Ukutheleleka Okuvamile Kwama-bacterium Kungaba Kubuhlungu Kuzifo Eziphakeme ze-HIV
I-Mycobacterium avium complex, eyaziwa nangokuthi yi-MAC, isifo esithathelwanayo se-bacterial ngokuvamile esibonakala kubantu abanesandulela ngculaza. Ngesikhathi noma ubani engenwa igciwane le-MAC, ukugula ngokuvamile kuvele kulabo abanamasosha omzimba ahlaselwe kakhulu.
Ngenxa yalokho, i-MAC ibhekwa njengesifo esichaza i- AIDS , esithinta noma yikuphi abantu abavela ku-20-40% abantu abane-AIDS abahlobene ne-AIDS abangenalo ukwelashwa kwe-HIV noma ukuthatha imithi yokuvimbela i-prophylactic.
I-MAC ijwayele kakhulu ukuthinta amaphaphu, nakuba eziningi zalezi zifo zingabhekwa njengengozi yokuphila.
Kodwa-ke, uma inani le- CD4 lomuntu liwela ngaphansi kwe-50 cell / mL, i-MAC ingadlulela ngaphesheya kwamapayipi futhi ifaka ezinye izinhlelo ezinkulu zomzimba, kuhlanganise nesibindi, u-spleen, nomnyosa wethambo. Ngaleso sikhathi ukutheleleka kwe-MAC kungaba nzima ekusongeni ukuphila.
Yiziphi Izimpawu Zama-MAC?
Ukutheleleka kwe-MAC kuvame ukuvela emaphashini noma emathunjini futhi ngokuvamile kungabonakala ngezimpawu ezimbalwa, uma zikhona, izimpawu. Kodwa-ke, uma usakazeka (usakaza) ngaphesheya kwamapayipi nasendaweni yegazi, kungabangela ukutheleleka okubanzi. Izimpawu zokuqala zeMAC ezithunyelwa zihlanganisa:
- Fever
- Izithukuthuku ebusuku
- Ama-Chills
- Ukhathala (ngokuvamile ngenxa ye-anemia)
- Uhudo
- Ukulahlekelwa kwesisindo (i-cachexia)
- Ubuhlungu besisu
I-MAC ihlolwe kanjani?
Isifo se-MAC sitholwa yizivivinyo ze-laboratory ezingakwazi ukubona amabhaktheriya e-MAC kuma-sampuli egazi noma ematheni. Amasampula omnkantsha wamathambo avame ukukhishwa esitokisini se-hip ngenaliti, kuyilapho ama-sampuli egazi eqoqwe ukudweba kwegazi elijwayelekile.
Isampuli sikhuliswa ngamatayipi wokuhlola ukuhlola ukuthi ngabe amabhaktheriya e-MAC akhona noma cha. Lokhu kuthatha izinsuku eziyisikhombisa.
Abantu Bathola Kanjani I-MAC?
Izilwane ze-MAC zihlala zizungezile, kufaka phakathi inhlabathi, ekudleni, nasemitholampilo yansuku zonke. Ama-bacterium e-MAC angatholakala nasemithonjeni eminingi yamanzi okuphuza, kuhlanganise nezinhlelo zamanzi eziphuthwe, ngisho nasothuli lomkhaya.
Ngakho-ke, kunzima kakhulu ukugwema. Ngakolunye uhlangothi, i-MAC ayibonakali idluliselwa kumuntu oyedwa kumuntu.
Ngingakugwema Kanjani I-MAC?
Njengoba ukugwema i-MAC kunzima ukungalindeleki, indlela engcono kakhulu yokugwema izifo ukuqinisekisa ukuthi amasosha omzimba wakho ahlala engaqondile. Lokhu kufezekiswa kakhulu ngokuphatha ukutheleleka nge-HIV nge- antiretroviral therapy (ART) . Ukusetshenziswa kwe-ART akugcini nje ukuqinisekisa ukuthi amasosha omzimba wakho ahlala eqinile, ukugcina izibalo eziphakeme ze-CD4, kungabuyiselwa umsebenzi wokuzivikela ngisho nabantu abanomthelela wokunciphisa umzimba omzimba.
Njengamanje, i-ART inconywa kubo bonke abantu abane-HIV ngesikhathi sokuxilongwa. Ukuxilongwa kokuqala kanye nokwelapha ngeke kuvimbele kuphela imithi ye-MAC kanye nezinye izifo ezithathelanayo, futhi kuhlotshaniswa nokuphila okude futhi kuncane izifo ezihlobene negciwane lesandulela-ngculazi kanye nokungenalo i-HIV.
Kubantu abane-HIV abanezibalo ze-CD4 ngaphansi kwamaseli angu-50 / mL, izidakamizwa ze-prophylactic nsuku zonke zibekiwe ukuze zivimbele kangcono ukuthuthukiswa kwe-MAC. Izidakamizwa ezivame ukusetshenziswa zihlanganisa:
- I-Clarithromycin, uhlobo lwemithi elwa namagciwane ekwazi ukusula ngokushesha i-MAC egazini
- I-Azithromycin ibhekwa njengenye indlela ehlukile ku-clarithromycin
- I-Rifabutin, enye indlela ebonakalayo (nakuba eyaziwa ukusebenzisana nemithi ethile ye-HIV)
I-MAC iphatheke kanjani?
Isifo se-MAC sivame ukuphathwa ngokuhlanganiswa kwe-clarithromycin ne- ethambutol , noma ngaphandle kwe-rifabutin. I-ART nayo izoqaliswa kulabo abangakabi ukwelapha.
Kodwa-ke, kubantu abanezibalo eziphansi kakhulu ze-CD4, kunethuba lokuthi izimpawu ze-MAC zingahle zivuke uma i-ART iqala. Lokhu kuyinto eyaziwa njenge-immune reconstitution inflammatory syndrome (i-IRIS), lapho isimiso somzimba samasosha omzimba esibucayi senziwa ngokungazelelwe, senza impendulo yomzimba wonke yokuvuvukala. Uma lokhu kwenzeka, i-corticosteroids ingahle ibekwe ukuphatha izimpawu ezihambisana ne-IRIS kuze kube yilapho impendulo yomzimba igxila.
Uma inani le-CD4 yomuntu lingaphezu kwamangqamuzana angu-100 / mL futhi lizinza ngaphezu kwalesi sivivinyo izinyanga eziyisithupha, ukwelashwa kwe-prophylactic kungamiswa.
Imithombo:
Izikhungo Zempilo Zikazwelonke (NIH). "Imihlahlandlela Yokuvimbela Nokunakekelwa Kwezifo Ezingavamile Ezinganeni Ezikhulelwe Ne-Adolescents - I-Broadcasting Avium Complex". I-Bethesda, e-Maryland; ibuyekeziwe ngoMeyi 17, 2013.
I-US Preventive Services Task Force (USPSTF). "Ukuhlolwa kwesandulela ngculazi: Isitatimende Sokuncoma Sezinsizakalo Zezinsizakalo Ze-US Preventive Services." I-Rockville, e-Maryland; April 2013.
I-NIH. "Ukuqala Ukwelashwa Kwe-Antiretroviral Kuqala Kwenyusa Imiphumela Yabantu Abathintekayo Ngegciwane lesandulela ngculazi." I-Bethesda, e-Maryland; ikhishwe ngoMeyi 27, 2015.