I-HIV-Associated Dementia nabanye
Njengoba igama layo libonisa, i- immunodeficiency virus (i-HIV) ihlasela isimiso somzimba sokuzivikela. I-HIV ngokukhethekile ihlasela amangqamuzana omzimba omzimba okuthiwa i- CD4 positive T-cells . Njengoba lawa maseli efa, umzimba ujwayele ukwelashwa nezifo zomdlavuza ukuthi abantu abaphilile bazokwazi ukulwa.
Lokho abanye abantu abangaboni ukuthi igciwane lesandulela ngculazi ngokwayo lingabangela izinkinga ezinkulu ngisho ngaphandle kokunye ukutheleleka okubandakanyekayo.
Enye yalezi zinkinga i- HIV-Associated Dementia (HAD) , eyaziwa nangokuthi i-HIV encephalopathy noma isifo se-AIDS senhliziyo.
Ngenkathi bevame ukucatshangwa ukuthi bekwenzeke kuphela ku-HIV ephakeme, manje sibona kubantu abangeke bazinze imishanguzo yabo futhi abanezibalo eziphakeme kakhulu ze-CD4.
Izifo ezihambisana ne-HIV ezihambisana ne-HIV
Izinhlobo zokukhubazeka kwengqondo ezihlotshaniswa ne-HIV zikhona ezinhlobonhlobo zobunzima. Uma kucutshungulwa ndawonye, lezi zinhlobo zokukhubazeka zibhekwa njengezifo ezibangelwa i-HIV-Associated Neurocognitive Disorders.
Inhlobo encane kakhulu ye-Neurocognitive Disorder ehlobene ne-HIV iwukukhubazeka okungenangqondo, lapho umuntu ehluleka khona ukuhlola ukuhlolwa kwegazi, kodwa impilo yabo ayithinteki ngokuphawulekayo. Uma impilo yomuntu ingathintekile kodwa ingathí sina, abanye abahlengikazi bayobe behlonza isiguli esinenkinga encane yokuzizwa-motor (MCMD).
Uma le nkinga ingabonakala kokuhlolwa kwe-neuropsychological futhi iphazamise kakhulu impilo yansuku zonke, ukuxilongwa kungenziwa nge-HIV-Associated Dementia.
Izimpawu ze-Dementia ehambisana ne-HIV
Abantu abaningi bacabanga ukuthi i-HIV-Associated Dementia (HAD) izofana nezinhlobo eziziwa kangcono zesifo sengqondo somqondo esifana nesifo so-Alzheimer's.
Lokhu akuvamile ukuthi kwenzeke. Nakuba imemori ingakwazi ukukhubazeka njengoba isengqondweni yesifo se-Alzheimer, abantu abane-HIV-Associated Dementia nabo bangaba nobunzima bokugxila noma ukunakekelwa, okungahlali kubonakala ku-Alzheimer's disease. Abantu abane-HIV-Associated Dementia nabo bahamba kancane kunokuba babeke, hhayi nje ekucabangeni, kodwa ngokuvame ukuhamba nabo. Ngale ndlela, ukuwohloka komqondo okubangelwa igciwane lesandulela ngculazi kungalingisa ukugula kwengqondo kaParkinson (PDD).
Abantu abane-HAD bangase babe nezinguquko ezinhliziyweni zabo ezifana nokunganaki, lapho bengenaso isisusa sokwenza okuningi kunoma yini. Njengoba lesi sifo siqhubeka, singase sithukuthele kakhulu, futhi amaphesenti angaba ngu-5 ukuya ku-8 ahlakulele i-AIDS mania ngezinto ezingokwengqondo ezifana ne-paranoia kanye nama-hallucinations.
Isizathu SENDLELA
I-HIV ingena ohlelweni lwesimiso esiphakathi (CNS) ngokushesha ngemuva kokutheleleka kokuqala. Nakuba ubuchopho buvikelwe uchungechunge lwezicubu ezibizwa ngokuthi i- blood-brain certification , amanye amangqamuzana omzimba omzimba, njenge- macrophages , angafinyelela. Lokhu kwenza izinga elithile lomqondo. Ngokuvamile, lawa maseli asetshenziselwa ukulwa nokutheleleka. Nokho, e-HIV, amangqamuzana empeleni ethwala ukutheleleka. Kunjengokufana nokugqoka njengogada ukuze kungenele enqabeni.
Ngesinye isikhathi ebuchosheni, igciwane alifaki amangqamuzana omzimba ngokwawo kodwa alilimaza ngokungaqondile ngokubangela impendulo yokuvuvukala.
