmt":"2016-05-27T10:31:36","slug":"arv-va-tac-dung-trong-dieu-tri-hiv","status":"publish","type":"post","link":"https:\/\/khogiaodien.itheme.vn\/GD0007\/arv-va-tac-dung-trong-dieu-tri-hiv.html","title":{"rendered":"ARV v\u00e0 t\u00e1c d\u1ee5ng trong \u0111i\u1ec1u tr\u1ecb HIV"},"content":{"rendered":"

ARV l\u00e0 thu\u1ed1c \u0111i\u1ec1u tr\u1ecb d\u00f9ng cho nh\u1eefng ng\u01b0\u1eddi b\u1ecb HIV, c\u00f3 t\u00e1c d\u1ee5ng l\u00e0m gi\u1ea3m s\u1ef1 ph\u00e1t tri\u1ec3n c\u1ee7a virus HIV v\u00e0 l\u00e0m ch\u1eadm giai \u0111o\u1ea1n HIV sang AIDS. D\u00f9ng ARV cho ng\u01b0\u1eddi c\u00f3 HIV \u0111\u01b0\u1ee3c nh\u00ecn nh\u1eadn l\u00e0 m\u1ed9t trong nh\u1eefng bi\u1ec7n ph\u00e1p t\u00edch c\u1ef1c gi\u00fap ng\u01b0\u1eddi c\u00f3 HIV c\u1ea3i thi\u1ec7n s\u1ee9c kho\u1ebb v\u00e0 k\u00e9o d\u00e0i th\u1eddi gian s\u1ed1ng c\u1ee7a m\u00ecnh.<\/strong><\/p>\n

ARV l\u00e0 g\u00ec?<\/strong><\/p>\n

ARV l\u00e0 vi\u1ebft t\u1eaft c\u1ee7a Antiretrovaral l\u00e0 m\u1ed9t lo\u1ea1i thu\u1ed1c \u0111\u01b0\u1ee3c ch\u1ebf ra nh\u1eb1m l\u00e0m gi\u1ea3m s\u1ef1 sinh s\u00f4i n\u1ea3y n\u1edf c\u1ee7a HIV trong c\u01a1 th\u1ec3. N\u1ebfu \u0111i\u1ec1u tr\u1ecb ARV hi\u1ec7u qu\u1ea3 th\u00ec c\u00f3 th\u1ec3 l\u00e0m ch\u1eadm s\u1ef1 ti\u1ebfn tri\u1ec3n ho\u00e0n to\u00e0n c\u1ee7a AIDS trong nhi\u1ec1u n\u0103m, l\u00e0m gi\u1ea3m nguy c\u01a1 l\u00e2y truy\u1ec1n v\u00e0 l\u00e0m t\u0103ng ch\u1ea5t l\u01b0\u1ee3ng s\u1ed1ng c\u1ee7a ng\u01b0\u1eddi nhi\u1ec5m HIV\/AIDS. Thu\u1ed1c ARV \u0111\u01b0\u1ee3c khuy\u1ebfn kh\u00edch s\u1eed d\u1ee5ng l\u1ebft h\u1ee3p \u0111\u1ec3 ng\u0103n ch\u1eb7n h\u00ecnh th\u00e0nh kh\u00e1nh thu\u1ed1c.<\/p>\n

\"Thu\u1ed1c

Thu\u1ed1c ARV<\/p><\/div>\n

C\u00e1c nh\u00f3m thu\u1ed1c ARV \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng t\u1ea1i Vi\u1ec7t nam:<\/strong><\/p>\n

– Nh\u00f3m \u1ee9c ch\u1ebf men sao ch\u00e9p ng\u01b0\u1ee3c nucleoside v\u00e0 nucleotide (NRTI).<\/p>\n

– Nh\u00f3m \u1ee9c ch\u1ebf men sao ch\u00e9p ng\u01b0\u1ee3c kh\u00f4ng ph\u1ea3i l\u00e0 nucleoside (NNRTI).<\/p>\n

