Kuphunzira Kumasonyeza Zofunika Kwambiri, "Pambuyo Pake" Matenda Angathe Kugonjetsa Odwala
Ngakhale kuti zakhala zikufalitsidwa kwambiri pa zizindikiro zoyambirira za zizindikiro za HIV , palibenso kufotokozedwa kwakukulu koti "matenda" omwe angakhalepo angakhalepo pamayambiriro oyambirira. Ndipo ndizovuta.
Ngakhale kuti boma likuyesetsa kuonjezera kuyesa kwa HIV pakati pa anthu onse a ku America a zaka zapakati pa 15 ndi 65, anthu ambiri adzadikira mpaka nthawi ngati "zizindikiro zoyambirira" za matenda zikuwonekera.
Chifukwa chakuti matenda opatsirana kwambiri omwe angakhalepo popanda zizindikiro zimangowonjezera vutoli ndipo amatha kufotokoza chifukwa chake 20% mwa Achimereka okwana 1.2 miliyoni omwe ali ndi kachilombo ka HIV sadziwa zambiri.
Kuti amvetsetse nkhani zowonjezereka, kwa omwe ali ndi zizindikiro, kafukufuku tsopano akusonyeza kuti paliponse paliponse 25-40% adzabwera ndi zinthu zomwe sizikugwirizana ndi kachilombo ka HIV. Zotsatira zake, ndizowopsa kuti matenda atsopano akuphonyedwa kapena osadziwitsidwa-osati ndi wodwalayo okha koma ndi ochitira okhawo.
Zizindikiro zosadziwika za matenda oyambirira zikhoza kukhala ndi matenda a m'mimba ndi pakatikati a mitsempha, komanso maso, mapapo, impso, chiwindi, ndi ziwalo.
Zizindikiro Zowonongeka ndi Zachilendo za HIV yoyamba
Kawirikawiri, pafupifupi 40 peresenti ya anthu atsopano omwe ali ndi kachilomboka adzalandira zizindikiro za matenda a retroviral (kapena ARS) . ARS ndi njira yomwe thupi limayankhira kwa HIV pamene imateteza chitetezo kwa wodwala tizilombo toyambitsa matenda, ndi kutupa komweku kumayambitsa zizindikiro zofanana ndi za chimfine.
Chiwopsezo, kutopa, kupweteka mutu, kupweteka, kupweteka kwa maselo a mitsempha, ndipo kupweteka kwa minofu / kuphatikiza sizinthu zachilendo za ARS. Ena akhoza kuyamba kuthamanga (nthawi zambiri amatchedwa "Kuthamanga kwa HIV" ), zomwe zingathe kuwonetseredwa ndi ziphuphu zamtundu, makamaka pamtunda wapamwamba wa thupi. Ena adzalinso ndi msanga, kusanza, kapena kupweteka m'mimba.
Ngakhale kuti izi zikutengedwa ngati zizindikiro zowonjezereka za ARS, umboni wochuluka wa umboni ukuwoneka kuti ukuganiza kuti ena akhoza kukhala ndi mikhalidwe yovuta kwambiri, ngakhale omwe amaopseza moyo.
Mu 2015, asayansi omwe ali ndi Zurich Primary HIV Prevention Study ku Switzerland adayesetsa kukhazikitsa zizindikiro zosiyana siyana zomwe zingachitike pakadwala kachilombo ka HIV. Malinga ndi kafukufuku, sikuti adatha kupeza matenda 18 kapena zosiyana-siyana kuposa momwe zinakhazikitsidwa kale-iwo adanena kuti chiwerengero chachikulu chasowa chiwerengero cha matendawa.
Odwala okha omwe anadziwika pa matenda oyambirira anali ophatikizidwa, otanthauzidwa monga:
- Kutenga kachilombo koyambitsa matenda a HIV , kutanthauza kuti munthu adakhala ndi zizindikiro pamodzi ndi kuyezetsa kachilombo ka HIV kapena kosadziwika , kapena alibe zizindikiro koma adayesedwa kuti ali ndi kachilombo koyambitsa matendawa m'kati mwa masiku makumi asanu ndi atatu.
- Kutenga kachilombo ka HIV komweko posachedwa , kutanthauza kuti munthu ali ndi zizindikiro pamodzi ndi kachilombo ka HIV, kapena alibe zizindikiro koma adayesedwa kuti ali ndi kachilombo koyambitsa matendawa m'kati mwa masiku 90-180.
Zotsatirazo zinali zodabwitsa. Mwa odwala 290 omwe adakhutitsa zoyenera kuchita, 25% anali ndi zizindikiro zomwe sizigwirizana ndi ARS. Pakati pa anthu omwe ali ndi zizindikiro, chiwerengerocho chinakula kwambiri, ndipo 28.5% a acute ndi 40% mwa odwala atsopano omwe ali ndi kachilombo ka HIV ndi matenda omwe alibe HIV.
