Ukuhlola Okubonisa Okubalulekile, "Isigaba Esizayo" Izifo Zingakwazi Ukubhekana Nokutheleleka Kwangaphambi Kokuqala
Ngenkathi sekushicilelwe okuningi ngezibonakaliso zokuqala ze-HIV , kusenayo incazelo eningi evunyelwene ngayo ngokuthi ukutheleleka "okujwayelekile" kungase kubonakale kanjani ngezigaba zakuqala (eziyinkimbinkimbi). Futhi yinkinga.
Naphezu kwemizamo kahulumeni yokwandisa ukuhlolwa kwe-HIV phakathi kwabo bonke abaseMelika abaneminyaka eyi-15 kuya ku-65, abantu abaningi bayolinda kuze kube isikhathi esithi "izimpawu zokuqala" zokutheleleka zivele.
Ukuthi ukutheleleka okusha okuzobe kunakho konke kungabikho izibonakaliso kuphela okwandisa le nkinga futhi kungachaza ukuthi kungani ama-20% abantu baseMelika abaphila negciwane lesandulela ngculazi bengaboni.
Ukuze ucindezele izindaba ngisho nangaphezulu, kulabo abanezibonakaliso, ucwaningo manje lubonisa ukuthi noma yikuphi okuvela ku-25-40% kuzoletha ngezimo ezingahlotshaniswa ne-HIV. Ngenxa yalokho, kungenzeka ukuthi izifo ezintsha ziphuthelwa noma zingasetshenziswanga kahle-hhayi nje kuphela yilowo osuleleke kodwa ngabaphathi ngokwabo.
Izimpawu ezinjalo ezingavamile zokutheleleka kokuqala zingabandakanya izifo zesimiso sezinzwa zomzimba nezisemzimbeni, kanye namehlo, amaphaphu, izinso, isibindi, nezitho zangasese.
Izimpawu ezijwayelekile futhi ezingavamile zengculazi yangaphambi kwesikhathi
Ngokuvamile, cishe abangama-40% abantu abasanda kutholakala bazobona izimpawu ze- acute retroviral syndrome (noma i-ARS) . I-ARS imane nje impendulo yomzimba ku-HIV njengoba iphakamisa ukuzivikela ngokumelene nomhlaseli wegciwane, kanye nokuvuvukala okuqhubekayo okubangelwa izimpawu ezifana nalokho okhuhlane.
I-fever, ukukhathala, ikhanda, ubuhlungu obukhulu, imitholampilo ye-lymph, futhi ubuhlungu bomzimba / obuhlangene akuzona izici ezingavamile ze-ARS. Abanye bangase bahlakulele (okuvame ukubhekwa ngokuthi "ukuqhuma kwe-HIV" ), okungabonakalisa ngama-patches ama-bumpy, ngokuvamile engxenyeni engenhla yomzimba. Abanye bangase babe nesisindo esincane esifushane, ukuhlanza noma isisu.
Yize lezi zibhekwa njengezibonakaliso ezivame kakhulu ze-ARS, ubufakazi obusayo obuningi bubonakala bubonisa ukuthi abanye bangase babe nezimo ezinzima kakhulu, ngisho nezingozi ezisongela ukuphila.
Ngonyaka ka-2015, ososayensi abaneSifundo Sokuvimbela I-HIV E-Zurich Primary eSwitzerland bahlose ukusungula ububanzi kanye nemvamisa yezimpawu ezingenzeka ngesikhathi sokutheleleka kwe-HIV. Ngokusho kocwaningo, akukhona kuphela ukuthi bakwazi ukukhomba izifo ezingu-18 noma izimo ezahlukene-okuningi kunalokho okwakungenwe ngaphambili-babika inani elibalulekile elitholakali ekutholeni ukuxilongwa.
Iziguli ezikhonjwe ngesikhathi sokutheleleka kokuqala zifakiwe, zichazwe ngokuthi:
- Ukutheleleka okutheleleke ngegciwane lesandulela ngculazi , okusho ukuthi umuntu uye wabonisa izimpawu kanye nokuhlolwa okungalungile noma okungenqunyelwe ukuhlolwa kwegciwane lesandulela ngculazi , noma wayengenalo izimpawu kodwa uhlolwe kahle nge-HIV zingakapheli izinsuku ezingu-90 zokuchayeka.
- Ukutheleleka kwegciwane lesandulela ngculazi , okusho ukuthi umuntu olethwe ngezimpawu kanye nokuhlolwa okuhle kwegciwane lesandulela ngculaza, noma wayengenalo izimpawu kodwa wahlolelwa ukuthi unesandulela ngculazi ezinsukwini ezingu 90-180 zokuchayeka.
Imiphumela yayimangalisa. Kulezi ziguli ezingu-290 ezanelisekile indlela yokuqasha, ama-25% anezibonakaliso ezingahambelani neze-ARS. Phakathi kwalabo abanezibonakaliso, lesi sigameko sakhula nakakhulu, nge-28.5% we-acute futhi 40% weziguli zakamuva ezithola izifo ezithathelwana nge-HIV-nezingahlobene ne-HIV.
