Ukukhubazeka kuyashintsha kodwa kuyabonakala kubantu abano-HIV
Ukuxilongwa kwe-AIDS komqondo (ADC), owaziwa nangokuthi i-HIV encephalopathy, isifo esiyinkimbinkimbi yegazi esibangelwa yi- HIV . Isimo esihlukaniswe yiCenter for Disease Control and Prevention (CDC) njengesimo esichaza i- AIDS futhi sibonakala ukuwohloka komsebenzi wokuqonda, wezimoto nokuziphatha, izimpawu ezingabandakanya:
- izinkumbulo kanye nezinkinga zokuhlushwa
- kunciphisa impendulo engokomzwelo kanye / noma yengqondo
- izinguquko zokuziphatha eziphawuliwe
- unciphise amandla / amaphutha
- ukulahlekelwa ngamakhono amakhono emoto (isb. ukuthuthumela, ukuhlushwa)
- ukulahlekelwa okuqhubekayo kokuhamba
- ukuwohloka komqondo
I-Dementia ichazwa njengokungaphazanyiswa okuqhubekayo kwezinqubo zengqondo ezimakwe izinguquko zobuntu, ukukhathazeka kwememori, nokucabanga okungafaneleki.
Izimbangela ze-AIDS Dementia
I-ADC ngokuvamile ivela ezifweni eziphambili lapho isibalo se-CD4 sesiguli singaphansi kwamangqamuzana angu-200 / μl futhi ngokuvamile sihambisana nomthamo wegciwane eliphakeme.
Ngokungafani nezimo eziningi ezichaza i-AIDS, i-ADC akuyona igciwane lesandulela ngculazi njengoba isimo sibangelwa i-HIV ngokwayo. Ukucwaninga kubonisa ukuthi amangqamuzana egazi omhlophe anegciwane lesandulela ngculazi okuthiwa ama-macrophages namaseli ayisisindo okuthiwa i-microglia secrete neurotoxins ezithinta kakhulu izicubu ezisathuthuka nezivuthiwe. Ngokuhamba kwesikhathi, lokhu kungabangela ukuguqulwa komsebenzi we- synaptic (okungukuthi ukudluliswa kolwazi phakathi kwe-neurons), kanye nokudubula ngokuqondile ukushaya iseli ekufeni.
Ukuqaphela nokuphatha i-AIDS Dementia
Ayikho ivivinyo elilodwa elikwazi ukuqinisekisa ukuxilongwa kwe-HIV encephalopathy. Ukuxilongwa kwenziwa ngokuyinhloko ngokukhishwa, kubusa ezinye izimbangela zokukhubazeka. Ukuhlolwa okuphelele kufanele kwenziwe ngumtholampilo onolwazi, ukuhlola umlando wesiguli, ukuhlolwa kwelebhu (isib. Ukukhishwa kwesibhamu ), ukuhlolwa kobuchopho (i-MRI, i-CT scan) , nokubuyekezwa kwezinto okuthiwa "izici zesigaba."
Izici zesiteleka zinquma ubunzima bokukhubazeka esikalini sika-0 kuya ku-4, kanje:
- Isiteji sesi-0: Umsebenzi ovamile kanye nengqondo.
- Isigaba 0.5: Ukungasebenzi okuncane kakhulu nge-gait evamile namandla. Umuntu uyakwazi ukusebenza futhi enze imisebenzi evamile yansuku zonke.
- Isigaba 1: Ukungasebenzi kahle kwezimoto kanye / noma amakhono engqondo. Umuntu angakwazi ukuhamba ngaphandle kosizo futhi aqhubeke nonke kodwa imisebenzi edingekayo nsuku zonke.
- Isigaba sesi-2: Ayikwazi ukusebenza futhi sinenkinga yokubhekana nezici ezinzima kakhulu zokuphila kwansuku zonke. Kodwa-ke, lo muntu usakwazi ukuzinakekela yena ngokwakhe futhi uyakwazi ukuhamba (noma ngezinye izikhathi ngosizo lomuntu oyedwa).
- Isigaba sesi-3: Ukukhubazeka okukhulu kwengqondo kanye / noma ukuhamba. Umuntu akakwazi ukuzinakekela yena ngokwakhe.
- Isigaba sesi-4: Isizwe esiseduzane nesitshalo.
Nakuba ukubonakaliswa okunamandla kwe-ADC kuye kwehla kakhulu ezinombeni kusukela ekufikeni kwe- antiretroviral therapy (ART) , ukukhubazeka okuncane kwe-neurocognitive kusabonakala kumaphesenti angaba ngu-30 alabo abanesifo sengculazi esingenasifo sengqondo kanye namaphesenti angu-50 alabo abane-AIDS.
Ngokuvamile, ingozi ye-ADC ibonakala ibe ephakeme kubantu abangazange bazuze ukucindezelwa kwegciwane, nakuba kungaqhubeka emaphesenti amathathu kuya kwengu-10 alabo abanegciwane elilawulwa ngokugcwele.
Kunconywa ukuthi ukungena kwangaphambi kwe-ART kungabambezeleka noma kuncishiswe ingozi ye-ADC.
Kulabo abanokukhubazeka okubangelwa yi-neurocognitive, i-ART ingabe ifaka phakathi izidakamizwa ezimbili ngokungena ngokujulile kwengqinamba yengqondo-yegazi. Izinketho zihlanganisa i-nucleoside reverse transcriptase i-inhibitor-ekilasini izidakamizwa Retrovir (AZT) noZiagen (abacavir), kanye ne-protease inhibitor-class drug Crixivan (indinavir).
Obeye aziwe njengo:
- Ukwelashwa kwe-HIV
- Isifo se-neurocognitive ehambisana ne-HIV (HAND)
- I-dementia ehambisana ne-HIV (HAD)
> Imithombo:
> Heaton, K .; Nikeza, mina .; Amabhuku; et al. "I-HNRC 500-I-Neuropsychology yokutheleleka nge-HIV ngezigaba ezahlukene zezifo." Journal of the International Neuropsychological Society. May 1995: 1 (3), 231-251.
> Banika, I .; Sacktor, N .; UMcArthur, J .; et al. "Ukuzivikela komuntu okugciwane lesandulela ngculaza-okuhlobene nokuphazamiseka kwegazi: Gcina igebe." Ama-Annal of Neurology. Juni 2010; 67 (6): 699-714.
> Robertson, K .; I-Smurzynski, M .; Ama-Parsons, T .; et al. "Ukusabalalisa kanye nesimo sokukhubazeka okungenangqondo esikhathini se-HAART." AIDS. Ngo-Septhemba 12, 2007; 21 (14): 1915-1921.
> Tozzi, V .; I-Balestra, i-P .; I-Bellagamba, i-R .; et al. "Ukuphikelela Kwezephulelo Ze-Neuropsychologic Naphezu Kwemithi Yesikhathi Eside Ephezulu Yokulwa Ne-Antiretroviral Antiretroviral Iziguli Ezinezifo Ezihlobene Ne-HIV Ezihlobene Negciwane lesandulela-ngculazi: Izingozi Nezimo Eziyingozi." I-Journal ye-Immune Deficiency Deficiency Syndromes. Juni 1, 2007; 45 (2): 174-182.
> I-Eden, A .; Intengo, R; Hagberg, L .; et al. "Ukuphunyuka akuvamile kubantu abanegciwane lesandulela ngculaza-1 ku-ART ezinzile." I-17th Conference kwi-Retroviruses kanye nezifo ezithinta amathuba. I-San Francisco, eCalifornia; 2010.