Naphezu kokuphikisana, Ingozi ibonakala njengePhakeme kwezinye amaqembu
Nakuba ukujova ukusetshenziswa kwezidakamizwa kuhlale kuyi-primary mode yokudluliselwa kwegciwane lesifo sofuba (HCV) , ukugxila okukhudlwana kuye kwabekwa ithuba lokutheleleka ngokuxhumana kocansi. Sisho okungenzeka - ngokuchasene, ukusho, ingozi noma amathuba - njengoba ochwepheshe abaningi besabheka umqondo wokudluliselwa kwe-HCV ngokocansi njengengxabano. Futhi, iqiniso litshelwe, ubufakazi obuningi bubonakala busekela lesi simo.
Ucwaningo olulodwa oluvela eNyuvesi yaseCalifornia, eSan Francisco ngo-2013 lwalinganiselwa ukuthi ingozi ye-HCV phakathi kwabesifazane abesilisa nabesilisa abesilisa nabesifazane babesemgqeni we-ballpark owodwa oxhumana nabo ngokocansi abangu-190 000. Ngaphezu kwalokho, abacwaningi baphetha ngokuthi ubudlelwane obuphakathi kweHCV kanye nezenzo zobulili ezithile bekungcono kakhulu futhi ukuthi imibhangqwana yokuxhasana kufanele ihlinzekwe "imiyalezo yokunikeza ukwelulekwa okuqinisekisayo" mayelana nengozi ephansi kakhulu yokutheleleka.
Ubufakazi obamuva kakhulu, noma kunjalo, bubonisa ukuthi ukuqinisekiswa okunjalo akugcini nakwamanye amaqembu. Eqinisweni, kusukela ngo-2004, ucwaningo oluthile luye lwaphetha ngokuthi ingozi yeHCV ngokusebenzisa ubulili akuyona nje ephezulu phakathi kwamadoda alala namadoda (MSM ) kodwa iyanda- ikakhulukazi kulabo abanegciwane lesandulela ngculaza .
Ukuphikisana nokudluliswa kwe-HCV ngokocansi kuma-Gay Men
Olunye lwephenyo lokuqala lokuqala luqhutshwa ngo-2005 yi-Swiss HIV Cohort Study, ephakathi nendawo eminingi. Ukuhlola idatha kusuka ku-3,327 i-MSM ene-HIV kusukela ngo-1988 no-2004 (futhi ingabandakanyi labo abafakwe izidakamizwa), abacwaningi bathola ukuthi izinga lokutheleleka kulabo abahlanganyela ocansini elingenalo ikhondomu laliyikhulu lamaphesenti angaphezu kuka-300 abasebenzisa ikhondomu njalo.
Lokhu kwakuhluke kakhulu kolunye ucwaningo olunyatheliswa ngo-2005 oluvela eNyuvesi yaseQuebec, oluphetha ukuthi abukho ubufakazi bokudluliswa ngokocansi kwe-HCV phakathi kwe-MSM nokuthi imbangela yodwa yokutheleleka emphakathini wabo wokutadisha kwakufaka injecting ukusetshenziswa kwezidakamizwa. Kodwa-ke, iziphetho zokucwaninga zazincishiswa kakhulu ngesikhathi esifushane sokuqapha (izinyanga eziyisishiyagalolunye phakathi kukaJanuwari noSeptemba 2001).
Kwakukhona ngo-2007 kuphela ukuthi ucwaningo olujulile (oluvame ukugxila emiphakathini emikhulu, emadolobheni asezindaweni ezisemakhaya) yaqala ukuphikisana nombono wendabuko wesayensi mayelana nokudluliswa ngokocansi phakathi kwe-MSM engenayo inject.
Ucwaningo olulodwa lwamatshe ekhoneni oluvela e-Amsterdam Cohort Study, oluphindaphindiwe lwahlola ama-MSM angu-1,836 kusukela ngo-1984 kuya ku-2003, ukuthi isilinganiso se-HCV esitholakale ngokocansi akusiyo kuphela ephezulu phakathi kwe-MSM enegciwane lesandulela ngculazi kodwa izinga lokutheleleka liye landa kathathu. Ukubuyekezwa kwamarekhodi e-hospitalization kwaqhubeka kubonisa ukuthi, emva kuka-2000, amaphesenti angu-59 ala madoda ayebike isifo sofuba esithathelwana ngocansi , kanti amaphesenti angu-55 abika "ukuhlukunyezwa ngokocansi" (isib. Ukuphoqa ). Akekho kula madoda avunyelwe ukujova ukusetshenziswa kwezidakamizwa.
