Intsholongwane kaGawulayo / uGawulayo

Le ntsholongwane ibangela uGawulayo. Xa umntu osulelwe yi-HIV, intsholongwane ihlasela kwaye iwenze buthathaka amajoni omzimba. Njengokuba amajoni omzimba esiba buthathaka, umntu usemngciphekweni wokufumana usulelo olusongela ubomi kunye nomhlaza. Xa oko kusenzeka, isigulo kuthiwa nguGawulayo. Nje ukuba umntu abe nentsholongwane, ihlala ngaphakathi emzimbeni ubomi bonke.

Intsholongwane iyasasazeka (idluliselwe) emntwini ukuya kumntu ngamanzi athile omzimba:

• Igazi
• Ubudoda kunye nolwelo lwangaphambi kwesisu
• Amanzi afudumeleyo
• Ulwelo lobufazi
• Ubisi lwebele

INTSHOLONGWANE KAGAWULAYO ​​ingasasazeka ukuba la manzi adibana:

• Inwebu yangaphakathi (ngaphakathi emlonyeni, kwilungu lobudoda, kwilungu lobufazi, kwilayini)
• Izicubu ezonakalisiweyo (izicwili ezinqunqiweyo okanye ezikhutshiweyo)
• Inaliti kumjelo wegazi

Intsholongwane kaGawulayo ayinakusasazeka ngokubila, amathe, okanye umchamo.

E-United States, i-HIV isasazeka ikakhulu:

• Ngokwabelana ngesondo kwilungu lobufazi okanye ezimpundu nomntu one-HIV ngaphandle kokusebenzisa ikhondom okanye akawathathi amayeza okuthintela okanye ukunyanga i-HIV
• Ngokwabelana ngenaliti okanye esinye isixhobo esisetyenziselwa ukutofa iziyobisi nomntu one-HIV

Ngaphantsi kakhulu, i-HIV iyasasazeka:

• Ukusuka kumama kuye emntwaneni. Umfazi okhulelweyo angayosasaza intsholongwane kumntwana wakhe ngokuhamba kwegazi ekwabelwana ngalo, okanye umama oncancisayo angayidlulisela kusana lwakhe ngobisi lwebele. Ukuvavanywa nokunyangwa koomama abane-HIV kuncede kwehlisa inani leentsana ezifumana i-HIV.
• Ngeentonga zenaliti okanye ezinye izinto ezibukhali ezingcoliswe yi-HIV (ingakumbi abasebenzi bokhathalelo lwempilo).

Intsholongwane ayisasazwa ngu:

• Ukunxibelelana okungaqhelekanga, njengokuwolana okanye ukuvisana ngomlomo
• Iingcongconi okanye izilwanyana zasekhaya
• Ukuthatha inxaxheba kwezemidlalo
• Ukuchukumisa izinto ezazichukunyiswe ngumntu onentsholongwane
• Ukutya ukutya okuphethwe ngumntu one-HIV

Intsholongwane kaGawulayo negazi okanye igalelo lomzimba:

• Intsholongwane kaGawulayo ayinwenwanga emntwini onikela ngegazi okanye ngamalungu omzimba. Abantu abanikela ngamalungu awanxibelelani ngokuthe ngqo nabantu abafumanayo. Ngokunjalo, umntu onikela ngegazi akaze adibane nomntu olifumeneyo. Kuzo zonke ezi nkqubo, kusetyenziswa iinaliti eziyinyumba kunye nezixhobo.
• Ngelixa kunqabile, kwi-HIV eyadlulayo ibisasazeke emntwini ofumana igazi okanye amalungu omntu osulelekileyo osulelekileyo. Nangona kunjalo, lo mngcipheko mncinci kakhulu kuba iibhanki zegazi kunye neenkqubo zokunikezela ngamalungu zijonga kakuhle (isikrini) abanikeli, igazi, kunye nezicubu.

Imiba yomngcipheko wokufumana i-HIV ibandakanya:

• Ukuba neentlobano zesini ezimpundu okanye ezokulala ungakhuselekanga. Ukwamkelwa ngesondo ezimpundwini yeyona kuyingozi. Ukuba namaqabane amaninzi kwandisa umngcipheko. Ukusebenzisa ikhondomu entsha ngokuchanekileyo ngalo lonke ixesha usabelana ngesondo kunceda kakhulu ekuthatheni umngcipheko.
• Ukusebenzisa iziyobisi nokwabelana ngeenaliti okanye iisirinji.
• Ukuba neqabane elabelana ngesondo ne-HIV elingathathi amayeza e-HIV.
• Ukuba nesifo esosulela ngokwabelana ngesondo.

