一(yi)般來(lai)說,一(yi)種(zhong)病毒進入人體(ti)(ti)(ti)后(hou),會(hui)刺(ci)激人體(ti)(ti)(ti)的免疫系統產生一(yi)種(zhong)針(zhen)對該病毒的抗(kang)體(ti)(ti)(ti),抗(kang)體(ti)(ti)(ti)會(hui)對病毒進行(xing)“瓦解”、“中和”和“消(xiao)(xiao)(xiao)滅”工作,最(zui)終將病毒消(xiao)(xiao)(xiao)除(chu)。但有的病毒刺(ci)激人體(ti)(ti)(ti)的免疫系統所產生的抗(kang)體(ti)(ti)(ti)并不(bu)能(neng)達到消(xiao)(xiao)(xiao)除(chu)病毒的作用,只是和病毒共(gong)同存在。那么艾滋病病毒是不(bu)是能(neng)被它的抗(kang)體(ti)(ti)(ti)(抗(kang)—HIV)消(xiao)(xiao)(xiao)滅呢?
在感染者(zhe)體內病毒和抗(kang)體有(you)什(shen)么變(bian)化(hua)
在(zai)(zai)艾(ai)滋(zi)病(bing)(bing)(bing)病(bing)(bing)(bing)毒(du)感(gan)(gan)染(ran)(ran)初期(qi),病(bing)(bing)(bing)毒(du)在(zai)(zai)人體內會很快復制(zhi),感(gan)(gan)染(ran)(ran)者外周血(xue)(xue)液中的病(bing)(bing)(bing)毒(du)量(liang)首先(xian)出(chu)(chu)(chu)現(xian)一個高峰;在(zai)(zai)感(gan)(gan)染(ran)(ran)后(hou)4~8周,感(gan)(gan)染(ran)(ran)者的體內就會產(chan)(chan)生艾(ai)滋(zi)病(bing)(bing)(bing)病(bing)(bing)(bing)毒(du)的抗(kang)體,而(er)(er)且水平很快上升;在(zai)(zai)抗(kang)體出(chu)(chu)(chu)現(xian)以(yi)后(hou),人體血(xue)(xue)液中的艾(ai)滋(zi)病(bing)(bing)(bing)病(bing)(bing)(bing)毒(du)量(liang)很快下降(jiang)。因(yin)此(ci),在(zai)(zai)感(gan)(gan)染(ran)(ran)初期(qi),能從血(xue)(xue)中直(zhi)(zhi)接檢測到(dao)病(bing)(bing)(bing)毒(du)的時間(jian)很短。一直(zhi)(zhi)到(dao)艾(ai)滋(zi)病(bing)(bing)(bing)發病(bing)(bing)(bing)以(yi)后(hou),出(chu)(chu)(chu)現(xian)第(di)二個病(bing)(bing)(bing)毒(du)復制(zhi)高峰,才可再次從血(xue)(xue)液中測出(chu)(chu)(chu)病(bing)(bing)(bing)毒(du)。而(er)(er)抗(kang)體自產(chan)(chan)生之時起(qi),就一直(zhi)(zhi)持續存在(zai)(zai)。
病毒和抗(kang)體檢(jian)測有什么意義
要想知道是否感(gan)染(ran)(ran)了艾(ai)滋(zi)(zi)(zi)(zi)(zi)病(bing)(bing)(bing)(bing)(bing)(bing)病(bing)(bing)(bing)(bing)(bing)(bing)毒(du)(du),有兩種(zhong)方(fang)法(fa)(fa):一(yi)種(zhong)是檢(jian)(jian)測(ce)(ce)(ce)(ce)血中(zhong)的(de)(de)艾(ai)滋(zi)(zi)(zi)(zi)(zi)病(bing)(bing)(bing)(bing)(bing)(bing)抗(kang)體(ti),另一(yi)種(zhong)是檢(jian)(jian)測(ce)(ce)(ce)(ce)艾(ai)滋(zi)(zi)(zi)(zi)(zi)病(bing)(bing)(bing)(bing)(bing)(bing)病(bing)(bing)(bing)(bing)(bing)(bing)毒(du)(du)抗(kang)原(yuan)或(huo)核酸。但并不是感(gan)染(ran)(ran)了艾(ai)滋(zi)(zi)(zi)(zi)(zi)病(bing)(bing)(bing)(bing)(bing)(bing)病(bing)(bing)(bing)(bing)(bing)(bing)毒(du)(du)后,在(zai)任何時期(qi)(qi)這兩種(zhong)方(fang)法(fa)(fa)都能使用(yong)。