Kuyanjanitsa mgwirizano pakati pa mtengo ndi chisamaliro chapamwamba
Kafukufuku waposachedwapa sanayang'ane kokha kufunika kokhala ndi kachilombo koyambitsa kachilombo koyambitsa matenda koma kachilombo ka HIV kamakhala kovuta pazirombo zosiyanasiyana.
Phunziro lina lochokera ku US Centers of Disease Control and Prevention (CDC) loyesa kulingalira kuti mtengo wa moyo wa anthu onse omwe ali ndi kachilombo ka HIV, womwe umayambira nthawi zonse (CD), umayamba kuwerengera ( CD4 chiwerengero cha maselo 500 / ml kapena osachepera). (200 maselo / mL kapena zochepa).
Zotsatirazo zatsimikizira kuti maphunziro ang'onoang'ono angapo akhala akusonyeza kuti: kuyamba koyambirira kwa ART mogwirizana ndi ndalama zochepa kwambiri za moyo.
Malingana ndi kafukufuku, kwa omwe akuyambitsa chithandizo pa ma CD4 apamwamba, chiŵerengero cha moyo wawo wonse ndi pafupifupi $ 250,000. Mosiyana ndi zimenezo, omwe akuyambira pa maselo 200 / mL kapena osachepera amatha kupepiritsa ndalama ziwirizo kuchokera kulikonse pakati pa $ 400,000 ndi $ 600,000.
Zina mwa zifukwa zomwe zimatchulidwa kuti ndalama zowonjezereka ndizoopsa kwambiri chifukwa cha matenda okhudzana ndi kachilombo ka HIV ndi omwe alibe kachilombo ka HIV mwa iwo omwe ali ndi machitidwe okhudzana ndi HIV. Kuwonjezera pamenepo, mwinamwake munthu akhoza kubwezeretsa chitetezo cha thupi kumayendedwe apamwamba (mwachitsanzo, ma CD4 a maselo 500-800 / mL) amakhala osachepera kenako amayamba mankhwala.
Kufufuza kwachidwi kuchokera ku College ya Medical College ya Weill Cornell kunathandizira zogwirizana. kufufuza anthu omwe ali ndi HIV kuyambira ali ndi zaka 35 mpaka imfa.
Ngakhale mtengo wamachiritso kwa omwe anayambitsa chithandizo pa matenda ($ 435,200) anali oposa kwambiri kuposa omwe adachedwetsa mankhwala ($ 326,500), kupulumutsidwa mwa matenda ndi kupewera kuchipatala kunkaonedwa kuti ndi kwakukulu.
Ofufuzawo anatha kuzindikira kuti nthawi yomwe moyo wapadera wopezera kutenga kachilombo ka HIV kamakhalapo pakati pa $ 229,800 mpaka $ 338,400.
Kuyika Zomwe Moyo Wonse wa HIV Uyenera Kuchita
Ngakhale kuti nthawi zonse zothandizira mankhwala, zikuoneka kuti zikuwoneka kuti zikuwoneka kuti ndizopangitsa kuti pakhale mankhwala osokoneza bongo a HIV kapena ndalama zothandizira zachipatala ku America-ndikofunika kuyang'anitsitsa zomwe zimagwirizana ndi zina zomwe zimakhudza thanzi.
Mwachitsanzo, taganizirani kuti nthawi yomwe munthu amafunika kusuta fodya wamwamuna wazaka 24 ndi $ 183,000, pomwe mayi wazaka 24 angathe kuyembekezera ndalama zokwana $ 86,000. Pambuyo pa mtengo wa ndudu okha, ndalama zogonana ndi Medicare, Medicaid, Social Security, ndi inshuwalansi ya umoyo zikuwoneka kuti ndizokulu kwambiri-kaya chifukwa cha kusuta fodya , emphysema, khansara yamapapo, ndi zina zotero.
(Ziwerengerozi zimawonjezereka chifukwa chakuti kusuta, monga kudziimira, kumadziwika kuchepetsa chiyembekezo cha moyo ndi zaka 12.3 kwa anthu omwe ali ndi kachilombo ka HIV.)
Pakalipano, nthawi ya kumwa mowa zitatu zakumwa zoledzeretsa tsiku limabwera madola 263,000 odabwitsa pa moyo wawo wonse, womwe umagwirizanitsa ndi 41% ya chiopsezo chachikulu cha khansa kwa amuna, kaya ali ndi kachilombo ka HIV kapena kachilombo ka HIV.
