Izifo Ezihlanganiswe Nengozi Ephezulu Yokufa, Ukulimala Kwebhondi
I-HIV ingalimaza isimiso sakho somzimba; lokho kucacile. Njengoba i- HIV isebenza ngokwengeziwe futhi yenza amakhophi amaningi ngokwabo, umonakalo ungaba nzima kakhulu, okwenza kube nengozi enkulu ekuthuthukiseni izifo ezithathelanayo .
Esinye sezibi kakhulu yisifo esibizwa ngokuthi i- multifocal leukoencephalopathy (PML) eqhubekayo . Isimo sichazwa ngegama layo: "leuko" elisho mhlophe, "encephalo" okusho ubuchopho, futhi "indlela" echaza izifo.
Njengoba i-PML ingumonakalo oqhubekayo wezindaba ezimhlophe zobuchopho ezindaweni eziningi (multifocal).
Lesi simo sibangelwa ukuhlwithwa kancane kancane kwegceke le-myelin elihlanganisa iziphetho zezinzwa, ikakhulukazi indaba emhlophe yobuchopho. Njengesifo sokudonsa phansi, i-PML ibonisa okuningi ngendlela efanayo ne- multiple sclerosis (MS) , naphezu kokushesha.
Igciwane elibhekele i-PML yilabo bonke abantu abaye bavezwa ngokuthi yi-JC virus (noma igciwane likaJohn Cunningham). Nakuba kucatshangwa ukuthi abantu abangama-70-90% abaye bahlushwa igciwane, kungabangela izifo kuphela uma umuntu enesisindo esikhulu sokuzivikela ngegciwane lesandulela ngculazi njengoba kwenzeka nge-AIDS.
I-PML inezinga eliphakeme lokushona lapho selithola, kanti abantu abangu-30-50% bafa ezinyangeni zokuqala zokuxilongwa. Labo abasinda ngokuvamile banezimo ezihlukahlukene zokulimala komqondo-ezinye zilinganiselwe, ezinye zinzima.
I-PML ingenzeka kakhulu uma umuntu one-HIV enesisindo se- CD4 esingaphansi kwamangqamuzana angama-100 / mL.
Ngencazelo, ukuxilongwa nge - AIDS kwenziwa uma i-CD4 iwela ngaphansi kwama-200 amaseli / mL
Izimpawu nezibonakaliso ze-PML
Izimpawu nezimpawu ze-PML zingafana nezinye izimo eziningi, ikakhulukazi ezinyathelweni zakuqala. Ngokuvamile, uphawu olulodwa lwezinkinga lungabandakanya:
- Ububuthakathaka obucashile ezandleni nasemilenzeni
- Kunzima ukucabanga noma ukugxila
- Ukungabi nokusebenzisana okwengeziwe
- Izinsizwa
Izikhathi eziningi, abantu baphutha ngalezi zinkinga ngenxa yokukhathala, imiphumela emibi yezidakamizwa, noma ngisho nokushaya kabuhlungu noma ukuhlaselwa kwe-ischemic okudlulayo . Njengoba i-PML iqhubeka, izimpawu ezingathí sina zingase zithuthuke, kufaka phakathi inkulumo nokukhubazeka kombono, kanye nokuguqulwa komuntu kanye nokushintsha komuntu.
Kwezinye izimo, iziguli zingase zithole lokho okubizwa ngokuthi yi- alien hand syndrome lapho isandla sithinta khona ngaphandle komuntu ngisho nokukwazi noma ukukwazi ukuyilawula.
Ukuxilongwa kwe-PML
I-PML ingatholakaliswa ngenye yezindlela ezimbili:
- Ngokuhlola umthamo wamagogasi ngenxa yobufakazi bezakhi zofuzo ze-JC igciwane elisekelwa yi- MRI (magnetic resonance Imaging) scan ukuqinisekisa izilonda endabeni emhlophe yobuchopho.
- Ngenye indlela, i-biopsy yobuchopho ingasetshenziswa, kuhlanganise namasu okuqinisekisa ukuthi kukhona i-JC virus.
Ingabe Kukhona Ukwelashwa Kwe-PML?
Ngaphambi kokufika kwe- antiretroviral therapy (ART) , i-PML yayihlala ibulalayo phakathi kwamasonto ambalwa noma izinyanga zokuxilongwa. Nakuba okwamanje akakho izidakamizwa ezingakwazi ukuvimbela noma ukuphilisa i-PML ngokuphumelelayo, ukuqaliswa kwe- ART kunganciphisa izimpawu eziningi ngokubuyisela umsebenzi omzimba womuntu.
Kuye kwaboniswa ukuthi i-ART ingandisa isikhathi somuntu womuntu ophethe i-PML iminyaka eminingana.
Ehlangothini lwe-flip, ingozi ye-PML ingavinjelwa kakhulu ngokuqinisekisa ukuqaliswa kokuqala kwe-ART, ngesikhathi esifanele sokuxilongwa futhi ngaphambi kokuqeda ukusebenza komzimba.
Izinqubo eziningi zokwelashwa nazo zihlolwe, nakuba imiphumela ixutshwe noma i-anecdotal engcono kakhulu. Zihlanganisa nokusetshenziswa kwemithi ye-anti-malarial mefloquine kanye nokwelashwa nge-interleukin-2 (iphrotheni elawula amaseli egazi amhlophe).
Kuze kube manje, kuye kwaba nesandla esincane nje somuntu obonakala sengathi uphulukiswe nge-PML usebenzisa i-mefloquine, kuyilapho iziguli ezimbili zivele ziphinde zisebenzise i-protein-immune, i-interleukin-2.
Ngeshwa, kuzo zombili lezi zimo, izinga eliphakeme lokushukela elihlobene nokusetshenziswa kwezidakamizwa luyinkimbinkimbi ukwelashwa kulabo abane-PML.
Imithombo :
Izikhungo Zempilo Zikazwelonke (NIH). "I-Progressive Multifocal Leukoencephalopathy Information Page" Washington, DC; ibuyekezwe ngoFebhuwari 14, 2014; kufinyelelwe ngoFebhuwari 24, 2016.
Shackelton, L .; I-Rambaut, A .; I-Pybus, G.; et al. "I-JC Virus yokuziphendukela kwemvelo nokuhlangana kwayo nabantu". Journal of Virology . 2006; 80 (20): 9928-9933.
I-Gofton, T .; I-Al-Khotani, A .; U-O'Farrell, uB .; et al. "I-Mefloquine ekwelapheni i-letifencephalopath ye-multifocal eqhubekayo". Journal of Neurology, Neurosurgery and Psychiatry. Juni 2010; 82 (4): 452-455.
UBuckanovich R. Liu, G .; Okumnyama, C; et al. "Ukufakelwa kwe-non-elimeablative allogeneic stem cell ye-Hodgkin's lymphoma engavumelani neyinkimbinkimbi ye-interleukin-2 ephendula ngokuphindaphindiwe ye-leukoencephalopathy." Unyaka weHematology. Julayi 2002: 81 (7): 410-413.