Ngonyaka ka-2009, esinye isifundo esivela e-Amsterdam sagcizelela umthelela we-HIV ekudluliseni kwe-HCV, lapho okungaphansi kuka-1% ku-MSM engenayo i-HIV yathonywa ama-HCV kuya kuma-17 ekhulwini le-MSM ene-HIV. Kulaba, amaphesenti angu-82 abika akukho ukusetshenziswa kwezidakamizwa okujova. Ukuhlukunyezwa, ubulili beqembu, wabelana ngamathoyizi wezocansi, nokusetshenziswa kwe-gamma hydroxyl butyrate (GHB) yezidakamizwa kuboniswa njengezici eziyinhloko zokutheleleka kwi-MSM ene-HIV.
Ukuhlaziywa kwe-meta ka-2010 okuvela kwisikhungo sikazwelonke se-HIV / AIDS, i-Viral Hepatitis, i-STD, kanye nokuvimbela i-TB kwabonisa ukuthi ukukhandla, njengento ezimele, kwanda ingozi ye-HCV ngamaphesenti angu-500 ku-MSM-nge-HIV-cishe ngenxa yokonakaliswa noma ukuchithwa ama-tissue ama-rectal-ngenkathi ubambiswano lwezocansi ohlanganyelwe ngaphezu kokuphindaphinda kabili ingozi.
Amadoda Gay Angahle Awena Owodwa Osesengozini
Ucwaningo oluthile lwamanje luphakamisa ukuthi ingozi yeHCV ngezocansi ayikwazi ukulinganiselwa ku-MSM. Ngokwesifundo se-2009 esivela ku-Women's Interagency Cohort Study, ingozi ye-HCV phakathi kwabesifazane abangu-3,636 abane-HIV abangenalo umlando wokusebenzisa izidakamizwa ezivame ukuphindwa kabili kwabesifazane abangenayo i-HIV. Ngaphezu kwesimo se-HIV, ingozi kubantu besifazane yayihlotshaniswa nabalingani bobulili besilisa ababesebenzisa abasebenzisa izidakamizwa. Abalingani abaningi bezocansi, ukusetshenziswa komakhondomu okungahambisani, ubumpofu nokungasebenzi kwakubonakala kubangelwa yizimbangela.
Konke okukhulunywe ngakho, abaphenyi baphetha ngokuthi ukusabalalisa kwe-HCV kulesi sifundazwe kwaba ngu-6.5%, okuphakamisa ukuthi umlayezo wokweluleka kwabesifazane udinga ukuguquka, ukugxila kakhulu engozini yokwanda ye-HCV ngokusebenzisa ucansi-ikakhulukazi labo abane-HIV (noma abasengozini) we-HIV ), kanye nalabo abalingani besilisa abafaka izidakamizwa.
Imithombo:
I-Terrault, N .; Dodge, J .; I-Murphy, E .; et al. "Ukudluliswa ngokocansi kwesifo se-hepatitis C phakathi kwamabhangqwana abesilisa nabesifazane abesilisa nabesifazane: isifundo somlingani we-HCV." I-Hepatology. Mashi 2013; 57 (3): 881-889.
I-Rauch, A .; UMartin, uM .; I-Weber, R .; et al. "Ubulili Engaphephile Nokukhula Kwesifo Se-Hepatitis C Virus phakathi kwabesilisa abane-HIV abathintekayo abalala nezingane: Isifundo se-Swiss HIV Cohort." Izifo Ezithathelwanayo Emitholampilo. 2005; 41 (3): 395-402.
Anouk, U .; i-van de Laar, i-T .; I-Stolte, I .; et al. "Ukutheleleka kwegciwane le-Hepatitis C kubantu abathintekayo abanegciwane lesandulela ngculazi abalala namadoda: isifo esiyanda." AIDS. NgoJulayi 31, 2009; 23 (12): F1-F7.
Frederick, T .; Ukungcwaba, P .; I-Terrault, N .; et al. "Izinto Ezihlobene Nezifo Ezithathelwanayo Zesifo Se-Hepatitis C Phakathi Kwabesifazane Abathintekayo be-HIV abangenalo Umlando Obikiwe Wokujova Ukusetshenziswa Kwedakamizwa: Isifundo Sezinkampani Zama-Interagency Cohort Study (WIHS)." Ukunakekelwa Kwezandulela Ngculazi kanye nezifo ze-STD. Novemba 20, 2009; 23 (11): 915-923,
UTohme, R. kanye noHolmberg, S. "Ingabe ukuxhumana ngokocansi kuyindlela enkulu yokudlulisela i-hepatitis C?" I-Hepatology. Okthoba 2010; 52 (4): 1497-1505.