Malangizo ochokera ku US Public Health Service
Mu 1996, US Public Health Service (USPHS) adapereka njira yoyamba yogwiritsira ntchito mankhwala opatsirana pogonana monga post-exposure prophylaxis (PEP) panthawi ya ntchito ya HIV ndi ogwira ntchito zaumoyo (HCP).
Mu August 2013, a USPHS adasintha ndondomekoyi nthawi yachinayi, akutsatira malingaliro awo pa kupezeka ndi kuthandizira kwa ARV zatsopano, komanso zomwe zilipo panthawi yomwe chitetezo cha ma ARV chimagwiritsidwa ntchito kale.
Zina mwa zochitika za gulu lofotokozera:
- Kuchita bwino kwa ma ARV
- Kulekerera ndi poizoni
- Kugwiritsa ntchito mankhwala osokoneza bongo pakulera komanso panthawi ya lactation
- Piritsi yolemera komanso maulendo ambiri
Kutanthauzira Kuchita Ntchito Zogwira Ntchito
Kuwonetsa kachilombo ka HIV pakati pa HCP kumatanthauzidwa ngati kuvulaza kwapadera (mwachitsanzo, chosowa kapena chodulidwa kuchoka ku chinthu chakuthwa), kapena kukhudzana ndi mucous membrane kapena khungu lomwe silili lolondola (mwachitsanzo, kutsekedwa, kutsekedwa kapena kutaya magazi) ndi magazi opatsirana ndi HIV , minofu, kapena madzi ena amthupi omwe amawoneka kuti angathe kutenga matenda.
Izi zimaphatikizapo mchere wamadzimadzi, amniotic madzi, pericardial fluid (madontho a membrane oyandikana ndi kumva), synovial zamadzimadzi (zamadzimadzi kuchokera m'malo mwake), phokoso lamadzimadzi (chimadzimadzi kuchokera m'magulu ozungulira mapapo); ndi peritoneal fluid (mafuta odzola mkati mwa ziwalo za m'mimba).
Zingwe, mitsempha, mfuti, mkutu, thukuta, misonzi, mkodzo ndi kusanza sizingatengeke ngati zingakhale zosazizwitsa.
Komanso, pamene kulumidwa kwa munthu kuyenera kuyesedwa payekha, sipanakhalepo zochitika zokhudzana ndi kachilombo ka HIV kupyolera mwa kulumidwa kwa anthu mu malo owonetsera thanzi.
Kusintha Kwakukulu mu Zotsatira za USPHS
Malangizo omwe anatsogoleredwa, omwe anaperekedwa mu 2005, adalimbikitsa kuti kuwonetsetsa kwapadera kuyesedwe kuti adziwe ngati angagwiritse ntchito ma ARV kapena awiri.
Malangizowo akutha kwathunthu, ndipo a USPHS amavomereza kugwiritsa ntchito ma ARV kapena ma ARV pazochitika zonse za ntchito.
Malangizo atsopanowa amasonyeza kuti kugwiritsa ntchito mayeso achinayi antigen / antibody akhoza kuchepetsa nthawi yoyezetsa kuchipatala kuyambira miyezi isanu ndi umodzi mpaka miyezi inayi.
Zambiri zazitsogozozo
Pochitika ntchito yokhudzana ndi HIV:
- PEP iyenera kugwiritsidwa ntchito mwamsanga, mwachangu mkati mwa maola ochepa. Kufunsira kwa akatswiri kumafunidwa nthawi zonse, koma osati chifukwa cha kuchedwa kwa mankhwala.
- Kuyeza koyambitsa kachirombo ka HIV kudzapatsidwa kuti adziwe momwe HIV imachitira HCP. Ngati n'kotheka, momwe HIV imayambira wodwalayo ayenera kuyesedwa kuti athandize kutsogolera ntchito yoyenera ya PEP.
- Mankhwala atatu a ARV kapena oposa angapangidwe, malinga ndi maonekedwe abwino omwe amawoneka bwino komanso nthawi yabwino. (Onani Njira Zothandizira Mankhwala Ovomerezeka , m'munsimu.) Kudziwidwa kapena kuganiza kuti kutenga mimba (kapena kuyamwa) kungapangitsenso kusankha mankhwala ena.
- Kuphatikiza pa kuyesedwa koyambitsa HIV, HCP iyenera kupatsidwa mayeso oyenerera a ma labata kuti ayambe kuyeza mankhwala osokoneza bongo. Mayesowa ayenera kuphatikizapo, kuchepa, kuchuluka kwa magazi (CBC), komanso mayeso a ntchito za impso ndi chiwindi.
- PEP idzayamba ndi kupitilira kwa masiku 28. Uphungu wa chithandizo chamankhwala uyenera kuperekedwa kuti ukwaniritse zoyenera kutsata , zotsatira zowonongeka, komanso kugwiritsidwa ntchito kwa mankhwala.
- Maimidwe otsogolera ayenera kuyamba mkati mwa maola 72, ndikuphatikizira kuyesa kachirombo ka HIV ndi uphungu. Kuwunika kalasi lachiwiri kwa mankhwala osokoneza bongo ayenera kuchitidwa milungu iwiri.
- Pambuyo pake, kuyezetsa kachirombo ka HIV kuyenera kuchitidwa pa masabata asanu ndi limodzi, masabata khumi ndi awiri, ndi miyezi isanu ndi umodzi mutatha kuwonekera. Ngati mbadwo wachinayi umagwirizanitsa HIV p24 kachirombo ka HIV / kachirombo ka HIV kamagwiritsidwa ntchito, kuyesa kutsata kungathe kuchitika patatha milungu isanu ndi umodzi ndi miyezi inayi pambuyo poonekera.
Zovomerezeka Zotsatira za Drug
A USPHS amalimbikitsa kugwiritsa ntchito Viread (tenofovir) ndi Emtriva (emtricitabine) -kuphatikizana kwa mankhwala awiri mu mapiritsi amodzi, Truvada -plus Isentress (raltegravir) ya PEP mu zochitika za ntchito.
Njira zina zothandizira mankhwalawa zingagwiritsidwe ntchito ngati matenda opatsirana pogwiritsa ntchito mankhwala kapena zifukwa zina zomwe zingatsutse kugwiritsa ntchito mankhwala operekedwa.
Viramune (nevirapine) sayenera kulembedwa kwa PEP, pamene ma ARV sagwiritsidwa ntchito nthawi zonse kuti PEP ipewe. Izi zikuphatikizapo Videx (didanosine) ndi Aptivus (tipranavir), komanso kuphatikiza Zerit (stavudine) ndi Videx.
> Chitsime:
> Kuhar, D .; Henderson, D .; Sungunuka, K .; et al. "Yapangidwira US Guidelines Service Guidelines for Management of Occupational Exposures kwa Human Immunodeficiency Virus ndi Malangizo a Postexposure Prophylaxis." Kugonjetsa matenda ndi matenda opatsirana. August 6, 2013; 34 (9): 875-892.