– Nh\u00f3m \u1ee9c ch\u1ebf men protease (PI).<\/p>\n

T\u00e1c d\u1ee5ng c\u1ee7a ARV<\/strong><\/p>\n

– \u1ee8c ch\u1ebf s\u1ef1 nh\u00e2n l\u00ean c\u1ee7a virus HIV v\u00e0 k\u00ecm h\u00e3m l\u01b0\u1ee3ng virus trong m\u00e1u \u1edf m\u1ee9c th\u1ea5p nh\u1ea5t. Thu\u1ed1c ARV kh\u00f4ng ch\u1eefa kh\u1ecfi ho\u00e0n to\u00e0n b\u1ec7nh HIV<\/p>\n

– Ph\u1ee5c h\u1ed3i ch\u1ee9c n\u0103ng mi\u1ec5n d\u1ecbch, gi\u1ea3m nguy c\u01a1 m\u1eafc v\u00e0 t\u1eed vong doc c\u00e1c b\u1ec7nh nhi\u1ec5m tr\u00f9ng c\u01a1 h\u1ed9i \u1edf b\u00eanh nh\u00e2n nhi\u1ec5m HIV<\/p>\n

– C\u1ea3i thi\u1ec7n ch\u1ea5t l\u01b0\u1ee3ng s\u1ed1ng v\u00e0 t\u0103ng th\u1eddi gian s\u1ed1ng cho ng\u01b0\u1eddi b\u1ec7nh – Ng\u0103n c\u1ea3n s\u1ef1 ti\u1ebfn tri\u1ec3n HIV sang AIDS \u1edf b\u00eanh nh\u00e2n nhi\u1ec5m HIV<\/p>\n

Nguy\u00ean t\u1eafc khi s\u1eed d\u1ee5ng ARV<\/strong><\/p>\n

– \u0110i\u1ec1u tr\u1ecb ARV l\u00e0 m\u1ed9t ph\u1ea7n trong t\u1ed5ng th\u1ec3 c\u00e1c d\u1ecbch v\u1ee5 ch\u0103m s\u00f3c v\u00e0 h\u1ed7 tr\u1ee3 v\u1ec1 y t\u1ebf, t\u00e2m l\u00fd v\u00e0 x\u00e3 h\u1ed9i cho ng\u01b0\u1eddi nhi\u1ec5m HIV\/AIDS.<\/p>\n

– \u0110i\u1ec1u tr\u1ecb ARV ch\u1ee7 y\u1ebfu l\u00e0 \u0111i\u1ec1u tr\u1ecb ngo\u1ea1i tr\u00fa v\u00e0 \u0111\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh khi ng\u01b0\u1eddi b\u1ec7nh c\u00f3 \u0111\u1ee7 ti\u00eau chu\u1ea9n l\u00e2m s\u00e0ng ho\u1eb7c x\u00e9t nghi\u1ec7m v\u00e0 ng\u01b0\u1eddi b\u1ec7nh \u0111\u00e3 s\u1eb5n s\u00e0ng \u0111i\u1ec1u tr\u1ecb.<\/p>\n

– B\u1ea5t c\u1ee9 ph\u00e1c \u0111\u1ed3 \u0111i\u1ec1u tr\u1ecb n\u00e0o c\u0169ng ph\u1ea3i c\u00f3 \u00edt nh\u1ea5t 3 lo\u1ea1i thu\u1ed1c. \u0110i\u1ec1u tr\u1ecb ARV l\u00e0 \u0111i\u1ec1u tr\u1ecb su\u1ed1t \u0111\u1eddi, ng\u01b0\u1eddi b\u1ec7nh ph\u1ea3i tu\u00e2n th\u1ee7 \u0111i\u1ec1u tr\u1ecb tuy\u1ec7t \u0111\u1ed1i \u0111\u1ec3 \u0111\u1ea3m b\u1ea3o hi\u1ec7u qu\u1ea3 v\u00e0 tr\u00e1nh kh\u00e1ng thu\u1ed1c.<\/p>\n

– Ng\u01b0\u1eddi nhi\u1ec5m HIV \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb ARV v\u1eabn ph\u1ea3i \u00e1p d\u1ee5ng c\u00e1c bi\u1ec7n ph\u00e1p d\u1ef1 ph\u00f2ng l\u00e2y nhi\u1ec5m virus cho ng\u01b0\u1eddi kh\u00e1c.<\/p>\n