Ndondomeko Zogonjetsera Mtengo
Palibe izi, zenizeni, zothandizira kuchepetsa mavuto a zachuma a HIV, onse payekha komanso dongosolo lachipatala lonse.
Kuchokera pa lingaliro la munthu payekha, mtengo wa chisamaliro cha HIV umakhudzana mwachindunji ndi momwe wodwalayo amasungidwira mosamala ndi momwe munthuyo angagwiritsire ntchito mankhwala oyenera. Mu machitidwe awo a May 2014 a machitidwe a chithandizo cha HIV ku United States, Dipatimenti ya Zaumoyo ndi Zaumoyo (DHHS) inalongosola zodandaulazi povomereza kuti madokotala "amachepetsa ndalama zowononga mankhwala osagwiritsa ntchito mankhwala ngati kuli kotheka."
Izi zikuphatikizapo kugwiritsa ntchito njira zamagetsi zowonjezereka ngati zingatheke kapena zomveka. Komabe, chigamulocho chiyenera kutsatiridwa ndi kufufuza mosamala kuti ngati ndalama zochepetseka zingapangitse mapiritsi kuti asamalire.
Zikatero, kugwiritsa ntchito magetsi kungachepetse ndalama zonse koma pokhapokha ngati munthu akutsatira mosavuta . Kuwonjezera pamenepo, zida zowonjezereka za mankhwala osokoneza bongo zingayambitse ndalama zambiri zothandizira inshuwalansi, kuwonjezeka osati kuchepetsa ndalama zowonjezera.
Momwemonso, DHHS yatsimikizira kuchepetsa kuchuluka kwa CD4 kuwunika kwa odwala omwe akhala pa ART kwa zaka zosachepera ziwiri ndipo akhala ndi mavitamini osasinthika. Ngakhale kuti izi zikuwoneka kukhala zosakhudzidwa kwambiri potsata ndondomeko yamtengo wapatali, mayesero ogwirizana monga CD8 ndi CD19 alidi, okwera mtengo; musakhale ndi mtengo wa kliniki; ndipo sakuvomerezedwa ngati njira yothetsera chisamaliro cha HIV.
Kwa iwo omwe adziwonetsa kuwononga kwa nthawi yayitali pa ART, tsopano DHHS ikuyamikira izo
- Kuwona CD4 kumachitika miyezi khumi ndi iwiri kwa iwo omwe ali ndi ma CD4 pakati pa 300 ndi 500 maselo / mL;
- Kuwona CD4 kumaonedwa ngati kotheka kwa omwe ali ndi CD4 chiwerengero cha ma cell 500 / ml.
Malingana ndi malangizowa, ma CD4 amatsogolera pamene ayambitsa kapena kusiya mankhwala opatsirana omwe amatetezedwa kuti ateteze matenda opatsirana , kapena kuti aone ngati wodwalayo ali ndi kachilombo ka HIV . (Yankho "lokwanira" limatanthawuzidwa ngati kuchuluka kwa CD4 chiwerengero cha 50 mpaka 150 maselo pa chaka choyamba cha mankhwala, ndi kuwonjezeka komweku chaka chilichonse mpaka chikhazikitso chikupezeka.)
Mosiyana ndi kuyesedwa , kuyesedwa kwa chiwerengero cha tizilombo kuyenera kuonedwa kuti ndipopopopera kuchipatala. Momwemonso, DHHS imalimbikitsa kuyang'anira mavairasi pa miyezi 3-4 iliyonse kwa odwala omwe ali ndi vutoli.
Zotsatira:
Farnham, P .; Gopalappa, C .; Dipo, S .; et al. "Zosintha za Moyo wa Ndalama Zosamaliranso ndi Moyo Womwe Zimayesa Anthu Omwe ali ndi kachilombo ka HIV ku United States: Kutha Posachedwapa ndi Kufufuza Kwambiri ndi Kulowa M'kusamalidwa." Journal of Deficiency Immune Deficiency Syndromes. October 2013: 64: 183-189.
Schackman, B ;; Fleishman, J .; Su, A ..; et al. "Ndalama zonse zachipatala zomwe zimakhalapo pa moyo wanga wonse kuti zisaletse HIV ku United States." Msonkhano wa 2015 pa Retroviruses ndi Matenda Opondereza (CROI). February 23-26, 2015; Seattle, Washington, umboni 1104.
Dipatimenti ya Zaumoyo ya Umoyo ku United States (DHHS). "Malangizo othandizira kugwiritsira ntchito ma antiretroviral mu HIV-1-Akuluakulu Okhudzidwa ndi Achinyamata." Bethesda, Maryland; inapezeka pa May 6, 2016.