Ena mwa iwo, 23% ali ndi vuto la AIDS , kutanthauza kuti chizindikiro chawo choyamba cha kachilomboka ndi matenda omwe amawoneka m'thupi lachiderali. Izi zinaphatikizapo milandu ya osaphageal candida (thrush , cytomegalovirus (CMV) ya m'matumbo kapena chiwindi, herpes zoster (shingles) , komanso ngakhale kachilombo ka HIV kowononga matenda , vutoli limangokhala ndi matenda opititsa patsogolo.
Zizindikiro za m'mimba zosagwirizana ndi HIV zinali zotsatizana pa mndandandanda, zomwe zinkawerengera 14% ya mawonedwe ovomerezeka. Pafupifupi theka anali ndi matenda a tonsillitis, pomwe mawonetseredwe owonjezereka anali ndi kutuluka kwa m'mimba, kupweteka kwa chifuwa cha impso, matenda a impso, ndi matenda a herpes (omwe sanagwiritsidwe ntchito pokhapokha ngati mankhwala ovomerezeka koma kenako amachititsa kuti pakhale kuchotsa pang'onopang'ono).
Matenda a Central nervous system (CNS) amachititsa kuti 12% a milandu yowonongeka. Pakati pa izi, odwala matenda opatsirana kwambiri ( encephalitis ) ndi meningitis amadziwika kuti ndi odwala. Zochitika zapachiwalo zowonongeka nthawi zonse zimatchulidwanso nthawi zonse, monga momwe zinaliri ndi magulu akuluakulu a matenda a maganizo.
Zowonjezera zowonjezera, pafupifupi theka la mavotiwa adalandira matenda osapatsirana kachilombo ka HIV asanayambe kuyesedwa.
Kotero Kodi Izi Zikutiuza Chiyani?
M'mbuyomu, tikhoza kuganiza kuti munthu amene akudwala matenda okhudza kachilombo ka HIV adangotenga kachilombo zaka zambiri zapitazo ndipo tsopano anali kungokhala chizindikiro. Tsopano tikudziwa kuti, mwa odwala ena, matenda aakulu angathe kutsagana ngakhale magawo oyambirira a matenda.
Chodabwitsa kwambiri, ife tsopano tikudziwa kuti izi zimakhala zikuchitika kwa odwala omwe ali ndi machitidwe abwino a chitetezo cha mthupi. Malingana ndi kafukufuku, anthu omwe ali ndi mphamvu yowonongeka ya chitetezo cha mthupi (mwachitsanzo, CD4 chiwerengero choposa 500 maselo / mL) omwe mwachiwonekere amakhala ndi chiwopsezo chachikulu kwambiri kuposa munthu amene ali ndi dongosolo lopopera bwino.
Ngakhale njira zothetsera mavutozi sizowonekera bwino, tikudziwa kuti zinthu zina zingathe kuwonjezera mwayi wawo, kuphatikizapo kuchuluka kwa mavairasi oyambirira m'matenda oyambirira (pafupifupi 4-5 miliyoni / mL) ndi mtundu wa kachilombo munthuyo ali ndi kachilombo ka HIV ndi (makamaka omwe si a B-HIV subtype ).
Tikudziwanso zambiri zokhudza kukula kwa kachilombo ka HIV m'matumbo ndi ubongo, komanso zinthu zomwe zingapangitse munthu kukhala ndi matenda akuluakulu a m'mimba ndi CNS.
Kuchokera pamalingaliro a munthu payekha, kafukufuku akuthandizira kwambiri kuitanitsa boma kwa kuyesa kwa HIV kwa anthu onse a ku America zaka 15-65 monga gawo la ulendo wa dokotala. Sitingaganizirenso kuti munthu ali pa chiopsezo chochepa chifukwa chakuti sakupereka ndi chizindikiro "chachikale" cha matenda.
Ngakhale akatswiri ofufuza a ku Swiss anatsimikizira kuti zenizeni zenizeni za zizindikiro zoopsa zapachiyambi zingakhale pafupifupi 15 peresenti, zomwe zikutanthauzira chimodzi mwa magawo asanu ndi atatu oposa omwe angapezeke. Ndipo anthu omwe ali ndi chiopsezo chotenga kachilombo ka HIV akukwera m'magulu ambiri (kuphatikizapo amuna omwe amagonana ndi amuna ndi AAfrica ), ndiwo amodzi mwa asanu ndi atatu omwe sitingakwanitse.
Zotsatira
Braun, D ;; Kouyos. R ;; Balmer, B .; et al. "Kuwonongeka ndi mawonedwe ambiri a ma kachipatala omwe sali kuyembekezera kwa kachirombo ka HIV koyambirira." Matenda opatsirana pogonana . 2015; 61 (6): 1013-1021.
Cohen, M .; Gay, C .; Kuthamanga, P .; ndi Hecht, F. "Kuzindikira kwa kachilombo koyambitsa matenda a HIV." Journal of Infectious Diseases. 2010; 202 (Supplement 2): S270-S277.
Moyer, V. "Kuwonetsa HIV: US Statement Prevention Services Task Force Recommendation." April 30, 2013. Annals wa Internal Medicine. April 30, 2013; lembani: 10.7326 / 0003-4819-159-1-201307020-0064.