Phakathi kwabo, u-23% wanikezwa isimo esichaza i- AIDS , okusho ukuthi isibonakaliso sabo sokuqala sokutheleleka kwakuyisifo esivame ukubonakala esibhedlela esilandelayo. Lawa afaka amacala we- candida (i-thrush , i- cytomegalovirus (i-CMV) ye-gut noma isibindi, i- herpes zoster (ama-shingles) , noma ngisho ne- HIV yokuchitha i-syndrome , isimo esivela kuphela esihlotshaniswa nokutheleleka okuthuthukisiwe.
Izimpawu ezingezona i-HIV ezihambisana ne-HIV zilandelayo ohlwini, zibheka ama-14% wezethulo ezisezingeni eliphezulu. Cishe isigamu sasingama-tonsillitis, kanti ukubonakaliswa okungathí sina okungaphezulu kwakuhlanganisa ukuphuma kwegazi esiswini, ukuvutha kwesibindi, ukuhluleka kwezinso, kanye nokutheleleka kwe-herpes (okungazange kutholakale kuphela ngokuthi i-appendicitis kodwa kamuva kwaholela ekususeni okuyingxenye yekoloni yesiguli).
Isimiso se-central nervous system (CNS) senza amacala angu-12% amacala ase-atypical. Phakathi kwalezi zikhungo, izibhedlela zabikwa ezigulini ezinezikhukhula ezikhukhumayo ( encephalitis ) kanye ne- meningitis . Ukukhubazeka okwenziwe isikhathi eside nakho kwaqashelwa njalo, njengoba kwakukhona izigameko ezinzima zezifo zengqondo.
Ngokuphathelene nokunye , mhlawumbe isigamu salezi zimo zathola ukuxilongwa ngaphandle kwe-HIV ngaphambi kokuhlolelwa igciwane.
Ngakho Lokho Kusitshela Kithina?
Esikhathini esedlule, singase sicabange ngokucacile ukuthi umuntu oveza ukugula okungathí sina, okuhlobene negciwane lesandulela ngculaza kwakunezinkinga ezithintekile eminyakeni edlule futhi manje nje nje kwaba uphawu oluphawulekayo. Manje siyaqonda ukuthi, kwezinye iziguli, izifo ezinzima zingase zihambisane nezinyathelo zokuqala zokutheleleka.
Okumangalisa nakakhulu ukuthi manje sesiyazi ukuthi lezi zimo zivame ukuvela ezigulini ezinempilo emizimba. Ngokusho kocwaningo, abantu abanomzimba omzimba onamandla (okungukuthi, inani le- CD4 ngaphezu kwamangqamuzana angu-500 / mL) okungenzeka babe nesipiliyoni esinzima kakhulu kunomuntu onesimiso esinqunywe ngokulinganisela.
Ngenkathi izinqubo zalezi zinkinga zingacacile ngokuphelele, siyazi ukuthi ezinye izinto zingandisa amathuba abo, kufaka phakathi umthamo wegciwane ephezulu kakhulu ekuthelelekeni kokuqala (isilinganiso samakhophi angama-4-5 million / mL) kanye nohlobo lwegciwane lomuntu onesifo kanye (ngokuqondile ne- non-B subtype ye-HIV ).
Siphinde sithole ukuqonda okubanzi ngesilinganiso nokulinganiswa kokungena kwegciwane lesandulela ngculazi emathunjini nasebuchosheni, futhi izici ezingase zibeke umuntu esimweni sokutheleleka kwamathambo amakhulu kanye ne-CNS.
Ngombono womuntu ngamunye, ucwaningo lusekela ngokuqinile ucingo lukahulumeni wokuhlola i-HIV kubo bonke abaseMelika abaneminyaka eyi-15-65 njengengxenye yokuvakasha kukadokotela. Ngeke sisakwazi ukucabanga ukuthi umuntu ungengozi ephansi ngoba nje engabonakali nge-"classical" yesignali.
Ngesikhathi abacwaningi baseSwitzerland bethetha ukuthi ukutholakala kwezimpawu zomzimba ezinama-atypical kungase kube ngu-15% kuphela, okwamanje kuhumusha eyodwa yezinguquko eziyisishiyagalolunye ezingabanjwanga. Futhi ngezinga lokutheleleka nge-HIV likhuphuka kubantu abaningi abasengozini (kubandakanya amadoda alala nobulili namadoda nabase- Afrika baseMelika ), yilowo nalowo kwabayisishiyagalombili asikwazi ukulahlekelwa.
Imithombo
I-Braun, D.; Kouyos. R .; I-Balmer, B .; et al. "Ukuphindaphindeka nokubukeka kwemibonakaliso engalindelekile yokutholwa kwe-HIV-1 eyinhloko." Izifo Ezithathelwanayo Emitholampilo . 2015; 61 (6): 1013-1021.
Cohen, M .; Gay, C .; Busch, P .; noHecht, F. "Ukutholakala kokutheleleka okutheleleka ngegciwane lesandulela ngculaza." I-Journal of Infectious Diseases. 2010; 202 (Ukwengeza 2): S270-S277.
Moyer, V. "Ukuhlolwa kwe-HIV: Isitatimende Sokuncoma Sezinsizakusebenza Ze-US Preventive Services." Ngo-Ephreli 30, 2013. Ama-Annal of Medicine Internal. Ngo-Ephreli 30, 2013; i-doi: 10.7326 / 0003-4819-159-1-201307020-0064.