在(zai)艾(ai)滋(zi)(zi)(zi)(zi)(zi)病(bing)(bing)(bing)(bing)(bing)(bing)病(bing)(bing)(bing)(bing)(bing)(bing)毒(du)(du)感(gan)染(ran)(ran)初期(qi)(qi),血液(ye)(ye)中(zhong)病(bing)(bing)(bing)(bing)(bing)(bing)毒(du)(du)出(chu)(chu)現的(de)(de)時間較短(duan),且目前的(de)(de)檢(jian)(jian)測(ce)(ce)(ce)(ce)技術不能檢(jian)(jian)測(ce)(ce)(ce)(ce)出(chu)(chu)所有的(de)(de)病(bing)(bing)(bing)(bing)(bing)(bing)毒(du)(du)亞型(xing)。因(yin)此,感(gan)染(ran)(ran)者血液(ye)(ye)內可(ke)能因(yin)檢(jian)(jian)測(ce)(ce)(ce)(ce)不到(dao)艾(ai)滋(zi)(zi)(zi)(zi)(zi)病(bing)(bing)(bing)(bing)(bing)(bing)毒(du)(du),造(zao)成“假陰性(xing)”結果,延誤艾(ai)滋(zi)(zi)(zi)(zi)(zi)病(bing)(bing)(bing)(bing)(bing)(bing)的(de)(de)診(zhen)斷。另外,直接檢(jian)(jian)測(ce)(ce)(ce)(ce)艾(ai)滋(zi)(zi)(zi)(zi)(zi)病(bing)(bing)(bing)(bing)(bing)(bing)病(bing)(bing)(bing)(bing)(bing)(bing)毒(du)(du)抗(kang)原(yuan)或(huo)核酸的(de)(de)方(fang)法(fa)(fa)需要用(yong)很(hen)昂貴(gui)的(de)(de)試驗才能檢(jian)(jian)測(ce)(ce)(ce)(ce)出(chu)(chu)來(lai)。1985年以(yi)后,科學家們發(fa)明(ming)了一(yi)些檢(jian)(jian)測(ce)(ce)(ce)(ce)艾(ai)滋(zi)(zi)(zi)(zi)(zi)病(bing)(bing)(bing)(bing)(bing)(bing)病(bing)(bing)(bing)(bing)(bing)(bing)毒(du)(du)抗(kang)體(ti)的(de)(de)方(fang)法(fa)(fa),大大提高了艾(ai)滋(zi)(zi)(zi)(zi)(zi)病(bing)(bing)(bing)(bing)(bing)(bing)診(zhen)斷的(de)(de)準確性(xing),降低了檢(jian)(jian)測(ce)(ce)(ce)(ce)費用(yong)。在(zai)感(gan)染(ran)(ran)艾(ai)滋(zi)(zi)(zi)(zi)(zi)病(bing)(bing)(bing)(bing)(bing)(bing)病(bing)(bing)(bing)(bing)(bing)(bing)毒(du)(du)后,人體(ti)內的(de)(de)抗(kang)體(ti)產生量是一(yi)個(ge)逐漸升高的(de)(de)過程,從無(wu)到(dao)有,從很(hen)低到(dao)可(ke)以(yi)用(yong)試劑檢(jian)(jian)測(ce)(ce)(ce)(ce)出(chu)(chu)來(lai),需要經過一(yi)段(duan)時間。從感(gan)染(ran)(ran)艾(ai)滋(zi)(zi)(zi)(zi)(zi)病(bing)(bing)(bing)(bing)(bing)(bing)病(bing)(bing)(bing)(bing)(bing)(bing)毒(du)(du)至(zhi)血液(ye)(ye)中(zhong)可(ke)以(yi)檢(jian)(jian)測(ce)(ce)(ce)(ce)出(chu)(chu)抗(kang)體(ti)這個(ge)時期(qi)(qi),即血液(ye)(ye)中(zhong)檢(jian)(jian)測(ce)(ce)(ce)(ce)不到(dao)艾(ai)滋(zi)(zi)(zi)(zi)(zi)病(bing)(bing)(bing)(bing)(bing)(bing)病(bing)(bing)(bing)(bing)(bing)(bing)毒(du)(du)抗(kang)體(ti)的(de)(de)這個(ge)時期(qi)(qi),被醫生們稱作艾(ai)滋(zi)(zi)(zi)(zi)(zi)病(bing)(bing)(bing)(bing)(bing)(bing)的(de)(de)“窗口期(qi)(qi)”。