– Ng\u01b0\u1eddi nhi\u1ec5m HIV \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb ARV khi t\u00ecnh tr\u1ea1ng mi\u1ec5n d\u1ecbch ch\u01b0a ph\u1ee5c h\u1ed3i c\u1ea7n ti\u1ebfp t\u1ee5c \u0111i\u1ec1u tr\u1ecb d\u1ef1 ph\u00f2ng c\u00e1c b\u1ec7nh nhi\u1ec5m tr\u00f9ng c\u01a1 h\u1ed9i.<\/p>\n

– T\u00f9y thu\u1ed9c v\u00e0o s\u1ef1 s\u1eb5n c\u00f3 c\u1ee7a thu\u1ed1c, t\u00ecnh tr\u1ea1ng c\u1ee7a ng\u01b0\u1eddi b\u1ec7nh, c\u00e1c nh\u00e0 chuy\u00ean m\u00f4n s\u1ebd l\u1ef1a ch\u1ecdn c\u00e1c ph\u00e1c \u0111\u1ed3 \u0111i\u1ec1u tr\u1ecb t\u01b0\u01a1ng th\u00edch theo c\u00f4ng th\u1ee9c tr\u00ean.<\/p>\n

\u0110i\u1ec1u tr\u1ecb ARV khi n\u00e0o?<\/strong><\/p>\n

– \u0110i\u1ec1u tr\u1ecb ARV cho b\u1ec7nh nh\u00e2n nhi\u1ec5m HIV d\u1ef1a v\u00e0o s\u1ed1 l\u01b0\u1ee3ng t\u1ebf b\u00e0o CD4 (t\u1ebf b\u00e0o b\u1ea1ch c\u1ea7u ch\u1ec9 huy).<\/p>\n

– Ch\u1ec9 s\u1ed1 CD4 trung b\u00ecnh c\u1ee7a m\u1ed9t ng\u01b0\u1eddi HIV \u00e2m t\u00ednh th\u01b0\u1eddng dao \u0111\u1ed9ng trong kho\u1ea3ng 500 \u0111\u1ebfn 1200 t\u1ebf b\u00e0o\/mm3 tuy nhi\u00ean m\u1ed9t s\u1ed1 ng\u01b0\u1eddi c\u00f3 ch\u1ec9 s\u1ed1 n\u00e0y cao ho\u1eb7c th\u1ea5p h\u01a1n b\u00ecnh th\u01b0\u1eddng do b\u1ea9m sinh.<\/p>\n

N\u1ebfu c\u00f3 x\u00e9t nghi\u1ec7m CD4, ch\u1ec9 \u0111\u1ecbnh \u0111i\u1ec1u tr\u1ecb ARV khi:<\/strong><\/p>\n

– Ng\u01b0\u1eddi nhi\u1ec5m HIV giai \u0111o\u1ea1n l\u00e2m s\u00e0ng 4, kh\u00f4ng ph\u1ee5 thu\u1ed9c s\u1ed1 l\u01b0\u1ee3ng t\u1ebf b\u00e0o CD4<\/p>\n

– Ng\u01b0\u1eddi nhi\u1ec5m HIV giai \u0111o\u1ea1n l\u00e2m s\u00e0ng 3 v\u1edbi CD4 < 350 TB\/mm3<\/p>\n

– Ng\u01b0\u1eddi nhi\u1ec5m HIV giai \u0111o\u1ea1n l\u00e2m s\u00e0ng 1, 2 v\u1edbi CD4 < 250 TB\/mm3 – N\u1ebfu kh\u00f4ng l\u00e0m \u0111\u01b0\u1ee3c x\u00e9t nghi\u1ec7m CD4, ch\u1ec9 \u0111\u1ecbnh \u0111i\u1ec1u tr\u1ecb ARV khi ng\u01b0\u1eddi nhi\u1ec5m HIV \u1edf giai \u0111o\u1ea1n l\u00e2m s\u00e0ng 3, 4<\/p>\n

