I-virus immunodeficiency virus (i-HIV) igciwane elihlasela futhi libhubhise izinhlobo ezithile zamangqamuzana egazi ezimhlophe ( CD4 + T-cells ) kubantu. Ukulahlekelwa kwalezi zimhlophe ezimhlophe zegazi kuholela ekwakheni izifo ezihlukahlukene, amagciwane, nezinye izinkinga zomzimba. Namuhla, kunabantu abangaphezu kwezigidi ezingu-30 emhlabeni wonke abaphila negciwane lesandulela ngculaza, abanamaphesenti angaphezu kwezigidi zalabo abahlala e-United States.
Lapho i-HIV iqaphela kuqala ekuqaleni-kuya ko-1980, ukutheleleka kwaqhubekela phambili ngokushesha kuya ekutholeni i- immunodeficiency syndrome (i-AIDS) kubantu abaningi abathintekile. Phakathi neminyaka yama-1990, ukwethula imithi ehlukahlukene yama- antiretroviral kwancipha kakhulu noma kwavimbela nokuqhubekela phambili kokutheleleka nge-HIV ku-AIDS. Abantu abanesandulela ngculazi bahlala isikhathi eside futhi bakhula ezinye izifo ezingelapheki ezivame kubantu abangenayo igciwane lesandulela ngculaza, njengezifo ezihlukahlukene zokwelapha .
Ingabe abantu abanesandulela ngculazi bathola izilonda ezingaphezulu?
Abantu abanegciwane lesandulela ngculazi bayaziwa ukuthi banamazinga aphezulu okuphikisana nomzimba (IgE) , ikakhulukazi njengoba amazinga e-CD4 + T-cell ehla. Lezizinga eziphezulu ze-IgE azikona ukuthi zibonisa ukuthi ziyingozi kakhulu, kodwa-ke, kodwa kungenzeka ukuthi ziwuphawu lokubhebhetheka komzimba ngenxa ye- B-cell dysfunction. Ama-antibodies ase-IgE aqondiswa ezinambuzane ezihlukahlukene (kubandakanya i-HIV), kunokuba zibhekane nezilonda.
Abantu abanegciwane lesandulela ngculaza bavame ukuthola amazinga aphezulu okumoya, noma kunjalo, kuhlanganise ne- allergenic rhinitis (hay fever) , izifo ezidakayo nezidakamizwa .
Lokhu kungenzeka ngenxa yokuphazanyiswa kwesilinganiso samasosha omzimba, okungaholela ekulahlekelweni kwezinqubo ezivamile zokulawula ukungezwani komzimba, kanye nezinye izimpawu zesifo sofuba.
I-Hay Fever kubantu abane-HIV
Abantu abanesandulela ngculazi babonisa izinga eliphezulu kakhulu lezimpawu zangasese, ngezifundo ezibonisa ukuthi 66% zikhononda ngezibonakaliso zomzimba ezingasese futhi ezingaphezu kwengxenye eyodwa kwezintathu zeziguli zegciwane lesandulela ngculaza ezinezibhedlela ezinebufakazi besinusitis .
Ucwaningo oluningi lubonisa ukuthi abantu abanegciwane lesandulela ngculaza banemiphumela emihle yemiphumela emihle yokuhlolwa kwesilwane , uma kuqhathaniswa nabantu abangenayo igciwane lesandulela ngculaza.
I-Treatin g i-rhinitis ye-allergen kubantu abanesandulela ngculaza kufana nabantu abangenayo i-HIV. Uma ukugwema i- allergen kungenakwenzeka, ukwelashwa ngama- antihistamines omlomo , ukuphalaza kwe-nasal sraid , kanye neminye imithi yokuphuza ingasetshenziswa ngokuphepha. I-Allergen immunotherapy , noma ukudubula kwamagciwane , kunzima kakhulu kubantu abane-HIV ngenxa yokuthi imiphumela yesikhathi eside yokuvuselela amasosha omzimba nge-immunotherapy aziwa kubantu abane-HIV.
Ukudakwa kwezidakamizwa kubantu abane-HIV
Abantu abanegciwane lesandulela ngculaza banamazinga aphezulu okubhekana nezifo ezibangelwa izifo, mhlawumbe ngenxa yokuphazamisa iziqondiso ezivamile zomzimba. Lokhu kuyiqiniso ngokukhethekile ku-trimethoprim-sulfamethoxazole (TMP-SMX), okuyinto imithi elwa ne- sulfa . Ukusabela okubi kwe- TMP-SMX kwenzeka ezingaphezu kwengxenye yabantu abanegciwane lesandulela ngculazi (kuqhathaniswa nabantu abangaphansi kuka-10% abangenwe igciwane lesandulela ngculaza). Ngenhlanhla, ukuhlukunyezwa kwe-TMP-SMX ukungezwani komzimba kuyaphumelela, okuvame ukudingeka ukuvimbela nokuphatha izifo ezivame ukubonakala kubantu abane-HIV.
Okunye okuvame ukubonwa izidakamizwa ezithathelwanayo yi-drug drug abacavir.
I-Abacavir iyi- nucleoside reverse transcriptase inhibitor engabangela ukusabela kwe-hypersensitivity esongela ukuphila ku-5-8% abantu abane-HIV. Kunesimo sezinto eziphathekayo zohlobo lwe-abacavir hypersensitivity okufanele lihlolwe ngokusetshenziswa kokuhlolwa kwegazi ngaphambi komuntu othatha abacavir. Uma umuntu engenayo igesi ehambisana nokuphendula, i-abacavir ingathathwa ngokuphepha.
I-asthma kubantu abane-HIV
Ukwelashwa kokutheleleka nge-HIV ngemithi ye-antiviral kuye kwabangela ukwanda kwezinkinga zamaphaphu ezitholakala kulaba baguli. Amadoda atheleleke ngegciwane lesandulela ngculaza aboniswe kwizifundo ukuba babe namanani aphezulu okuhamba ngesondo uma eqhathaniswa namadoda ngaphandle kokutheleleka nge-HIV, ikakhulukazi kulabo ababhema imikhiqizo kagwayi.
Abantwana abanegciwane lesandulela ngculazi bathola imishanguzo ye-antiviral futhi babonisa izinga eliphezulu le-asthma uma kuqhathaniswa nezingane ezinegciwane lesandulela ngculazi ezingathathi imithi yokuvimbela i-anti-virus.
Lezi zifundo zibonisa ukuthi abantu abane-HIV banesifo esithile esicasulayo sokubhema ugwayi, futhi ukusetshenziswa kwemithi yokuvimbela imishanguzo yokwelapha i-HIV kuvikela ekulahlekelweni komzimba, okungabangela ingozi yezimo ezibangelwa ukuphefumula, njenge-asthma. Ukwelashwa kwesifo sofuba kubantu abanegciwane lesandulela ngculazi kufana nalokhu kubantu abanesandulela ngculaza, nakuba i- corticosteroids yomlomo kufanele igwenywe noma kunini lapho kungenzeka khona, ngenxa yomphumela wokucindezela omzimba.
Umthombo:
I-Stokes SC, i-Tankersley MS. I-HIV: Impikiswano Ewusizo Ekusebenziseni I-Allergist-Immunologist. Ann Ukuzivocavoca Isifo Somoya Immunol. 2011; 107: 1-8.