Ukulinganisa Ubungozi Emiphakathini Yabantu Abangenayo Imfucuza
Ngo-May 26, 2006, i-US Food and Drug Administration (FDA) yavuma ukuthi umgomo wokugoma u- Zostavax uvimbele i- herpes zoster , isifo sofuba esivame ukubizwa ngokuthi ama-shingles. Ngenkathi kwasekuqaleni kuvunyelwe abantu abadala 60 nangaphezulu, kubandakanyeka ikakhulukazi labo abane- HIV .
Lezo ziphakamiso kamuva zabuyekezwa ngo-2011 ukufaka abantu abadala 50 nangaphezulu ngenkathi bengenzi izincomo eziqondile mayelana nokusetshenziswa kwabo kulabo abane-HIV.
I-Zostavax iyimithi yokugoma ephikisiwe, okusho ukuthi yenziwe ngegciwane eliphilayo, elibuthakathaka. Kungumthamo omkhulu wegciwane lesikhumba lapho kutholakala khona izikhathi ezingu-14. Ucwaningo luye lwabonisa ukuthi i-Zostavax inganciphisa ingozi yama-shingles ngamaphesenti angu-51 ngenkathi kunciphisa ubukhulu nobude bokuqhamuka ngamaphesenti angu-67.
Izimbangela Zama-Shingles
Ama-shingles abhekene nokugqunywa okubuhlungu nge-blisters ebonakala ebhentshini noma emgqeni kolunye uhlangothi ubuso noma umzimba. Kubangelwa ukuvuselelwa kwe- varicella zoster virus (VZV) kubantu abadala ababengenalo inkukhu.
Ngenkathi igciwane ngokuvamile lilele emangqamuzaneni emisipha eduze komgogodla, kungabangela ukuqhuma lapho kuvuselelwa. Ukuqhuma kuvinjelwe emthonjeni othize we-nerve, owaziwa ngokuthi i- dermatome , ehlangene noma ngakwesokunxele noma ngakwesokudla komzimba.
Kucatshangwa ukuthi umuntu oyedwa kubantu abathathu emhlabeni wonke uzokwakhiwa ngezibhamu esikhathini esizayo.
E-US, amacala angaphezu kwesigidi abikwa minyaka yonke. Ingozi yokukhwabanisa nayo iyaziwa ukuthi iyanda njengoba umuntu edala, ngaphezu kokuphindaphindiwe oneminyaka engama-65.
Ama-shingles kubantu abane-HIV
Ukuvuselelwa kwe-VZV kungenzeka uma ukuzivikela komzimba kuphansi. Lokhu kungenzeka njengomuntu ubudala kodwa futhi uma ukutheleleka ngegciwane lesandulela ngculazi kuchitha amangqamuzana omzimba okubizwa ngokuthi ama- CD4 T-cell .
Ukulahlekelwa kakhulu kwama-T-cell, okuyiyona ingozi enkulu (ikakhulukazi njengoba inani le- CD4 liwela ngaphansi kwama-350). Imithwalo ephezulu yegciwane lesandulela ngculazi nayo ihlotshaniswa nengozini yokukhuphuka kwesibindi.
Ngenkathi ukwelashwa kwegciwane lesandulela ngculaza kuye kwanciphisa izigameko zezibungu kubantu abaphila negciwane lesandulela ngculaza cishe ingxenye yesithathu, ingozi ihlala isilingana neyabantu abadala abangaphezu kuka-65. Konke okushiwo ukuthi, ingozi yokuqhathaniswa ne-HIV ingaphezu kwezikhathi ezingu-10 kunaleyo umphakathi jikelele.
Ngaphezu kwalokho, ukutheleleka ngegciwane lesandulela ngculazi kuhlotshaniswa nethonya elikhulu lokuhlukunyezwa kwesibindi, kufaka phakathi ukushaywa kwesibindi (okuthinta ama-dermatomes amathathu noma ngaphezulu), izibungu zamehlo noma izitho zangaphakathi, noma ukuphindaphinda ezinyangeni eziyisithupha.
