Matenda opatsirana, panthawi ya mimba, kachilombo ka HIV kamakhudza chiopsezo
Chiwindi cha chiwindi cha matenda a chiwindi ndi matenda omwe amachititsa chiwindi chomwe chimayambitsidwa kupyolera mu kugwiritsa ntchito singano ndi siringi. Koma si njira yokha imene anthu angatetezere. Chaka chilichonse ku US, amayi pafupifupi 40,000 omwe ali ndi matenda a hepatitis C amabereka, omwe ana awo okwana 4,000 amawoneka kuti ali ndi kachilombo koyambitsa matenda a hepatitis C (HCV).
Ngakhale kuti osachepera 10 peresenti amatha kupita ku matenda aakulu , izi ndizokwanira kudetsa nkhaŵa makamaka makamaka popeza pali zinthu zochepa, kapena zina, zomwe zingapangitse kapena kuchepetsa chiopsezo chotengeka kuchokera kwa mayi kupita kwa mwana.
Komanso, kusowa kwa katemera wa HCV , komanso kusowa kwa chidziwitso chogwiritsa ntchito mankhwala a hepatitis C panthawi yomwe ali ndi mimba, kumatanthawuza kuti njira zotetezera nthawi zambiri zimakhala zochepa.
Koma izi sizikutanthauza kuti palibe zomwe makolo angachite-kapena mafunso omwe angafunse-ngati mmodzi kapena onse ali ndi chiwindi cha C ndipo akuyembekeza (kapena akukonzekera kukhala ndi) mwana.
Chiwindi cha matenda a Hepatitis C ndi Mimba ya Mimba
Ngakhale zimakhala zofala m'mawu omwe akukula kuti HCV iwaperekedwe kuchokera kwa mayi kupita kwa khanda kudzera mu njira zochiritsira zosagwiritsidwa ntchito, ku US ndi maiko ena otukuka Kufalitsa kwa HCV kumachitika mchiberekero kapenanso panthawi yopweteka.
Kafukufuku wina amasonyeza kuti chiopsezo chimawonjezeka pamapeto otenga mimba.
Izi zikhoza kukhala chifukwa chimodzimodzi, kuti chiwerengero cha kachilombo ka HIV chiwonjezeke pa nthawi yachiwiri ndi itatu ya trimesters, yomwe imayamba kuchepa masabata pambuyo pa kubereka.
Kawirikawiri kulankhula, amniotic madzimadzi sangakhale ndi virusi. N'zotheka kuti kachilomboka kamapezeka pamene kachilombo kamalowa m'maselo a placenta ndi / kapena epithelial omwe amayendera chiberekero.
Sitikudziwa bwinobwino chifukwa chake izi zimachitika kwa amayi ena osati m'madera ena, kapena zomwe zimapangitsa kuti thupi likhale ndi kachilombo ka HIV.
Ngakhale kachilombo ka HIV kakhoza kuchitika panthawi yobereka chifukwa cha kuwonetsa magazi a mayi ndi amayi, chiwopsezo chimasiyanasiyana kwambiri chifukwa cha kukula kwa kachirombo ka mayi.
Chiwindi cha Hepatitis C Choyambitsa Mimba
Chomwe chimagwirizanitsa kwambiri ndi kufalitsa kwa mayi ndi mwana wa HCV ndi mlingo wa kachirombo ka magazi m'magazi a mayi ndi madzi. Izi zimayesedwa ndi mayeso otchedwa HCV , omwe amawerengera chiwerengero cha tizilombo toyambitsa matenda mu mililita ya magazi. Mtengo ukhoza kukhala wochepa kusiyana ndi zikwi zingapo za tizilombo toyambitsa matenda kwa mamiliyoni ambiri, ndi machitidwe apamwamba akugwirizanitsa ndi chiopsezo chachikulu.
Chinthu chinanso chokhudzana ndi kuwonjezeka kwa chiopsezo chotenga kachilombo ka HIV ndi HIV yomwe ilipo . Izi ndizofunikira makamaka kuti ma ARV omwe ali ndi kachilombo ka HIV amatha kufika pamtunda kuposa 20 peresenti m'mayiko ena.
Pakati pa mimba, matenda osatetezeka a kachirombo ka HIV angayambe kufalitsa kachirombo ka HCV ndi 20 peresenti, malinga ndi kafukufuku wochokera ku National Institutes of Health. Komanso, amayi omwe ali ndi kachilombo ka HIV ndi kachirombo ka HIV amatha kupatsira ana awo omwe sanabadwe kachiwiri kachiwiri ngati akugwiritsa ntchito mankhwala osokoneza bongo.
Hepatitis C ndi Gawo la Kaisareya
Zovuta kwambiri, ayi. Kafukufuku wambiri sanasonyeze kusiyana kwa chiwerengero pa mlingo wa kachilombo ka HIV ngati amayi apereka vaginally kapena C-gawo. Koma izi sizikutanthawuza kusonyeza kuti palibe kulingalira komwe kungapangidwe posankha nthawi ndi nthawi yobereka.