Iimpawu ezinxulumene nosulelo olubi lwe-HIV (xa umntu osulelekileyo okokuqala) zinokufana nomkhuhlane okanye ezinye izifo zentsholongwane. Ziquka:

• Fever kunye neentlungu zezihlunu
• Intloko ebuhlungu
• Umqala obuhkungu
• Ukubila ebusuku
• Izilonda zomlomo, kubandakanya usulelo lwegwele (thrush)
• Ukudumba kwamadlala
• Urhudo

Abantu abaninzi abanazimpawu xa beqala ukosulelwa yi-HIV.

Usulelo olunamandla lwe-HIV luyaqhubeka kwiiveki ezimbalwa ukuya kwiinyanga ukuze lube lusulelo lwe-HIV (akukho zimpawu). Eli nqanaba linokuhlala iminyaka eli-10 okanye ngaphezulu. Ngeli xesha, umntu usenokungabi nasizathu sokukrokrela ukuba une-HIV, kodwa angayosulela intsholongwane kwabanye.

Ukuba ngaba abanyangwa, phantse bonke abantu abosuleleke yi-HIV bayakuba ne-AIDS. Abanye abantu baba nesifo sikagawulayo kwisithuba seminyaka embalwa yosulelo. Abanye bahlala bephilile ngokupheleleyo emva kweminyaka eli-10 okanye engama-20 (ebizwa ngokuba zii-non-progressors).

Abantu abanoGawulayo amajoni abo omzimba onakaliswe yi-HIV. Basemngciphekweni omkhulu wokufumana usulelo olungaqhelekanga kubantu abanamajoni omzimba asempilweni. Olu sulelo lubizwa ngokuba ngamathuba osulelo. Oku kunokubangelwa ziintsholongwane, intsholongwane, ukungunda, okanye iprotozoa, kwaye inokuchaphazela naliphi na ilungu lomzimba. Abantu abanoGawulayo bakumngcipheko ophezulu womhlaza othile, ngakumbi ii-lymphomas kunye nomhlaza wolusu obizwa ngokuba yiKaposi sarcoma.

Iimpawu zixhomekeke kusulelo oluthile kwaye leliphi ilungu lomzimba elosulelekileyo. Usulelo lwemiphunga luxhaphake kwi-AIDS kwaye ngesiqhelo lubangela ukukhwehlela, umkhuhlane kunye nokuphefumla okufutshane. Usulelo lwamathumbu luqhelekile kwaye lunokubangela urhudo, iintlungu zesisu, ukugabha okanye ukuginya iingxaki. Ukwehla kobunzima, umkhuhlane, ukubila, irhashalala kunye nokudumba kwamadlala axhaphakileyo kubantu abanentsholongwane kagawulayo nogawulayo.

Kukho iimvavanyo ezenziwayo ukujonga ukuba awosulelwanga yintsholongwane.

IIMVAVANYO ZOPHANDO

Ngokubanzi, uvavanyo yinkqubo yamanyathelo amabini:

• Uvavanyo lokuvavanya-Zininzi iintlobo zovavanyo. Olunye luvavanyo lwegazi, olunye luluvavanyo lomlomo. Bakhangela izilwa-buhlungu kwintsholongwane ye-HIV, i-antigen ye-HIV, okanye zombini. Olunye uvavanyo lovavanyo lunokunika iziphumo kwimizuzu engama-30 okanye ngaphantsi.
• Uvavanyo lokulandelela- Oku kukwabizwa ngokuba luvavanyo lokuqinisekisa. Ihlala isenziwa xa uvavanyo lokuvavanywa luhle.

Iimvavanyo zasekhaya ziyafumaneka kuvavanyo lwe-HIV. Ukuba ucwangcisa ukusebenzisa enye, jonga ukuqinisekisa ukuba yamkelwe yi-FDA. Landela imiyalelo kwiphakheji ukuqinisekisa ukuba iziphumo zichanekile ngokusemandleni.