艾滋(zi)病“窗口期”到底有多長
“窗口期”的長短與檢測(ce)手段(duan)的敏(min)感性(xing)有關。以(yi)前,這一過程要(yao)半年(nian),現在隨著人類對艾滋病研究的深入,試劑的敏(min)感性(xing)越來(lai)越高,“窗口期”就縮短了(le)。
如果使(shi)用酶聯免疫吸附試驗(ELISA)的(de)(de)方法,在(zai)感(gan)染(ran)后3個月內,98%以上(shang)的(de)(de)感(gan)染(ran)者體內都(dou)能檢測(ce)出艾(ai)滋(zi)病(bing)病(bing)毒抗體。抗體產生的(de)(de)過程也存在(zai)著個體差異。有人在(zai)感(gan)染(ran)后4~8周即可在(zai)血中檢測(ce)出艾(ai)滋(zi)病(bing)病(bing)毒抗體,而有些人則要到3個月后才(cai)能檢測(ce)出來。
抗體能不能“對(dui)付”艾滋(zi)病病毒(du)
以往,大(da)家都知(zhi)道抗(kang)(kang)(kang)體(ti)(ti)(ti)(ti)(ti)是(shi)機體(ti)(ti)(ti)(ti)(ti)的(de)(de)(de)(de)(de)(de)(de)(de)免疫(yi)系(xi)(xi)統針(zhen)對(dui)(dui)侵入的(de)(de)(de)(de)(de)(de)(de)(de)病(bing)(bing)(bing)(bing)(bing)(bing)原微(wei)生(sheng)物產(chan)生(sheng)的(de)(de)(de)(de)(de)(de)(de)(de)武(wu)器(qi)。那么艾(ai)滋(zi)(zi)病(bing)(bing)(bing)(bing)(bing)(bing)病(bing)(bing)(bing)(bing)(bing)(bing)毒(du)的(de)(de)(de)(de)(de)(de)(de)(de)抗(kang)(kang)(kang)體(ti)(ti)(ti)(ti)(ti)能(neng)不(bu)(bu)(bu)(bu)(bu)能(neng)阻(zu)止艾(ai)滋(zi)(zi)病(bing)(bing)(bing)(bing)(bing)(bing)病(bing)(bing)(bing)(bing)(bing)(bing)毒(du)的(de)(de)(de)(de)(de)(de)(de)(de)增殖,起(qi)到(dao)抵(di)御(yu)艾(ai)滋(zi)(zi)病(bing)(bing)(bing)(bing)(bing)(bing)的(de)(de)(de)(de)(de)(de)(de)(de)作用呢?感染早期,大(da)多(duo)數艾(ai)滋(zi)(zi)病(bing)(bing)(bing)(bing)(bing)(bing)病(bing)(bing)(bing)(bing)(bing)(bing)毒(du)感染者能(neng)產(chan)生(sheng)有(you)針(zhen)對(dui)(dui)性(xing)的(de)(de)(de)(de)(de)(de)(de)(de)抗(kang)(kang)(kang)體(ti)(ti)(ti)(ti)(ti)。但這(zhe)種(zhong)抗(kang)(kang)(kang)體(ti)(ti)(ti)(ti)(ti)并(bing)不(bu)(bu)(bu)(bu)(bu)能(neng)完全(quan)阻(zu)止病(bing)(bing)(bing)(bing)(bing)(bing)毒(du)的(de)(de)(de)(de)(de)(de)(de)(de)增殖或抵(di)御(yu)艾(ai)滋(zi)(zi)病(bing)(bing)(bing)(bing)(bing)(bing)的(de)(de)(de)(de)(de)(de)(de)(de)發生(sheng)。這(zhe)是(shi)因(yin)為,艾(ai)滋(zi)(zi)病(bing)(bing)(bing)(bing)(bing)(bing)病(bing)(bing)(bing)(bing)(bing)(bing)毒(du)能(neng)夠把自己(ji)的(de)(de)(de)(de)(de)(de)(de)(de)基(ji)因(yin)整合到(dao)感染者CD4細胞的(de)(de)(de)(de)(de)(de)(de)(de)DNA內(nei),并(bing)處于不(bu)(bu)(bu)(bu)(bu)活化(hua)狀態(tai),使抗(kang)(kang)(kang)體(ti)(ti)(ti)(ti)(ti)不(bu)(bu