Chinthu chimodzi chomwe chikudziwika kuti chimaonjezera chiopsezo chotenga kachilombo ka HIV ndikutuluka kwa memphane nthawi yayitali. Kuwombera maola oposa asanu ndi limodzi kumakhala ndi chiwerengero cha 30 peresenti yowonjezera chiopsezo, kuwonetsa kuti kuyesayesa kulikonse koyenera kupangidwira kuti gawo lachiwiri la ntchito likhale lalifupi ngati n'kotheka. Izi ndi zoona makamaka ngati amayi ali ndi chiwerengero cha ma ARV.
Mofananamo, njira iliyonse yothandizira odwala omwe amachititsa kuti magazi azikhala ndi magazi angawonjezere mwayi wopatsirana. Izi zikuphatikizapo amniocentesis, yomwe imakhala ndi chiopsezo chochepa chotenga kachilombo ka HIV, komanso kuyang'anitsitsa kamene kamene kamakhala koyambirira, komwe kumayenera kupewa panthawi ya kuvutika.
Hepatitis C ndi Kuyamwitsa
Palibe umboni uliwonse wosonyeza kuti kuyamwitsa kumawonjezera chiopsezo chotenga HIV kuchokera kwa mayi kupita kwa mwana. Ndi chifukwa chake kuti Centers for Disease Control and Prevention (CDC) ndi American Congress of Obstetrics ndi Gynecologists (ACOG) amavomereza kuyamwitsa amayi omwe ali ndi HCV. Pomwe zikunenedwa, amayi omwe ali ndi mitsempha yotsekemera kapena yakupha ayenera kulingalira njira zina, makamaka ngati ali ndi chiwerengero chachikulu cha mavairasi.
Amayi omwe ali ndi kachilombo ka HIV ndi kachilombo ka HIV ayenera kupeŵa kuyamwitsa pamene kulibe chiopsezo chotumiza HIV kwa mwanayo . Izi ndizowona makamaka kwa amayi omwe sali ndi kachilombo koyambitsa matenda opatsirana pogonana kapena sangathe kukwaniritsa zowonongeka za HIV.
N'chiyani Chimachitika Ngati Mwana Ayesera Kukhala Wosangalala?
Pafupi ana onse obadwa ndi amayi omwe ali ndi HCV amasonyeza ma antibodies a kachilomboka. Izi sizikutanthauza kuti mwanayo ali ndi kachilombo. Ma antibodies ali ndi mapuloteni omwe amatuluka ndi thupi chifukwa cha odwala omwe amawopsa ngati HCV.
Ana obadwa kumene, ma antibodies a HCV amakhala obadwa nawo (kutanthauza kuti amapangidwa ndi amayi ndipo amaperekedwa kwa mwana). Choncho, kupezeka kwawo sikukutanthauza kuti mwanayo ali ndi kachilomboka. Kawirikawiri, chiwerengero cha ma antibodies chidzatha pakapita nthawi, ndipo paliponse paliponse 90 mpaka 96 peresenti ya ana omwe amachotsa kachilombo pakati pa zaka 18 ndi 24.
Choncho, ndibwino kuti ana ayesedwe kwa HCV pasanathe miyezi 18. Ngati kuyesedwa koyambirira kukufunika, mayesero omwe amatchedwa HCV RNA mayeso angathe kuchitika pambuyo pa miyezi isanu ndi iwiri ndikubwezeretsanso tsiku lotsatira kuti aone ngati pali umboni wa matenda. Ngakhale kuti matendawa asamayambitse mwanayo, nthawi zambiri amatha kusamalira makolo ake.
Ngati mwana watsimikiziridwa kuti ali ndi chiwindi cha C, izi sizikutanthauza kuti mwanayo amadwala. Chiwindi cha chiwindi chotchedwa Hepatitis C chimafalikira kwambiri kwa ana kusiyana ndi achikulire, ndipo makumi asanu ndi atatu (80%) amasonyeza kuti sizing'onozing'ono zapakati pa 18 (fibrosis) .
Kuwonjezera apo, ana ndi achinyamata omwe ali ndi HCV amavomereza kuti athane ndi matenda a hepatitis C, ngati akufunikira, kukwaniritsa miyezo ya mankhwala ochiritsira komanso zotsatira zochepa kusiyana ndi achikulire.
Kuteteza Chiwindi cha Chiwindi mu Kutenga
Ngati muli ndi matenda a chiwindi (C) omwe mukudwala matenda a chiwindi (C), ndipo mukuganiza kuti mutenga mimba, kambiranani ndi dokotala wanu za momwe mungapezere mankhwala. Masiku ano, mankhwala opatsirana mowa mwachindunji (DAAs) akukwaniritsa mankhwala opitirira 95 peresenti mwa anthu ena, okhala ndi nthawi yokhala ndi mankhwala osapitirira masabata 12 mpaka 16.
