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Chú ý khi điều trị HIV/AIDS ở trẻ em.  

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01:05 04/05/2016

Việc điều trị HIV/AIDS cần tuân thủ chặt chẽ theo chỉ định của bác sĩ chuyên khoa, phác đồ điều trị HIV/AIDS cho từng đối tượng lứa tuổi không giống nhau,do đó tránh tình.. [..]

Việc điều trị HIV/AIDS cần tuân thủ chặt chẽ theo chỉ định của bác sĩ chuyên khoa, phác đồ điều trị HIV/AIDS cho từng đối tượng lứa tuổi không giống nhau,do đó tránh tình trạng lạm dụng thuốc, sử dụng thuốc chồng chéo từ người này sang người kia làm giảm hiệu quả và tác dụng của thuốc.

Tiêu chuẩn bắt đầu điều trị ARV

-Đối với người lớn và trẻ từ 5 tuổi trở lên:

Chỉ định điều trị ARV khi tế bào CD4 < hoặc bằng 500 tế bào/mm3.

Điều trị không phụ thuộc số lượng tế bào CD4 trong trường hợp:

+Giai đoạn lâm sàng 3 hoặc 4 bao gồm mắc bệnh lao đồng nhiễm virut viêm gan B,C.

+Phụ nữ mang thai và phụ nữ đang cho con bú nhiễm HIV, người nhiễm HIV có vợ/chồng hoặc bạn tình không bị nhiễm HIV.

+Người nhiễm HIV thuộc các nguy cơ :người tiêm chích ma tuý, người bán dâm, nam quan hệ tình dục đồng giới

+ Người nhiễm HIV từ 50 tuổi trở lên; người nhiễm HIV sinh sống làm việc tại khu vực miền núi, hải đảo, vùng sâu, vùng xa.

-Đối với trẻ dưới 5 tuổi:

+Bắt đầu điều trị ARV cho tất cả trẻ em nhiễm HIV không phụ thuộc giai đoạn lâm sàng và số lượng tế bào CD4

+Bắt đầu điều trị ARV đối với trẻ dưới 18 tháng tuổi có xét nghiệm PCR dương tính hoặc xét nghiệm kháng thể kháng HIV dương tính và có biểu hiện sau: nấm miệng, viêm phổi nặng, nhiễm khuẩn nặng hoặc bất kỳ bệnh lý nào của giai đoạn AIDS.


Các phác đồ điều trị ARV bậc 1

-Người lớn và trẻ em từ 10 tuổi trở lên (bao gồm phụ nữ mang thai nhiễm HIV): phác đồ chính TDF + 3TC + EFV.

Ưu tiên dùng dạng thuốc viên hỗn hợp (FDC) để người bệnh dễ sử dụng và dễ tuân thủ. Nếu có chống chỉ định sử dụng TDF thì thay thế bằng AZT,Nếu có chống chỉ định sử dụng  EFV thì thay thế bằng NVP. Có thể sử dụng Emtricitabine (FTC) thay thế cho 3TC.

-Trẻ em từ 10 tuổi trở lên nhưng có cân nặng dưới 35kg hoặc trẻ em từ 3 đến 10 tuổi: Phác đồ chính ABC + 3TC + EFV.

Trong trường hợp có chống chỉ định sử dụng ABC thay thế bằng AZT; chống chỉ định sử dụng EFV thay thế bằng NVP. Emtricitabine (FTC) có thể dùng để thay thế cho 3TC.

-Trẻ em dưới 3 tuổi: Phác đồ chính: ABC + 3TC + LPV/r.

Nếu có chống chỉ định sử dụng ABC thay thế bằng AZT, chống chỉ định sử dụng LPV/r thay thế bằng NVP.

Nguồn tổng hợp.

Chú ý: Trên đây là những thông tin tham khảo,nếu bạn có bất kì thắc mắc gì hãy gọi tới tổng đài 19006180 để được các bác sĩ tư vấn trực tiếp và cụ thể.


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