Umhlahlandlela we-layman wokuqonda ukuhlolwa kwegciwane lesandulela ngculazi kwabantwana abasha
Ukuhlolwa kwegciwane lesandulela ngculazi ezinsaneni nasezincane (ezineminyaka eyi-18 noma ngaphansi) kuyahlukahluka kakhulu ukuthi abantu abadala bahlolwa kanjani. Esikhundleni sokuhlola ama-antibodies we-HIV (amaprotheni akhiqizwa amasosha omzimba lapho kukhona khona i- HIV ), odokotela bazobe behlola ukutholakala kwegciwane lesandulela ngculazi besebenzisa lokho okubizwa ngokuthi i- qualitative testal .
Lokhu kuhluke ekuhlolweni kwesandulela ngculaza (aka "umthamo wegciwane") osetshenziselwa ukukala i-HIV emzimbeni womuntu.
Esikhundleni salokho, i-qualitative test iqinisekisa ukuthi igciwane empeleni likhona noma cha.
Ukuhlolwa kwe-Antibody , kuhlanganise nokuhlolwa kwesizukulwane esisha, ngeke kutholakale ukutheleleka ngegciwane lesandulela ngculaza ezinganeni ngoba ama-antibodies angase abe ngowomama-adluliselwe kusuka kumama kuya kumntwana nge-placenta ngesikhathi sokukhulelwa. Kubalulekile, ngakho-ke, ukuqonda ukuthi ukutholakala kwalezi zinhlanzi "ezizuzwa njengefa" akubonakali ukutheleleka nge-HIV. Ngokuvamile, ama-antibodies omama azoshabalala kancane, ngokwesilinganiso lapho ingane ineminyaka eyizinyanga ezingu-14 (nakuba ingaba ngaphezu kwezinyanga ezingu-24).
Ukuze kuncishiswe ingozi yokutheleleka, ngokuvamile abantwana abashiwo inkambo yokuvikela (prophylactic) yokuvikela imishanguzo ye- antiretroviral isikhathi semasonto amane kuya kwamasonto ayisithupha. E-US nakwamanye amazwe athuthukile, iziqondiso zokukhulelwa zincoma ukuthi ukuncelisa ibele kufanele kugwenywe ukuvimbela ukudluliswa kwegciwane lesandulela ngculaza langakhona ngobisi lwebele.
Izivivinyo ze-HIV ezisetshenziswa ezinganeni nasezincane
Izivivinyo ze-virologic ezisetshenziselwa izinsana zingaba yi- polymerase test reaction (PCR) okuthiwa i- polymerase chain reaction (PCR) , okuthola ukuthi kukhona i-HIV DNA, noma i-HIV RNA test, ekhomba ngokucacile i-RNA ye-HIV.
Nakuba ukuhlolwa kwalokhu kuhlolwa kuphakama ngesikhathi sokuzalwa, ukuzwela kwabo (ikhono lokuthola i-HIV ngokunembile) kunganciphisa ama-55% we-PCR no-25% we-HIV RNA.
Kodwa-ke, ngesikhathi ingane isanda kufika ezinyangeni ezintathu, ukunemba kwezivivinyo ngokuvamile kuvame 100%.
Ezimweni ezithile, izivivinyo ze-HIV antibody zingasetshenziswa ezinganeni eziphakathi kweminyaka eyisithupha nesishiyagalolunye ukufakaza ngokutheleleka ukutheleleka nge-HIV. Kodwa-ke, akufanele asetshenziswe ukuqinisekisa ukutheleleka ngegciwane lesandulela ngculazi ngenxa yokukhathazeka mayelana namasosha omzimba asele omama.
Ukuqinisekiswa kokutheleleka ngegciwane lesandulela ngculazi kumele kubekelwe emibili imiphumela yokuhlolwa ephumelelayo ethathwe kuma-sampuli egazi ehlukene.
Ngokuphambene nalokho, ukuhlola okungalungile kubhekwa njengokucacile ngokusekelwe
- Izivivinyo ezimbili ze-virologic eziningana noma ngaphezulu ezithathwe eminyakeni eyodwa nezinyanga ezine, noma;
- izivivinyo ezimbili eziphikisayo ze-antibody ezithathwe ezimpandeni zegazi ezihlukene ezinganeni ezingaphezu kwezinyanga eziyisithupha.
Ezinganeni ezingaphezu kwezinyanga ezingu-18, imihlahlandlela yokuhlola igciwane lesandulela ngculazi esejwayelekile isebenza.