Ucwaningo oluvela kuJohn Hopkins University lisikisela ukuthi abantu abangamaphesenti angama-28 abantu abane-HIV abanezinkinga ezingenayo igciwane lesandulela ngculaza bangase babe nezinkinga ezinjalo.
Izincomo zabantu abane-HIV
Ngenkathi i-FDA ingenzi izincomo ezihlelekile mayelana nokusetshenziswa kweZostavax kubantu abane-HIV (ngaphandle kokusho ukuthi abantu "abanamandla okuzivikela omzimba" kufanele bakugweme). kukhona ubufakazi obukhulayo bokusekela ukusetshenziswa kwawo.
Ngonyaka wezi-2012, ososayensi abane-long clinical AIDS Clinical Trials Group baphetha ngokuthi i-Zostavax yayiphephile futhi isebenze kubantu abanezibalo ze-CD4 ezingaphansi kuka-200.
Ngenkathi imiphumela yayikhuthaza, abaningi bahlala bekhathazekile ngokugcwele komuthi wokugoma kubantu abanezibalo ze-CD4 ngaphansi kuka-200. Njengomuthi wokugoma ophilayo, kusekhona ukuthi kungenzeka ukuthi ngisho negciwane elibuthakathaka lingabangela ukugula lokho okuhloswe ngakho ukuvimbela.
Ngenkathi amaCentral for Disease Control and Prevention engasikhuthazi okwamanje i-Zostavax kubantu abane-HIV, imibono yomtholampilo ibonakala iyashintsha. Abaningi ababhekene nezifo ezithathelwanayo basekela ukusetshenziswa kweZostavax kubantu abadala abane-HIV abaneminyaka engama-50 nangaphezulu abaye banakekela umthamo wegciwane elingenakulinganiswa kanye ne-CD4 count ngaphezu kuka-200. Ngendlela efanayo, abaningi bayavuma ukuthi i-Zostavax akumele isetshenziswe kubantu abanezibalo ze-CD4 ngaphansi kuka-200 .
I-Zostavax kufanele futhi igwenywe kubantu abangenawo umlando wezinkukhu noma ubufakazi be-antibodies VZV. Kulabo bantu ngabanye, kumele kusetshenziswe ukugoma okuyinhloko kuphela yokugoma inkukhu (njenge-Varivax noma i-Varilrix).
> Imithombo:
> Ukuphathwa Kwezokudla Nezidakamizwa zase-US. "I-FDA ivumela ukugonywa kwe-Zostavax ukuvimbela ama-shingles kubantu abaneminyaka engu-50 kuya kwangu-59 ubudala." I-Silver Spring, e-Maryland; ikhishwe ngoMeyi 24, 2011.
> Ama-Blanks, L .; Polydefkis, M .; Moore, R. et al. "I-Herpes zoster phakathi kwabantu abaphila negciwane lesandulela ngculazi esikhathini sokuthi ukwelapha izidambisigciwane zamanje." I-Journal ye-Immune Deficiency Deficiency Syndromes. Okthoba 1, 2012; 61 (2): 203-207. I-DOI: 10.1097 / QAI.0b013e318266cd3c.
> Benson, C .; Hua, L .; U-Andersen, J .; et al. "I-ZOSTAVAX ngokuvamile iphephile futhi i-immunogenic kubantu abadala be-HIV + bagxiliwe ngokweqile ku-ART: imiphumela ye > isigaba > 2, isivivinyo esilawulwa ngokuphindaphindiwe, esine-double blind, esiphethwe yi-placebo." Ingqungquthela ye-19 yama-Retroviruses kanye nezifo ezivame ukuqhutshwa (CROI); Seattle, Washington; NgoMashi 5-8, 2012; abstract 96.