Ukuhlolwa kwe-combo okulandelayo kunikeza imiphumela esheshayo, ethembeke kakhulu
Uma kutholakala ukuthi ukutheleleka ngegciwane lesandulela ngculaza, kuvame ukutholakala yizivivinyo ezingathola ukuthi amangqamuzana abizwa ngokuthi ama-antibodies kanye / noma ama-antigens egazini noma ematheni.
An antibody is uhlobo lweprotheyini elifihlelwa ngamangqamuzana egazi amhlophe angakwazi ukubona nokubhubhisa imizimba yangaphandle njengama-virus noma amabhaktheriya. I-antigen, ngokuphambene nalokho, yiyona into engabangela ukuphendula kwamagciwane ngomzimba wamagciwane (njengoba kwenzeka nge-HIV).
Ukuhlolwa okusetshenziselwa ukuqinisekisa ukutheleleka ngegciwane lesandulela ngculaza kuklanyelwe ukusabela ngalawa ma agent. Umphumela "omuhle" usho ukuthi ama-antibodies / antigen anesandulela ngculaza atholakale nokuthi ukutheleleka kwenzekile. Umphumela "ongalungile" usho ukuthi akukho-antibodies / antigens ezitholiwe nokuthi ukutheleleka nge-HIV akukenzeki.
Ngakolunye uhlangothi, "ukuphika okungamanga" uma ukuhlolwa kungabonakali ngokungaqondile ukutheleleka ngegciwane lesandulela ngculazi, kanti "ukungahambi kahle kwamanga" lapho ukuhlolwa kungabonakali ukuthi akukho ukutheleleka okwenzekile. Zombili lezi zivame kakhulu ukusebenzisa izivivinyo zokuhlola zamanje.
Ukuqonda i-Window Period
Abantu bayovame ukuhlakulela amazinga okulinganisa ama-antibodies we-HIV zingakapheli izinsuku ezingu-30 zokutheleleka, nakuba abanye bangathatha isikhathi esiningi-izinyanga ezintathu kwezinye izimo. Ama-antigen a-HIV, ngokuphambene, thatha phakathi kwamasonto amabili kuya kwahlanu ukuthuthukisa.
Ngaphambi kwalokhu kwenzeka, kunenkathi lapho ama-antibody / ama-antigen amazinga aphansi kangangokuthi angahlonishwa.
Lokhu kubizwa ngokuthi isikhathi sewindi . Kule nkathi ukuthi umuntu olelekile angadlulisela i-HIV kwabanye, kodwa abe nomphumela omubi uma enikezwa i-HIV.
Uma ukholelwa ukuthi usulelekile futhi usolwa uma ngabe usuvele ubonakala nge-HIV, kubalulekile ukuthi wabelane ngalokhu nodokotela noma isikhungo sakho sokuhlola.
Bangasiza ekunqumeni ukuthi ukuhlolelwa i-HIV kungena esikhathini sefasitela noma uma kungenziwa ngamazinga afanelekayo okuthembeka.
Ukuhlolwa kwe-HIV Antibody
I-HIV ELISA (i-test immunosorbent-ehlobene ne-enzyme) iwuvivinyo olubucayi kakhulu olushintsha umbala uma ama-antibodies e-HIV ekhona. Imiphumela ibelwe inani lezinombolo, ngamanani angaphansi kwe-1.0 ekhombisa umphumela omubi namanani angaphezulu kwe-1.0 okubonisa umphumela omuhle (noma osebenzayo). Yize i-ELISA inika amathuba okutheleleka ngegciwane lesandulela ngculazi, ayisetshenziswanga yedwa njengoba kutholakala nge-HIV.
Uma i-ELISA yokuhlola ikhiqiza imiphumela emihle, ukuhlolwa kwesibili kwe-antibody, okuthiwa i- Western Blot , isetshenziselwa ukuqinisekisa imiphumela. Ngokubambisana, i-ELISA ne-Western Blot iboniswa ukuthi inembile yamaphesenti angu-99.9 kubantu base-United States jikelele, isilinganiso senkohlakalo esilinganiselwa ku-1 000 kuzo zonke izivivinyo eziyi-250,000 ezenziwe.
Ngezinye izikhathi, ukuhlolwa kungabuyela ngomphumela ongaqediwe noma ongaqondile. Lokhu kungenzeka ngezizathu eziningana:
- Ukutheleleka kungenzeka ukuthi kwakusanda kutholakala ukuze kutholakale ngokuthembeka.
- Kungenzeka kube nezinkinga ngesampuli yokuhlola noma inqubo yokuhlola ngokwayo.
- Izifo ezinzima ezinjenge- syphilis noma isifo seLyme ngezinye izikhathi zifaka umphumela omubi, njengoba nazo zingenza izimo ezizenzakalelayo ezifana ne-lupus noma isifo sikashukela .
Uma umuntu enemiphumela engavumelani, ukuhlolwa kufanele kuphindwe.
Ukuvivinya i-Antigen / Antibody Test
Ngo-Juni 27, 2014, iCenter for Disease Control and Prevention yakhuthaza isu elisha lokuhlolwa kwegciwane lesandulela ngculaza besebenzisa izilinganiso zokuhlanganiswa kwezizukulwane ezine. Lezi zivivinyo zesizukulwane esilandelayo ziyakwazi ukuhlolwa kokubili ama-antibodies (i-Ab) nama-antigens (Ag) futhi ingaqinisekisa ukutheleleka nge-HIV kuze kube amasonto amane ngaphambi kwe-ELISA / Western Blot.
Kunezivivinyo ezimbili ezinjalo ezivunyelwe yi-US Food and Drug Administration ukuze zisetshenziswe ekuhlolweni kwe-HIV: i-Alere Ikhetha i-HIV 1/2 Ag / Ab Combo ne-Abbott ARCHITECT i-HIV Ag / Ab Combo.