Amaziko oLawulo lweNtsholongwane kunye noThintelo (CDC) acebisa ukuba wonke umntu oneminyaka eli-15 ukuya kuma-65 avavanyelwe i-HIV. Abantu abaneendlela zokuziphatha eziyingozi kufuneka bavavanywe rhoqo. Abafazi abakhulelweyo nabo kufuneka benze uvavanyo lokuhlola.

IIMVAVANYO EMVA KOKUCHAZWA NGE-HIV

Abantu abanoGawulayo badla ngokuvavanywa igazi rhoqo ukukhangela ubalo lwamajoni omzimba wabo:

• Iiseli ze-CD4 T ziiseli zegazi ezihlaselwa yi-HIV. Zikwabizwa ngokuba ziiseli ze-T4 okanye "iiseli T zomncedisi."
• Njengokuba i-HIV yonakalisa amajoni omzimba, isibalo se-CD4 siyehla. Inani eliqhelekileyo le-CD4 lisuka kwi-500 ukuya kwi-1,500 iiseli / mm³ yegazi.
• Abantu badla ngokuba neempawu xa ubalo lwamajoni omzimba lwabo lwehla laya ngaphantsi kwama-350. Ubunzima obukhulu buye bube xa isibalo se-CD4 sehla saya kuma-200. Xa isibalo singaphantsi kwama-200, lo mntu kuthiwa une-AIDS.

Olunye uvavanyo lubandakanya:

• Inqanaba le-RNA ye-HIV, okanye umthamo wentsholongwane, ukujonga ukuba ingakanani i-HIV esegazini
• Uvavanyo lokuchasa ukubona ukuba intsholongwane ayinalo na utshintsho kwikhowudi yemfuza enokuthi ikhokelele ekuchaseni kumayeza asetyenziselwa ukunyanga i-HIV
• Gcwalisa ubalo lwegazi, chemistry yegazi, kunye novavanyo lomchamo
• Uvavanyo lolunye usulelo olosulela ngokwabelana ngesondo
• Uvavanyo lwe-TB
• Pap smear ukujonga umhlaza womlomo wesibeleko
• Uhlalutyo lwePap smear ukukhangela umhlaza we-anus

INTSHOLONGWANE KAGAWULAYO ​​/ GAWULAYO ​​inyangwa ngamayeza anqanda intsholongwane ukuba ingaphindaphindeki. Olu nyango lubizwa ngokuba lonyango lwe-antiretroviral (ART).

Kwixesha elidlulileyo, abantu abanentsholongwane kaGawulayo babeza kuqala unyango lwe-antiretroviral emva kokuba inani labo le-CD4 lehlile okanye babe neengxaki ze-HIV. Namhlanje, unyango lwe-HIV luyacetyiswa kubo bonke abantu abanosulelo lwe-HIV, nokuba isibalo sabo se-CD4 siqhelekile.

Uvavanyo lwegazi rhoqo luyafuneka ukuqinisekisa inqanaba lentsholongwane egazini (umthamo wentsholongwane) ligcinwa liphantsi okanye licinezelwe. Injongo yonyango kukuthoba intsholongwane kagawulayo egazini ukuya kwinqanaba eliphantsi kakhulu kangangokuba uvavanyo alunakubonwa. Oku kubizwa ngokuba ngumthamo wentsholongwane ongabonakaliyo.

Ukuba ubalo lwamajoni omzimba sele luyekile phambi kokuba unyango luqalwe, luza kuthi chu lonyuke kancinci. Iingxaki ze-HIV zihlala zinyamalala njengoko amajoni omzimba echacha.

Ukujoyina iqela lenkxaso apho amalungu abelana ngamava aqhelekileyo kunye neengxaki kunokuhlala kunciphisa uxinzelelo lweemvakalelo zokugula ixesha elide.

Ngonyango, uninzi lwabantu abane-HIV / AIDS banokuphila ubomi obusempilweni kwaye obuqhelekileyo.

Unyango lwangoku alulunyangi usulelo. Amayeza asebenza kuphela ukuba athathwa yonke imihla. Ukuba amayeza ayanqandwa, umthamo wentsholongwane uya kunyuka ze ubalo lwe-CD4 lwehle. Ukuba amayeza akathathwa rhoqo, intsholongwane iyakwazi ukunganyangeki kwelinye okanye nangaphezulu, kwaye unyango luza kuyeka ukusebenza.