C\u00e1c d\u1ea5u hi\u1ec7u ch\u1ee9ng t\u1ecf ng\u01b0\u1eddi b\u1ec7nh c\u00f3 \u0111\u00e1p \u1ee9ng v\u1edbi \u0111i\u1ec1u tr\u1ecb ARV<\/strong><\/p>\n

– S\u1ee9c kh\u1ecfe \u0111\u01b0\u1ee3c c\u1ea3i thi\u1ec7n: t\u0103ng c\u0103n, th\u00e8m \u0103n tr\u1edf l\u1ea1i v\u00e0 \u0103n ngon mi\u1ec7ng h\u01a1n, th\u1ec3 tr\u1ea1ng, t\u00e2m l\u00fd t\u1ed1t h\u01a1n, ng\u01b0\u1eddi b\u1ec7nh c\u00f3 nhi\u1ec1u s\u1ee9c h\u01a1n \u0111\u1ec3 th\u1ef1c hi\u1ec7n c\u00e1c ho\u1ea1t \u0111\u1ed9ng h\u1eb1ng ng\u00e0y.<\/p>\n

– C\u00e1c tri\u1ec7u ch\u1ee9ng li\u00ean quan \u0111\u1ebfn b\u1ec7nh HIV \u0111\u01b0\u1ee3c c\u1ea3i thi\u1ec7n.<\/p>\n

– C\u00e1c b\u1ec7nh nhi\u1ec5m tr\u00f9ng c\u01a1 h\u1ed9i c\u00f3 t\u1eeb tr\u01b0\u1edbc \u0111\u01b0\u1ee3c c\u1ea3i thi\u1ec7n, gi\u1ea3m t\u1ea7n su\u1ea5t m\u1eafc v\u00e0 m\u1ee9c \u0111\u1ed9 n\u1eb7ng c\u1ee7a c\u00e1c nhi\u1ec5m tr\u00f9ng c\u01a1 h\u1ed9i.<\/p>\n

T\u00e1c d\u1ee5ng ph\u1ee5 c\u1ee7a thu\u1ed1c ARV<\/strong><\/p>\n

M\u1ed9t s\u1ed1 \u0111\u1ed9c t\u00ednh, t\u00e1c d\u1ee5ng ph\u1ee5 kh\u00e1c c\u1ee7a thu\u1ed1c ARV c\u00f3 th\u1ec3 g\u1eb7p khi \u0111i\u1ec1u tr\u1ecb nh\u01b0:<\/p>\n

– B\u1ec7nh l\u00fd th\u1ea7n kinh ngo\u1ea1i vi:<\/em> Bi\u1ec3u hi\u1ec7n r\u1ed1i lo\u1ea1n c\u1ea3m gi\u00e1c ngo\u1ea1i vi, ch\u1ee7 y\u1ebfu \u0111\u1ea7u chi, \u0111i l\u1ea1i kh\u00f3 kh\u0103n. Th\u01b0\u1eddng g\u1eb7p khi d\u00f9ng d4T, ddI, c\u00e1c thu\u1ed1c kh\u00e1ng retroviruss non-nucleosid. C\u1ea7n d\u00f9ng vitamin B li\u1ec1u cao, n\u1ebfu n\u1eb7ng ph\u1ea3i thay th\u1ebf thu\u1ed1c.<\/p>\n

– Vi\u00eam t\u1ee5y:<\/em> G\u1eb7p khi d\u00f9ng ddI, d4T. C\u1ea7n d\u1eebng ngay thu\u1ed1c v\u00e0 thay b\u1eb1ng ZDV. – Ph\u00e2n b\u1ed1 l\u1ea1i m\u1ee1: Khi d\u00f9ng ddI, thu\u1ed1c \u1ee9c ch\u1ebf proteases. Bi\u1ec3u hi\u1ec7n t\u0103ng t\u00edch t\u1ee5 m\u1ee1 \u1edf ng\u1ef1c, b\u1ee5ng, l\u01b0ng, g\u00e1y; teo m\u00f4 m\u1ee1 \u1edf c\u00e1nh tay, c\u1eb3ng ch\u00e2n, m\u00f4ng, m\u00e1.<\/p>\n