Zomwezo zimagwiranso ntchito ngati mulibe HCV, koma mnzanuyo amachita. Ngakhale kuti palibe njira yoti mwamuna abweretse mwachindunji mwana, mwanayo ali ndi chiopsezo chotenga kachilombo ka HIV. (Ngakhale kuti mtengo wamtengo wapatali wa mankhwala a HCV, mwayi wowonjezera umakhala wochulukitsa ngati asungitsi amadziwa kuti ndalama zatha nthawi yaitali zokhudzana ndi kupewa khansa ya chiwindi ndi kupweteka kwa chiwindi .)
Ndikofunika kuzindikira kuti ngakhale kuti mankhwalawa sakhala akudziwitsidwa ngati palibe chithandizo chilichonse. Ngati chiwindi fibrosis sichipezekapo ndipo chiwerengero cha tizilombo ndi chochepa, mwina sizingayambe kuyamba mankhwala. Njira yokhayo ingakhale yoyamba kugwiritsa ntchito mankhwala osokoneza bongo omwe amavomereza kugwiritsa ntchito njira yobereka mpaka mankhwala atatha.
Koma ngati muli ndi matenda a chiwindi, ndipo mutakhala ndi pakati, onetsetsani kuti mukukumana ndi katswiri wa hepatologist kapena gastroenterologist kuti muwone kuti mumapewa mavuto ambiri okhudzana ndi kutengeka kwa mayi ndi mwana.
Chofunika kwambiri ndi chithandizo chachangu cha HIV , kaya muli ndi pakati kapena ayi. Mwa kuletsa HIV kuti ikhale yosawerengeka, mumachepetsa kwambiri kutupa kosagwirizana ndi matenda. Izi, zimathandizanso kuchepetsa mavairasi a HCV pamene ali ndi mimba komanso atabadwa.
Kafukufuku waposachedwapa wasonyeza kuti amayi omwe ali ndi kachilombo koyambitsa matenda a antiretroviral ali ndi kachilombo koyambitsa matenda a HCV monga amayi omwe alibe kachilombo ka HIV.
Kodi Mimba Idzakhala Yovuta Kwambiri Yanga Yachiwindi Yachiwindi?
Mwinamwake ayi. Komabe, deta yamakono nthawi zambiri imatsutsana, ndipo kafukufuku wina akusonyeza kuti mimba imayambitsa chiwindi cha chiwindi mwa amayi omwe ali ndi HCV pamene ena amanena kuti kuchepa kwa matenda akuchedwa.
Ndizinenedwa kuti, amayi omwe ali ndi HCV akhoza kukhala ndi chiopsezo chachikulu chokhala ndi pakati. Phunziro limodzi lokhazikika ku Washington linasonyeza kuti ana omwe anabadwa ndi amayi omwe ali ndi ma HCV amakhala ochepa pobereka, pamene amayi omwe anali ndi chiopsezo chowonjezereka chifukwa cha matenda a shuga (omwe nthawi zambiri amakhala okhudzana ndi kulemera kwakukulu).
Koma izi zikuwoneka kuti ndizosiyana kuposa malamulo. Kwa amayi ambiri omwe ali ndi HCV, kutenga mimba kumakhala kosavuta kuti matenda a chiwindi asapitirire ndipo palibe vuto lililonse kwa mwanayo.
> Zotsatira:
> Dunkelberg, J ;; Berkeley, E ;; Thiel, K.; et al. "Hepatitis B ndi C pakubereka: ndemanga ndi ndondomeko ya chisamaliro." Journal of Perinatology. December 2014; 34 (12): 882-891.
> Pergam, S .; Wang, C .; Gardella, C ;; et al. "Mavuto okhudzana ndi mimba omwe amapezeka ndi chiwindi cha C: chiwerengero chochokera ku 2003-2005 ku Washington State Cohort." American Journal of Obstetrics. 2008; 199: 38 (e 1-9).
> US Department of Health and Human Services. "Kuganizira za Kugwiritsa Ntchito Matenda Ochepetsa HIV / AIDS kwa Odwala Omwe Amagwiritsira Ntchito Zokwanira: Hepatitis C (HCV) / HIV Coinfections." Bethesda, Maryland; zasinthidwa pa July 14, 2016.
> US Department of Health and Human Services. "Malangizo a Gwiritsirani Ntchito Mankhwala Ochepetsa Matenda a Edzi Amayi Oyembekezera omwe ali ndi kachirombo ka HIV kwa amayi omwe ali ndi kachilombo ka HIV komanso njira zothandizira kuchepetsa kufala kwa HIV ku United States." Rockville, Maryland; zasinthidwa pa May 21, 2013.
> Yeung, C ;; Lee, H .; Chan, W .; et al. "Kupatsirana kwa kachilombo koyambitsa matenda a hepatitis C: Kudziŵa zamakono ndi momwe akuonera." World Journal ya Hepatology. September 27, 2014; 6 (9): 643-651.