Ngokususelwa ezingeni eliphezulu eliphezulu lokuhlola okuqondile, i-CDC itusa lokhu okulandelayo kwezinyathelo ezintathu:
- Yenza ukuhlolwa kokuqala ngezilingo ze-Ag / Ab combo. Uma umphumela ungalungile, akukho ukuhlolwa okunye okudingekayo.
- Uma umphumela wokuqala unempilo, yenza ukuhlolwa kwesibili ukuhlukanisa amasosha omzimba we- HIV-1 ne- HIV-2 , isinyathelo esibhekwe njengabalulekile ekunqumeni inkambo yokwelapha umuntu one-HIV.
- Uma imiphumela yesibili ingalungile, ukuhlolwa kwesithathu (okubizwa ngokuthi i-HIV-1 NAT) kuzokwenziwa ukuze kwahlukaniswe ukutheleleka okunamandla kwe-HIV-1 kusuka emphumela wokuqala wamanga omuhle . I-NAT ye-HIV-1 iyakwazi ukutholwa inani elincani le-RNA yegciwane elingamasonto amabili kuya kwamabili.
Njengoba kunikezwe inhlanganisela enokwethenjelwa yokuhlolwa kwe-Ag / Ab, ukuqinisekiswa ngendlela ye-Western Blot akusadingeki kubonakale kuyadingeka.
Ukuhlolwa kwe-HIV okungekho emakhaya
Ukuhlolwa kwegciwane lesandulela ngculazi ngokushesha ku-HIV kuyizivivinyo ezisuselwa ku-ELISA ezingakwazi ukuletha imiphumela kungakapheli imizuzu engu-20 (ngokungafani nezilinganiso ezijwayelekile ze-ELISA / Western Blot ezingathatha izinsuku eziningana). Izivivinyo zenziwa ngokusebenzisa amasampuli amathe, imiphumela okungenzeka ibe "engafanele" noma "ehamba phambili." Amaphesenti wokuqala kufanele aqinisekiswe nge-Western Blot eyenziwa ebhodini.
Ngo-2012, i-FDA ivume ukuhlolwa kwe- HIV okusheshayo kwekhaya lokuqala kokuthengiswa okuqondile kubathengi. Ngenkathi imikhiqizo ilula ukuyisebenzisa futhi inikeze ukuxhuma ukunakekelwa labo abahlola okuhle (nge-hotline yomthengi wamahora angu-24), abanye bakhathazekile ngokuthi ukungaboni ukubonisana ubuso nobuso kanye nokuphulwa okungahle kwenzeke emvumweni enolwazi kunganciphisa ukuvimbela imizamo.
Ngaphezu kwalokho, ngenkathi ukuhlolwa kwangaphakathi kwendawo kunikeza ukuzwela okufanayo nokucaca njengezivivinyo zokuqapha, ukucwaninga ngemitholampilo kubonise izinga elibi elingamaphesenti angaba ngu-7 (noma cishe ukuhlolwa okungu-12 kokubili).
Esinye isifundo eshicilelwe yiNyuvesi yaseCalifornia, eSan Francisco uye wasikisela ukuthi ukuhlolwa okusheshayo kwesizukulwane sesine kunesimo sangempela sezwe samaphesenti angaba ngu-86 ekuboneni kahle amacala ase-HIV kodwa kuphela amaphesenti angu-54 ekuqinisekiseni i-serostatus ngesikhathi sokuqala, Ukutheleleka nge-HIV.
Ngokufaka ubufakazi obuningi bokuthi ukuxilongwa kanye nokwelapha kwangaphambi kwesikhathi kungavimbela izinkinga eziningana zesikhathi eside-kuhlanganise nokunciphisa ezinqolobaneni zegciwane lesandulela ngculazi lapho i-HIV ingaqhubeka khona amashumi eminyaka-isidingo sokuchithwa okuqondile ngesikhathi sokutheleleka okunzima kuthathwa njengokubalulekile.
Izwi elivela
Ukukhethwa kokuhlolwa kwe-HIV kungumuntu oyedwa. Akukho okunye okungcono kunomunye uma kufeza enye yezinhloso ezimbili:
- Kukusiza ukuba ubone izici zakho siqu uma unesandulela ngculaza ukuze ukwazi ukuzigwema esikhathini esizayo.
- Ikuxhumanisa nokunakekela nokwelashwa okudingayo uma ubuyiselwa umphumela we-HIV.
Ukuze uthole indawo yokuhlola i-HIV eseduze nawe, sebenzisa indawo ye-inthanethi ku-HIV.gov.
Imithombo:
I-Greenwald, i-J .; Burstein, G .; Pincus, J .; et al. "Ukubuyekeza Okusheshayo Kwezingqinamba Zama-Anti-Antibody Test Rapid". Imibiko Yamanje Yokwelashwa. Mashi 2006; 8 (2): 125-131.
I-pilcher, i-C .; Louie, B .; Facente, S .; et al. "Ukusebenza kwe-Rapid Point-of-Care kanye nezivivinywa zeLebhubhu zeSandulela ngculazi eQinisekile futhi eqinisiwe eSan Francisco." PLOS | Enye. NgoDisemba 12, 2013; I-DOI: 10.1371 / iphephandaba.pone.0080629.
U-Branson, uB .; Owen, uS .; I-Wesolowski, M .; et al. "Ukuvivinywa kwelabhulali yokuthola ukutheleleka nge-HIV: Izincomo ezibuyekeziwe." Amasevisi aseMelika okuLawula nokuvimbela izifo (CDC). I-Atlanta, Georgia; ikhishwe ngo-June 27, 2014.