Kuyang'ana Anthu Oopsya Otetezedwa ndi Immune
Pa May 26, 2006, US Food and Drug Administration (FDA) inavomereza Zostavax katemera kupewa tizilombo toyambitsa matenda omwe amatchedwa shingles. Ngakhale kuti poyamba anavomerezedwa kwa anthu akuluakulu 60 kapena kuposerapo, iwo sanapatsidwe makamaka omwe ali ndi HIV .
Malangizowo adakonzedwanso mchaka cha 2011 kuti aphatikize anthu akuluakulu 50 kapena kuposerapo pomwe sadapange malingaliro enieni okhudza ntchito yake kwa omwe ali ndi HIV.
Zostavax ndi katemera wotetezedwa ndi moyo, kutanthauza kuti umapangidwa ndi kachilombo ka moyo, kofooka. Ndilo mlingo waukulu wa katemera wa nkhuku pafupifupi 14 nthawiyi. Kafukufuku wasonyeza kuti Zostavax ingachepetse chiopsezo chakumangirira ndi 51 peresenti pamene kuchepetsa kuopsa kwa chiphuphu ndi 67 peresenti.
Zifukwa za Mabomba
Mphuno imadziwika ndi kupweteka kopwetekedwa ndi zotupa zomwe zimawoneka mu gulu kapena mzere kumbali imodzi nkhope kapena thupi. Zimayambitsanso kubwezeretsa varicella zoster virus (VZV) mwa anthu akuluakulu omwe kale anali ndi nkhuku.
Ngakhale kuti kachilombo ka HIV kawiri kawiri kamakhala kakang'ono kwambiri pamasewu ammitsempha pafupi ndi msana, iyo ikhoza kuphulika pamene itayambiranso. Mphunoyi imapangidwira kumtunda winawake wa mitsempha, wotchedwa dermatome , yomwe imayambira kumanzere kapena kumanja kwa thupi.
Zikuyesa kuti mmodzi mwa anthu atatu padziko lonse lapansi adzakhala ndi ziphuphu pa moyo wawo wonse.
Ku US, milandu yoposa milioni imadziwika pachaka. Kuopsa kokwatira kumatchulidwanso ngati munthu ali ndi zaka zambiri, kuposa kukayikira ali ndi zaka 65.
Kusuntha kwa Anthu omwe ali ndi HIV
Kubwezeretsa VZV kungatheke pamene chitetezo cha mthupi chitsika. Izi zikhoza kuchitika ngati munthu wa zaka zambiri komanso pamene kachilombo ka HIV kamatulutsa maselo a m'thupi omwe amatchedwa CD4 T-cells .
Kutayika kwakukulu kwa T-maselo, kumakhala koopsa kwambiri (makamaka monga madontho a CD4 count pansi pa 350). Mankhwala amtundu wapamwamba amakhalanso ndi chiopsezo chowonjezeka.
Ngakhale kuti kachilombo koyambitsa matenda a kachilombo ka HIV kachepetsa chiwopsezo cha anthu omwe ali ndi kachilombo ka HIV, pafupifupi chiwerengero chachitatu, chiopsezo chimakhala chofanana ndi cha anthu akuluakulu oposa 65. Zonsezi zati, chiopsezo chotenga kachilombo ka HIV ndi katatu kuposa anthu ambiri.
Kuwonjezera apo, kachilombo ka HIV kamakhala ndi vuto lalikulu lakumangirira, kuphatikizapo ziphuphu zofalitsa (zomwe zimakhudza ziwalo zitatu kapena zambiri), matumbo a maso kapena ziwalo za mkati, kapena kubwereranso mkati mwa miyezi isanu ndi umodzi.
Kafukufuku wochokera ku Yunivesite ya John Hopkins ananena kuti pafupifupi 28 peresenti ya anthu omwe ali ndi kachilombo ka HIV omwe ali ndi matendawa amatha kuvutika.
Malangizo kwa anthu omwe ali ndi HIV
Ngakhale kuti a FDA sanapange malangizowo okhudzana ndi kugwiritsidwa ntchito kwa Zostavax kwa anthu omwe ali ndi kachirombo ka HIV (osati kunena kuti anthu omwe ali ndi "chitetezo cha chitetezo cha mthupi" ayenera kupeŵa). pali umboni wochuluka wochirikiza ntchito yake.
Mu 2012, asayansi omwe ali ndi gulu lalitali la AIDS Clinical Trials Group adanena kuti Zostavax inali yotetezeka kwa anthu omwe ali ndi CD4 chiwerengero cha 200.
Ngakhale zotsatira zake zinali zolimbikitsa, ambiri analibe nkhawa ndi katemera wa anthu omwe ali ndi kachilombo ka CD4 pansi pa 200. Monga katemera wamoyo, palibenso mwayi woti ngakhale kachilombo kofooka kangayambitse matendawo.
Ngakhale kuti Zochitika Zosamalira Zachilombo ndi Kupewa Matenda sizilangiza Zostavax pakalipano kwa anthu omwe ali ndi kachilombo ka HIV, lingaliro lachipatala likuwoneka kuti likusintha. Akatswiri ambiri odwala matenda opatsirana amathandiza kugwiritsa ntchito Zostavax omwe ali ndi kachilombo ka HIV 50 kapena kupitirira omwe akhalabe ndi mphamvu yosawerengeka ya mavairasi komanso CD4 chiwerengero choposa 200. Momwemonso, ambiri amavomereza kuti Zostavax sayenera kugwiritsidwa ntchito kwa anthu okhala ndi CD4 chiwerengero choposa 200 .
Zostavax iyeneranso kupeŵedwa kwa anthu omwe alibe mbiri ya nkhukupo kapena umboni wa ma antibodies a VZV. Kwa anthuwa, ndi nkhuku yoyamba yodzipatsira nkhuku (monga Varivax kapena Varilrix).
> Zotsatira:
> Utsogoleri wa US Food and Drug Administration. "FDA imavomereza katemera wa Zostavax popewera shingles pakati pa anthu a zaka 50 mpaka 59." Silver Spring, Maryland; adatulutsidwa pa May 24, 2011.
> Blanks, L .; Polydefkis, M .; Moore, R. et al. "Herpes zoster pakati pa anthu omwe ali ndi kachilombo koyambitsa matenda a antiretroviral." Journal of Deficiency Immune Deficiency Syndromes. October 1, 2012; 61 (2): 203-207. DOI: 10.1097 / QAI.0b013e318266cd3c.
> Benson, C .; Hua, L .; Andersen, J .; et al. "ZOSTAVAX nthawi zambiri imakhala yotetezeka komanso yotetezeka m'magulu akuluakulu a kachilombo ka HIV omwe amatsutsidwa pa ART. Zotsatira za > gawo > 2, mayesero, aŵiri-osaona, omwe amayesedwa ndi placebo." Msonkhano wa 19 wa Retroviruses ndi Matenda Osakanikirana (CROI); Seattle, Washington; March 5-8, 2012; chosamveka 96.