Ukufundwa Kuqukethe Impela Ukulingana Kweqiniso-Kwezwe Lokuhlolwa Kwegciwane lesandulela ngculaza elivunyelwe
Njengoba i-US ihlose ukwandisa ukuhlonza kokuqala kanye nokwelashwa kwabantu abane-HIV, kugxilwe kakhulu ekunqumeni ukunemba kokuhlolwa kwegciwane lesandulela ngculaza ezindaweni zangempela-hhayi nje kuphela ukunciphisa inani lemiphumela yokuhlolwa kwe-HIV engalungile namanga kodwa ayikho emthethweni kodwa ukuhlonza kangcono abantu ngesikhathi sokuqala (eziyinkimbinkimbi) zokutheleleka lapho ingozi yokudlulisela iphezulu kakhulu.
Ukuze kucatshangelwe lokhu, abacwaningi abavela eNyuvesi yaseCalifornia, eSan Francisco bahlaziya ukuhlolwa kuka-21 000 kwe-HIV phakathi kweminyaka ka-2003 no-2008 kwezinye izindawo eziphakeme kakhulu zedolobha. Ezinhlobonhlobo zezinhlobo ezine zokuhlolwa ezisetshenziswe phakathi nalesi sikhathi-kusukela ezivivinyweni zokuqala zokukhiqizwa kwe-antibody kuya ezivivinyeni zamuva, ukuhlola ngomlomo okusheshayo-abantu abangu-761 batholakala benesandulela ngculaza (3.6% ukusabalala), kanti abangu-58 bahlonzwa ngesikhathi sokutheleleka okunamandla.
Ucwaningo luhlose ukuqhathanisa nokunemba kwezivivinyo zokuhlola ezintsha-kuhlanganise nokuhlolwa kwe- 4th generation antigen / antibody- ngokuphindaphinda igazi kulabo abangu-58 ngaphambili ababonwa ukuthi bane-infection enesisindo.
Ukunemba kwalinganiselwe kokubili ngokuzwela (iphesenti yemiphumela yokuhlolwa ehle kahle) kanye nokucacile (iphesenti yemiphumela yokuhlolwa engalungile).
| Uhlobo lokuhlola | Ibhulogi | Ukuzwela kusuka ekuhlolweni kuka-21 234 | Okucacile kusuka kuzivivinyo ezingu-21 234 | Ukuzwela ukutheleleka okunzima kusuka ekuhlolweni kwe-58 |
| Isivivinyo sokuqala (antibody test test) (igazi) | I-Vironostika i-HIV-1 Microelisa | 92.3% | 100% | 0% |
| Isivivinyo sesi-3 sokuvikela i-antibody (igazi) | I-Genetic Systems HIV-1/2 | 96.2% | 100% | 34.5% |
| Isizukulwane sesithathu sokuhlola okusheshayo kwe-antibody (igazi) | I-OraQuick Advance | 91.9% | 100% | 5.2% |
| Isizukulwane sesi-3 sokuhlolwa okusheshayo kwe-antibody (amathe) | I-OraQuick Advance | 86.6% | 99.9% | - |
| Isizukulwane sesithathu sokuhlola okusheshayo kwe-antibody (igazi) | Uni-gold Recombigen | - | - | 25.9% |
| Isizukulwane sesithathu sokuhlola okusheshayo kwe-antibody (igazi) | I-Multispot i-HIV 1/2 | - | - | 19.0% |
| Isizukulwane sesithathu sokuhlola okusheshayo kwe-antibody (igazi) | I-Clearview Stat Pak | - | - | 5.2% |
| Isizukulwane sesi-4 sihlanganiswa ngokushesha kokuhlanganiswa kwe-antigen / antibody, (igazi) | Hlola i-HIV 1/2 Ag / Ab Combo | - | - | 54.4% |
| Isizukulwane sesine isizukulwane esine-lab-based antigen / antibody (lab) | I-ARCHITECT i-HIV Ag / Ab Combo | - | - | 87.3% |
Kuthiwani Konke Lokhu Kusitshela?
Okokuqala, kusukela ekubukeni kwezinto ezithile, izibalo ziqinisekisile ukuthi izibalo zamaphutha amanga ahlala ephansi kakhulu, ngisho nezivivinyo zokuqala zezizukulwane.
Ngokwenkontileka , izinga lezinhlupho zamanga zahluka kakhulu, ngokuhlolwa kwe- OraQuick Advance okusheshayo okuyiwona owenza okubi kakhulu, kanti cishe isiguli esingaphezu kwesigidi esisodwa sithola umphumela omubi wamanga.