Abantu abakunyango kufuneka bababone rhoqo ababoneleli babo. Oku kukuqinisekisa ukuba amayeza ayasebenza kwaye ujonga iziphumo ebezingalindelekanga zamayeza.

Biza ixesha lokubonana nomnikezeli wakho ukuba unazo naziphi na izinto ezinobungozi kusulelo lwe-HIV. Nxibelelana nomboneleli wakho ukuba uvela iimpawu zikaGawulayo. Ngokomthetho, iziphumo zovavanyo lwe-HIV kufuneka zigcinwe ziyimfihlo (yabucala). Umboneleli wakho uya kujonga iziphumo zakho zovavanyo nawe.

Ukuthintela i-HIV / AIDS:

• Vavanywa. Abantu abangaziyo ukuba banosulelo lwe-HIV kwaye bajongeke kwaye bazive besempilweni ngabona bantu kunokwenzeka ukuba bayidlulisele kwabanye.
• MUSA ukusebenzisa iziyobisi ngokungekho mthethweni kwaye ungabelani ngenaliti okanye iisirinji. Uluntu oluninzi luneenkqubo zokutshintshiselana ngenaliti apho ungalahla khona iisirinji ezisetyenzisiweyo kwaye ufumane ezintsha, ezingenazintsholongwane. Abasebenzi kwezi nkqubo banokukuthumela kunyango lweziyobisi.
• Kuphephe ukudibana negazi lomnye umntu. Ukuba kunokwenzeka, nxiba impahla ekhuselayo, imaski kunye nemigogo xa ukhathalela abantu abonzakeleyo.
• Ukuba ufunyenwe une-HIV, ungayidlulisela kwabanye. Akufuneki unikezele ngegazi, iplasma, amalungu omzimba, okanye isidoda.
• Abasetyhini abane-HIV abanokukhulelwa kufuneka bathethe nomboneleli wabo malunga nomngcipheko wosana lwabo olungekazalwa. Kuya kufuneka baxoxe nangeendlela zokuthintela usana lwabo ukuba lungosuleli, njengokuthatha amayeza ee-antiretroviral ngexesha lokukhulelwa.
• Ukuncancisa kufuneka kuthintelwe ukuthintela ukudlulisela i-HIV kwiintsana ngobisi lwebele.

Izenzo ezikhuselekileyo zesondo, ezinjengokusebenzisa iikhondom zelatex, ziyasebenza ekuthinteleni ukwanda kwe-HIV. Kodwa kusekho umngcipheko wokufumana usulelo, nokuba kusetyenziswa iikhondom (umzekelo, iikhondom zinako ukukrazula).

Kubantu abangosulelekanga yile ntsholongwane, kodwa basemngciphekweni omkhulu wokuyifumana, ngokuthatha amayeza afana neTruvada (emtricitabine kunye ne-tenofovir disoproxil fumarate) okanye i-Descovy (emtricitabine kunye ne-tenofovir alafenamide) inokunceda ukuthintela usulelo. Olu nyango lwaziwa ngokuba yi-pre-exposure prophylaxis, okanye i-PrEP. Thetha nomboneleli wakho ukuba ucinga ukuba iPrEP ingakulungela.

Abantu abane-HIV abathatha amayeza ee-antiretroviral kwaye abanayo intsholongwane egazini labo abayidlulisi intsholongwane.

Ubonelelo ngegazi lwaseMelika luphakathi kwezona zikhuselekileyo emhlabeni. Phantse bonke abantu abosuleleke yi-HIV ngotofelo-gazi bafumana olo gazi ngaphambi kowe-1985, unyaka wokuvavanywa kwe-HIV kuwo onke amagazi anikelweyo.

Ukuba uyakholelwa ukuba ukhe wabhencwa kwi-HIV, funa unyango ngoko nangoko. SUKULIBazisa. Ukuqala amayeza antiviral kanye emva kokuvezwa (ukuya kuthi ga kwiintsuku ezi-3 emva) kunokunciphisa amathuba wokosulelwa. Oku kubizwa ngokuba yi-post-exposure prophylaxis (PEP). Isetyenziselwe ukuthintela usasazeko kubasebenzi bokhathalelo lwempilo abonzakele ziinaliti.