– \u0110\u1ed9c cho gan<\/em>: NPV, EFV, ZDV v\u00e0 thu\u1ed1c \u1ee9c ch\u1ebf proteases r\u1ea5t \u0111\u1ed9c v\u1edbi gan, g\u00e2y h\u1ee7y ho\u1ea1i t\u1ebf b\u00e0o gan, t\u0103ng men gan. C\u1ea7n ng\u1eebng thu\u1ed1c n\u1ebfu c\u00f3 t\u0103ng men gan g\u1ea5p 5 l\u1ea7n b\u00ecnh th\u01b0\u1eddng.<\/p>\n

– \u0110\u1ed9c v\u1edbi th\u1ea7n kinh trung \u01b0\u01a1ng:<\/em> EFV bi\u1ec3u hi\u1ec7n l\u1eabn l\u1ed9n, r\u1ed1i lo\u1ea1n t\u00e2m th\u1ea7n, tr\u1ea7m c\u1ea3m. C\u1ea7n d\u1eebng v\u00e0 thay th\u1ebf thu\u1ed1c khi b\u1ec7nh nh\u00e2n c\u00f3 v\u1ea5n \u0111\u1ec1 v\u1ec1 t\u00e2m th\u1ea7n kinh.<\/p>\n

\u0110i\u1ec1u tr\u1ecb thu\u1ed1c kh\u00e1ng ARV cho nh\u1eefng ng\u01b0\u1eddi c\u00f3 HIV l\u00e0 \u0111i\u1ec1u tr\u1ecb su\u1ed1t \u0111\u1eddi,ch\u00ednh v\u00ec v\u1eady, th\u1eddi \u0111i\u1ec3m th\u00edch h\u1ee3p nh\u1ea5t \u0111\u1ec3 ng\u01b0\u1eddi c\u00f3 HIV b\u1eaft \u0111\u1ea7u tham gia \u0111i\u1ec1u tr\u1ecb l\u00e0 khi c\u00f3 ch\u1ec9 \u0111\u1ecbnh c\u1ee7a b\u00e1c s\u1ef9 v\u00e0 khi th\u1ef1c s\u1ef1 s\u1eb5n s\u00e0ng tham gia v\u00e0o vi\u1ec7c \u0111i\u1ec1u tr\u1ecb. Thu\u1ed1c ARV l\u00e0m gi\u1ea3m qu\u00e1 tr\u00ecnh sinh s\u00f4i c\u1ee7a virus HIV trong c\u01a1 th\u1ec3, l\u00e0m gi\u1ea3m qu\u00e1 tr\u00ecnh t\u1eeb HIV sang AIDS, ph\u1ee5c h\u1ed3i h\u1ec7 th\u1ed1ng mi\u1ec5n d\u1ecbch cho c\u01a1 th\u1ec3. \u0110i\u1ec1u tr\u1ecb b\u1eb1ng ARV l\u00e0 m\u1ed9t qu\u00e1 tr\u00ecnh l\u00e2u d\u00e0i v\u00e0 ph\u1ee9c t\u1ea1p n\u00ean ng\u01b0\u1eddi b\u1ec7nh c\u1ea7n tu\u00e2n th\u1ee7 \u0111\u00fang ph\u00e1c \u0111\u1ed3 \u0111i\u1ec1u tr\u1ecb c\u1ee7a b\u00e1c s\u0129.<\/p>\n

 <\/p>\n

Theo NTD<\/strong><\/p>\n

\n","protected":false},"excerpt":{"rendered":"ARV l\u00e0 thu\u1ed1c \u0111i\u1ec1u tr\u1ecb d\u00f9ng cho nh\u1eefng ng\u01b0\u1eddi b\u1ecb HIV, c\u00f3 t\u00e1c d\u1ee5ng l\u00e0m gi\u1ea3m s\u1ef1 ph\u00e1t tri\u1ec3n c\u1ee7a virus HIV v\u00e0 l\u00e0m ch\u1eadm giai \u0111o\u1ea1n HIV sang AIDS. D\u00f9ng ARV cho","protected":false},"author":1,"featured_media":2803,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[188],"tags":[510,297,513,512,514,516,511,515],"yoast_head":"\n\n\n\n\n\n\n\n\n\n\n\t\n\t\n\n\t\n\t\n\t\n