Ukuhlola Izinsana Kuze Kufike Ezinyangeni Eziyisithupha Zonyaka
Ngenxa yokunciphisa ukuhlolwa ngesikhathi sokuzalwa, izinsana ezivelele i-HIV zivame ukuhlolwa ezinsukwini ezingu-14 kuya kwezingu-21, bese kuthi izinyanga ezimbili kuya kwezinyanga ezimbili, futhi ekupheleni kwezinyanga ezine kuya kweziyisithupha.
Ngeviki ezimbili, ukuzwela kwezivivinyo kuthuthukisa ngokushesha. Uma imiphumela emihle eboniswa ezinsukwini ezingu-14 kuya kwezingu-21, odokotela bazokwenza ngokushesha ukuhlolwa kwesibili sokuqinisekisa. Uma bezinhle, odokotela babezoqala ukwelashwa kwe-antiretroviral yesikhathi esigcwele ezinganeni ezineminyaka eyi-12 noma ngaphansi.
Kuzingane ezingaphezu kweminyaka engu-12, ukuqaliswa kuzothathwa ngokusekelwe esimweni somtholampilo wengane kanye namanani we- CD4 / load viral load .
Kodwa-ke, uma ukuhlolwa kungalungile ngemva kwezinsuku ezingu-14 kuya kwezingu-21, ukuhlolwa kwesibili kuzokwenziwa amasonto amabili kuya kwamasonto ayisithupha ngemuva kokuqeda ukwelashwa kwe-prophylactic. Uhlolo lwesibili olubi ngalesi sigaba luzobonisa ukuthi ingane ingenakulondolozwa. I-negative yesibili ezinyangeni ezine kuya kweziyisithupha izobhekwa njengesifo sokuhlonza okungekho emthethweni.
Ukuvivinya Izingane Phakathi Nama-Ages Eziyisithupha Nama-18
Ukuhlolwa kwe-Antibody kungasetshenziswa ezinganeni ezingaphezu kwezinyanga eziyisithupha ukuya ezinyangeni ezingu-18.
Ngokuvamile, ukuvivinya okubili okungalungile kwama-antibody ezinyangeni eziyisithupha kuya kwezingu-12 kwanele ukuthi kubhekwe njengokucacile. Kodwa-ke, abanye odokotela bakhetha ukuhlola phakathi kwezinyanga ezingu-12 kuya kwezingu-18 ukuqinisekisa ukuthi wonke amantombazane omama aphelile.
Ukuhlolwa okuqhubekayo kungabonakaliswa ezimweni ezikhethekile, njengabantwana ababelethwe ngamabele noma abalalelwa amantombazane okubeletha abesilisa. (Ucwaningo olulodwa lubonise ukuthi abantwana abangaba ngu-14% banomdlavuza we-HIV ngemuva kwezinyanga ezingu-24 ngemuva kokuzalwa.)
Ukuhlola Izingane Eziphakeme Zengozi Ekuzalweni
Izinsana ezibhekwa njengengozi enkulu yokutheleleka (ngokwesibonelo, kumama abangazange bathathe imishanguzo ye-antiretroviral ngesikhathi sokukhulelwa noma abanikeza isifo sofuba ) bangase bahlolwe ngesikhathi sokuzalwa ngoba amathuba okutheleleka aphezulu kakhulu. Kuleli qembu, phakathi kuka-30% no-40% we-infections kungaqinisekiswa emahoreni angu-48 ngemva kokuzalwa. Ezimweni ezinjalo, ukwelashwa kwe-prophylactic kuyomiswa futhi ukwelashwa isikhathi esigcwele kuzoqala.
Imithombo:
UMnyango WezeMpilo waseMelika kanye Nezinsizakalo Zabantu (DHHS). "Imihlahlandlela yokusetshenziswa kwama-Antiretroviral Agents ekukhulelweni kwe-HIV ngesandulela ngculazi: Ukuthola ukutheleleka kokutheleleka nge-HIV ezinganeni nasezingane." I-Rockville, e-Maryland; olusha ngo-Februwari 12, 2014; kufinyelelwe ngo-Ephreli 14, 2014.
I-Gutierrez, M; ULudwig, D .; Khan, S .; et al. "Ingabe ukwelashwa kwe-antiretroviral ekhuthele kakhulu kwandise isikhathi sokwenza isisereversion kwi-HIV evuliwe kodwa izingane ezingenakulinganiswa?" Izifo Ezithathelwanayo Emitholampilo . Novemba 2012; 55 (9): 1255-1261.