)(bu)(bu)(bu)能(neng)找到(dao)它的(de)(de)(de)(de)(de)(de)(de)(de)靶子,不(bu)(bu)(bu)(bu)(bu)知(zhi)道去(qu)消(xiao)滅(mie)(mie)誰;而且,艾(ai)滋(zi)(zi)病(bing)(bing)(bing)(bing)(bing)(bing)病(bing)(bing)(bing)(bing)(bing)(bing)毒(du)有(you)多(duo)種(zhong)亞型,其突變率相當高,人體(ti)(ti)(ti)(ti)(ti)內(nei)的(de)(de)(de)(de)(de)(de)(de)(de)抗(kang)(kang)(kang)體(ti)(ti)(ti)(ti)(ti)難以應(ying)對(dui)(dui)其不(bu)(bu)(bu)(bu)(bu)斷翻新的(de)(de)(de)(de)(de)(de)(de)(de)變化(hua)。最重(zhong)要(yao)的(de)(de)(de)(de)(de)(de)(de)(de)是(shi),艾(ai)滋(zi)(zi)病(bing)(bing)(bing)(bing)(bing)(bing)病(bing)(bing)(bing)(bing)(bing)(bing)毒(du)破壞的(de)(de)(de)(de)(de)(de)(de)(de)就(jiu)是(shi)人體(ti)(ti)(ti)(ti)(ti)的(de)(de)(de)(de)(de)(de)(de)(de)免疫(yi)系(xi)(xi)統,使指揮(hui)機體(ti)(ti)(ti)(ti)(ti)免疫(yi)反(fan)應(ying)的(de)(de)(de)(de)(de)(de)(de)(de)總(zong)指揮(hui)——CD4細胞直接受到(dao)毀滅(mie)(mie)性(xing)破壞,根本(ben)無法產(chan)生(sheng)足以消(xiao)滅(mie)(mie)病(bing)(bing)(bing)(bing)(bing)(bing)毒(du)的(de)(de)(de)(de)(de)(de)(de)(de)有(you)力武(wu)器(qi)。因(yin)此,艾(ai)滋(zi)(zi)病(bing)(bing)(bing)(bing)(bing)(bing)病(bing)(bing)(bing)(bing)(bing)(bing)毒(du)的(de)(de)(de)(de)(de)(de)(de)(de)抗(kang)(kang)(kang)體(ti)(ti)(ti)(ti)(ti)似乎成(cheng)了(le)一個擺設,只是(shi)用來(lai)證(zheng)明人體(ti)(ti)(ti)(ti)(ti)感染了(le)艾(ai)滋(zi)(zi)病(bing)(bing)(bing)(bing)(bing)(bing)。
到目(mu)前(qian)為止,臨床上只見(jian)到大約7%的(de)人(ren)感(gan)染(ran)(ran)艾(ai)(ai)滋病病毒(du)(du)后,在沒(mei)有進行抗病毒(du)(du)治(zhi)療的(de)前(qian)提下,CD4淋巴(ba)細(xi)胞(bao)數長期(qi)保(bao)持在正常(chang)水平或接近正常(chang)水平,無任何臨床癥(zheng)狀,此(ci)類(lei)感(gan)染(ran)(ran)者(zhe)被(bei)稱為“長期(qi)無癥(zheng)狀生(sheng)(sheng)(sheng)存者(zhe)”。在對艾(ai)(ai)滋病高危人(ren)群的(de)調查研究中也發現,非洲有些性(xing)工(gong)作(zuo)者(zhe)長期(qi)和(he)艾(ai)(ai)滋病病毒(du)(du)感(gan)染(ran)(ran)者(zhe)發生(sheng)(sheng)(sheng)性(xing)接觸而沒(mei)有被(bei)感(gan)染(ran)(ran)。科學家們(men)認(ren)為這些長期(qi)無癥(zheng)狀生(sheng)(sheng)(sheng)存者(zhe)和(he)不(bu)被(bei)艾(ai)(ai)滋病病毒(du)(du)感(gan)染(ran)(ran)的(de)性(xing)工(gong)作(zuo)者(zhe)體內可能(neng)存在著(zhu)抵抗病毒(du)(du)的(de)物質(zhi)。如果能(neng)找到這種物質(zhi)及(ji)其發生(sheng)(sheng)(sheng)規律,人(ren)類(lei)將可能(neng)找到抵御(yu)艾(ai)(ai)滋病的(de)方法。
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