Usulelo lwe-HIV; Usulelo - i-HIV; Intsholongwane kaGawulayo; Ukufumana isifo sokunqongophala komzimba: i-HIV-1

• Isondlo sangaphakathi-iingxaki zokulawula umntwana
• Ityhubhu yokondla isisu - i-bolus
• Ityhubhu yokondla iJejunostomy
• I-Oral mucositis - ukuzikhathalela

• Ii-STD kunye nobuhle bendalo
• Intsholongwane kaGawulayo
• Usulelo lwe-HIV oluphambili
• Ukuqaqanjelwa sisikhongozelo (isilonda esineentsholongwane)
• Usulelo lwe-Mycobacterium marinum esandleni
• Dermatitis - seborrheic ebusweni
• UGawulayo
• IKaposi sarcoma -ukusondela
• I-Histoplasmosis, isasazwa kwisigulana se-HIV
• IMolluscum esifubeni
• Kaposi sarcoma ngasemva
• I-sarcoma kaKaposi ethangeni
• IMolluscum contagiosum ebusweni
• Iintsholongwane
• Isifo sephepha emiphungeni
• I-Kaposi sarcoma -isilonda elunyaweni
• I-Kaposi sarcoma - iperianal
• I-Herpes zoster (shingles) iyasasazwa
• Dermatitis seborrheic - kufutshane

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Amaziko oLawulo lweNtsholongwane kunye noThintelo lwewebhusayithi. IPREEP. www.cdc.gov/hiv/basics/prep.html. Ukuhlaziywa ngoNovemba 3, 2020. Ifikeleleke ngo-Epreli 15, 2019. UDiNenno EA, Prejean J, Irwin K, et al. Iingcebiso malunga nokuhlolwa kwe-HIV kwabantu abathandana besini esinye, abesilisa nabasetyhini, kunye namanye amadoda abelana ngesondo namadoda-eUnited States, 2017. MMWR Mntundini wokufa Wkly Rep. Ngo-2017; 66 (31): 830-832. www.cdc.gov/mmwr/volumes/66/wr/mm6631a3.htm.

UGulick RM. Unyango lwe-Antiretroviral yentsholongwane yokuchasana komzimba nokufumana isifo se-immunodeficiency syndrome. Ku: IGoldman L, iSchafer AI, ii-eds. Amayeza eGoldman-Cecil. Ngomhla wama-26. IPhiladelphia, PA: Elsevier; 2020: isahluko 364.

UMoyer VA; Umsebenzi woKhuseleko kwi-US. Ukuvavanywa kwe-HIV: Ingxelo yengcebiso yamandla okhuseleko e-US. UAnn Intern Med. Ngo-2013; 159 (1): 51-60. IINKCUKACHA: 23698354 pubmed.ncbi.nlm.nih.gov/23698354/.

UReitz MS, uGallo RC. Iintsholongwane zokungasebenzi komzimba. Ku: Bennett JE, Dolin R, Blaser MJ, ii-eds. Mandell, Douglas, kunye neBennett's Principles and Practice of Infectious Diseases. Umhla we-9. IPhiladelphia, PA: Elsevier; 2020: isahluko 169.

I-Simonetti F, i-Dewar R, i-Maldarelli F.Ukuchongwa kosulelo lwentsholongwane emzimbeni. Ku: Bennett JE, Dolin R, Blaser MJ, ii-eds. Mandell, Douglas, kunye neBennett's Principles and Practice of Infectious Diseases. Umhla we-9. IPhiladelphia, PA: Elsevier; 2020: isahluko 120.

ISebe lezeMpilo laseMelika kunye neeNkonzo zoLuntu, iwebhusayithi yeClinical Info.gov. Isikhokelo sokusetyenziswa kweearhente ze-antiretroviral kubantu abadala nakwishumi elivisayo abaphila ne-HIV. clinicalinfo.hiv.gov/en/guidelines/adult-and-adolescent-arv/whats-new-guidelines?view=full. Ukuhlaziywa ngoJulayi 10, 2019. Kufikeleleke ngoNovemba 11, 2020.

UVerma A, uBerger JR. Ukubonakaliswa kwe-Neurological yosulelo lomntu kwintsholongwane yabantu abadala. Ku: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, ii-eds. I-Neurology kaBradley kwiKlinikhi yokuziqhelanisa. Umhla wesi-7. IPhiladelphia, PA: Elsevier; Ngo-2016: isahluko 77.