Izilonda Zomlomo Kungaba Isibonelo Sokukhula Kwegciwane lesandulela ngculaza
I-leukoplakia enomuncu (eyaziwa nangokuthi i-leukoplakia enomlomo, noma i-OHL) ivame ukubonwa izilonda zomlomo kubantu abathintekayo ekuzivikelweni, okubonakala ngamapheshana amhlophe ohlangothini lwelulwimi kanye nesici "sokubukeka kwekhanda". Ngenye yezifo eziningana zomlomo ezingathinta abantu abanesandulela ngculazi njalo, kaningi lapho inani le- CD4 yomuntu liwela ngaphansi kwama-200 / mL.
I-OHL ibangelwa igciwane le-Epstein Barr (i-EBV), igciwane lomndeni we-herpes elichaphazela cishe amaphesenti angama-95%, nakuba iningi lizothuthukisa imishanguzo evimbela ukuthi igciwane lingabonakali ngokubonakalayo. Kodwa-ke, kubantu abanesandulela ngculazi, umsebenzi wokuzivikela omzimba owenziwe ukutheleleka uvumela i-OHL ithuba lokukhula. Ngenxa yalokho, kubhekwa ukutheleleka okuhloswe ngegciwane lesandulelangculaza (OI) .
Izilonda ze-OHL ziyingozi futhi azibangeli ezinye izimpawu. Esikhundleni salokho, isimo sibonisa kokubili ukunciphisa ukuzivikela komzimba nokunciphisa amandla okunye kwamanye ama-OIs amakhulu. Ngokuvamile, i-OHL ibonakala kaningi emadodeni kunabesifazane, futhi ayitholakali kubantwana.
Ngaphambi kokutholakala kwe- antiretroviral (ART) , i-OHL yayibikezela ngokuqhubekayo ukuqhubeka kweso sifo, lapho abaningi abangu-47% beqhubeka besuka e- HIV kuya e-AIDS phakathi neminyaka emibili.
Namuhla, ngokuqaliswa kokuqala kwe-ART, isifo se-OHL sehlile ngokuphawulekayo, ngokungafani nezinye izifo zomlomo ezihlobene ne-HIV eziqinile futhi zikhona kumazinga aphezulu e-CD4.
Phakathi naleso sikhathi, ucwaningo lwamuva luye lwabonisa nokuthi ukubhema , ngokubambisana nesibalo esincane se-CD4, kubangele ukwanda okuphindwe kabili engozini ye-OHL.
Ukuxilongwa, Ukwelashwa Nokuvimbela OHL
Izilonda ze-OHL zihluka ngobukhulu. I-albhamu ingabonisa kunoma iyiphi eyodwa noma zombili izinhlangothi zolimi noma ngaphakathi kwehlathi. Akuvamile ukubuhlungu ngaphandle uma kukhona ukutheleleka okuyisisekelo, okuyisisekelo.
Ngesinye isikhathi, izilonda zingase zivele zinyathele, zenze kube nzima ukuhlukanisa nezinye, izifo ezifanayo. Nokho, ngokungafani ne- candidiasis yomlomo (thrush) , i-OHL ayikwazi ukukhishwa kalula ngolimi. Lokhu, kanye ne-nameake's nameake ukubukeka, yizici eziphakamisa kakhulu i-OHL kubantu abane-HIV.
Ngesikhathi ukuhlolwa komtholampilo kuvame ukwanele ukusekela ukuxilongwa okuhle, ezinye izifundo zibonisa ukuthi kufika ku-17% kokuhlolwa okubukwayo akulungile. Uma kunesidingo, ukuxilongwa okucacile kungenziwa ngokuhlolwa okuncane kakhulu kwe-biopsy nezinye izindlela zokuxilonga ukuqinisekisa ukutheleleka kwe-EBV.
Ngenxa yokuthi i-OHL lesion iyingozi, akukho ukwelashwa okudingekayo. Kodwa-ke, kwabanye-ikakhulukazi labo abane-CD4 yokubala-i -high-dose Zovirax (acyclovir) bangasiza ukuxazulula lesi simo. Noma kunjalo, ukuphindaphinda kwe-OHL kuphakeme uma ukwelashwa kwe-acyclovir kumiswa ngaphandle kokuba kuvuselelwe amandla omzimba.
I-OHL ingase iphinde ibuye lapho ukuphikiswa kwezidakamizwa ze-HIV kukhula futhi imithi ye- antiretroviral yesiguli ingasebenzi kahle ekulawuleni i-HIV.
Ukuvimbela i-OHL kuxhomeke kakhulu ekuxilongweni kokuqala kanye nokwelashwa kwe-HIV, futhi iziqondiso zamanje zase-US zikhuthaza ukuqaliswa kwama-ART kuma-CD4 izibalo phakathi kuka-350 no-500 amaseli / mL, ngisho nasezifundweni ze-CD4 ezingaphezu kwama-cell cell / mL.
Ukuyeka ukubhema kuphakanyiswa kakhulu ukuvimbela ukubukeka kwe-OHL, kanye nezinye izifo eziningi ezihlobene ne-HIV ezihlobene ne-HIV.
Imithombo:
I-Katz, M .; Greenspan, D .; Westenhouse, J .; et al. "Ukuqhubekela phambili kwe-AIDS kwabangqingili abanegciwane lesandulela ngculazi nabesilisa nabesifazane abesilisa nabesifazane abesilisa abanezinwele ezinezinwele ezinomunwe we-leukoplakia ne-candidiasis yomlomo." AIDS. Januwari 1992; 6 (1): 95-100.
I-Cherry-Pepper, G .; UDaniels, uC .; Amamaki, V .; et al. "Ukubonakala komlomo esikhathini se-HAART." . I-Journal ye-National Medical Association. NgoFebruwari 2003: 95 (Supplement 2): 21S-32S.
I-Chattopadhyay, A .; I-Caplan, D .; USlade G .; et al. "Ukukhubazeka komlomo we-candidiasis nomlomo we-leukoplakia onomlomo omdala abantu abanegciwane lesandulela ngculaza eNorth Carolina." I-oral oral Oral Med Oral Medal Pall Oral Radiol Endod. Ukuhlinzwa Otshenziswa Ngomlomo Okwemlomo Omlomo I-Oral Pathology Oral Radiology Endodontology . Januwari 2005; 99 (1): 39-47.
U-Chapple, I. no-Hamburger, J. "Ukubaluleka kwempilo yomlomo ngesifo se-HIV." . Izifo ezithathelwana ngocansi. Agasti 2005; 76 (4): 236-243.