Izingozi Zezingozi ze-HAD
Izinkinga ezinkulu ze-HAD zibandakanya ukunamathela kabi emithini ye-antiretroviral kanye nomthamo wegciwane otholakala . Ubude besikhathi umuntu onegciwane lesandulela ngculaza abubaluleke kakhulu kunalokho ukuthi inani labo le-CD4 lifinyelele kangakanani.
Ukuhlolwa kwe-HAD
Ngenxa yokuthi igciwane lesandulela ngculaza lenza abantu bakwazi ukubhekana nezinye izinkinga ezingabangela ushintsho lwezinkinga, ezifana nezifo kanye namanqamu, ukuhlolwa okuphelele kuyadingeka lapho umuntu onesandulela ngculazi engenawo ushintsho endleleni acabanga ngayo.
Lokhu kuyiqiniso ikakhulukazi uma othile ehamba ngokushesha ngokushesha. Iningi le- dementias lihamba kancane, futhi inkambo yokushesha ingasho ukuthi kunenkinga ehlukile eqhubekayo, noma ukuthi i-HIV isuka ekulawuleni.
Ukukhathazeka kwe-HIV yomqondo we-HIV kufanele kufake i- MRI yobuchopho ukuba ibheke izimpawu zokutheleleka noma umdlavuza. Ukuwohloka komqondo okuhambisana ne-HIV ngokwayo kubangela ushintsho oluphawulekayo esithombeni sobuchopho obuthathwa yi-MRI. Ubuchopho bungaboniswa ukuthi bukhuni, futhi kunezibalo ezengeziwe zempilo emhlophe, okuyizindawo ezikhanyayo lapho zingekho khona.
Ukwelashwa kwe-HAD
Njengamanye amafomu amaningi e-dementia, akucaci ukuthi yini, uma ikhona, ukwelashwa kungasiza umuntu one-HIV-Associated Dementia. Omunye wemithi ejwayelekile esetshenziswa esibhedlela i-Alzheimer's, i-Memantine, isiqinisekisiwe ukuthi ngeke isisize, futhi asikho isizathu sokukholelwa ukuthi enye imithi esetshenziselwa i-Alzheimer izoba usizo.
Ukunamathela kahle kwe-antiretroviral therapy kuye kwahlotshaniswa nezingozi ezincane ze-HAD, kodwa akuqiniseki ukuthi ukufaka noma ukushintsha imithi kumuntu onama-HAD kunanoma iyiphi inzuzo. Kwesinye isifundo, ukushintsha imishanguzo ye-antiretroviral empeleni kwenza abantu babi kakhulu. Kodwa-ke, uma othile enesifo esihlobene ne-HIV-Associated Dementia, abantu abaningi bazoshintsha imishanguzo, ikakhulukazi uma imithi isiguli esiphezuyo ingaziwa ngokufaka isimiso sezinzwa zomphakathi (CNS). Imithi efana ne-tenofovir, i-zalcitabine, i-nelfinavir, i-ritonavir, i-saquinavir ne-enfuviritide yonke iboniswe ukuthi ikwazi ukungenelela ku-CNS, nakuba ukusizwa kwalolu daba kuhlale kukhulunywa, futhi kungabangela ukulimala kunokuba kuhle.
Abanye abantu basebenzisa i-methylphenidate (Ritalin) ukuze basize ngokuncipha kwengqondo. Ngokuvamile, ukuhlala ngokwengqondo, emphakathini nasemzimbeni kuyasebenza.
I-HIV yomqondo we-HIV yinkinga enkulu, futhi ngeshwa, asazi okuningi ngakho. Ngokungafani nezinye izinhlobo eziningi ze-dementia, abantu abane-dementia ye-HIV ngezinye izikhathi bathuthukisa, ngakho-ke kubalulekile ukuxoxa ngalezi zimpawu ngudokotela oqeqeshiwe.
Imithombo:
U-Antinori A, u-Arendt G, u-Becker JT, et al. I-neology yokucwaninga ebuyekeziwe yezinkinga eziphathelene ne-HIV ezihlobene ne-HIV. I-Neurology 2007; 69: 1789.
Ukuqokwa kwamagama kanye nezincazelo zocwaningo zocwaningo lwezinzwa ze-neurologic ye-immunodeficiency virus-type 1 (HIV-1) ukutheleleka. Umbiko weqembu elisebenzayo le-American Academy of Neurology AIDS Task Force. I-Neurology 1991; 41: 778.
Intengo RW. Izinkinga ze-neurological zokutheleleka nge-HIV. Lancet 1996; 348: 445.