Lesi sibalo sabe siphumelele kakhulu uma sizama ukuthola igazi ngenxa yezifo ezithinta amagciwane. Kulezi zibonelo ezingu-58 ezivivinywe, isivivinyo esilandelayo esiphuthumayo sesi-3 sathola ukuzwela kuphela ngo-5.2% kuya ku-25.9%, okusho ukuthi iningi lalezi zifo ngeke liphuthelwe ngokusebenzisa lezi zindlela zobuchwepheshe eziphuthumayo, ezisekelwe ku-antibody.
Ngisho nesizukulwane sesine Ukuqeda ukuhlolwa okusheshayo kwe-antigen / antibody kwakwazi ukukhomba isigamu sezifo ezimbi, naphezu kokuzwela okungamaphesenti angu-96.6 no-100%. Ngokusho kwabacwaningi base-UCSF, i- Determine yasebenza kahle ngesikhathi sokutheleleka okunamandla lapho umthamo wegciwane lesiguli ungaphezu kwama-500,000 amakhophi / mL.
Akumangalisi ukuthi inhlanganisela ye- ARCHITECT yama -lab- antigen / antibody t e st yenza okusemandleni okuhlolwa okusemandleni. Ngomqondo olinganisiwe phakathi kuka-99.1% nesimo esithile esingu-100%, ukuhlolwa kwakwazi ukukhomba cishe amaphesenti angama-90 we-infect acute.
Lokho Kusho Ukuthini Kuye?
Mayelana nokukhethwa kokuhlolwa nokusebenza, lezi ziphetho ezilandelayo zingadonseka ngokucacile:
- Ukuhweba ngokweqile, ukuhlolwa okuphezulu kwe-HIV kwenza okungenani okuphelele kahle, hhayi kuphela ekutholeni ukutheleleka okunamandla kodwa ngokubuyisela izinga elingamanga elingama-7% .
- Ukuhlanganiswa kwe-HIV antigen / anti-antibody ukuhlolwa kunembile kakhulu ukuthi izilingo zendabuko elwa nama-antibody, ikakhulukazi phakathi nesigaba esicacile sokutheleleka.
- Ukuhlola okusekelwe yi-Lab kusengaphezu kwesimo sokuhlolwa, i-point-of-ukunakekelwa kwe-HIV, ikakhulukazi uma kwenzeka ukutholakala kwegciwane lesandulela ngculaza.
Ngalokho kuthiwe, amazinga aphezulu okuzwela kuphela yingxenye yokuthi izivivinyo ezithile zithandwa ngaphezu kwabanye.
Isibonelo, inani elibalulekile labantu lihluleka ukubuya imiphumela ye-HIV ngemuva kokuhlolwa. Ngakho-ke, ikhono lokubuyisela imiphumela yokuhlola phakathi nemizuzu engu-20-30 yenza ukuhlolwa okusheshayo kuhle, ikakhulukazi uma kuvumela imitholampilo ukuthi ixhumanise nomuntu ngokushesha ukuze anakekele.
Ngokufanayo, abantu abanezinkinga eziyimfihlakalo noma ukwesaba mayelana neHIV kungabhekwa kangcono ngokuthatha ukuhlolwa okusheshayo ekhaya ( okufanekiselwe ).
Ngenkathi kunedatha encane yokuhlola inani langempela labantu elixhunywe nokunakekelwa ngemuva kokuthola imiphumela emihle, emakhaya, kucatshangwa ukuthi ukuhlolwa okunjalo kunikeza iphuzu lokungena kulabo abangase baqede izikhungo zokuhlola noma izilungiselelo zemitholampilo.
Umthombo:
I-Pilcher, D .; Louie, B; Facente, S .; et al. "Ukusebenza kwe-Rapid Point-of-Care kanye nezivivinywa zeLebhubhu zeSandulela ngculazi eQinisekile futhi eqinisiwe eSan Francisco." I-PLOS | Eyodwa. NgoDisemba 12, 2013; I-DOI: 10.1371 / iphephandaba.pone.0080629.
I-US Food and Drug Administration (FDA). "Ikhaya lokuqala lokuqala-sebenzisa i-HIV Kit evunyelwe ukuzihlola." I-FDA Ulwazi Lwezempilo Lwabathengi. I-Silver Spring, e-Maryland; Julayi 2012; idokhumenti: UCM311690.