I-HIV / AIDS

I-human immunodeficiency virus (HIV) igciwane elibanga ingculaza. Lapho umuntu engenwa yi-HIV, leli gciwane lihlasela futhi lenze buthaka amasosha omzimba. Njengoba amasosha omzimba eba buthakathaka, umuntu usengozini yokuthola izifo ezisongela impilo nomdlavuza. Uma lokho kwenzeka, ukugula kubizwa nge-AIDS. Uma umuntu esenegciwane, lihlala ngaphakathi emzimbeni impilo yakhe yonke.

Leli gciwane lisakazeka (lidluliselwe) kumuntu nomuntu ngokusebenzisa uketshezi oluthile lomzimba:

• Igazi
• Isidoda noketshezi lwangaphambi kwesisu
• Uketshezi olungokoqobo
• Uketshezi lwesitho sangasese sowesifazane
• Ubisi lwebele

I-HIV ingasakazeka uma lolu ketshezi luhlangana no:

• Ulwelwesi lwamafinyila (ngaphakathi emlonyeni, ipipi, isitho sangasese sowesifazane, i-rectum)
• Izicubu ezilimele (izicubu ezisikiwe noma ezikhutshiwe)
• Ukujova emfudlaneni wegazi

I-HIV ayikwazi ukusakazwa ngomjuluko, ngamathe, noma ngomchamo.

E-United States, i-HIV isakazeka kakhulu:

• Ngocansi lwesitho sangasese sowesifazane noma sangasese nomuntu one-HIV ngaphandle kokusebenzisa ikhondomu noma engathathi imithi yokuvikela noma yokwelapha i-HIV
• Ngokwabelana ngenaliti noma enye imishini esetshenziselwa ukujova izidakamizwa nomuntu one-HIV

Ngokuvamile, i-HIV iyasakazeka:

• Kusuka kumama kuye enganeni. Owesifazane okhulelwe angasabalalisa leli gciwane enganeni yakhe ngokusebenzisa ukusakazwa kwegazi okwabiwe kanyekanye, noma umama ongumhlengikazi angalidlulisela enganeni yakhe ngobisi lwebele. Ukuhlolwa nokwelashwa komama abane-HIV kusizile ukwehlisa inani lezingane ezithola i-HIV.
• Ngezinti zezinaliti noma ezinye izinto ezibukhali ezingcoliswe yi-HIV (ikakhulukazi abasebenzi bezempilo).

Igciwane ALISABALALISWA ngu:

• Ukuthintana okuvamile, njengokugona noma ukuvala umlomo
• Omiyane noma izilwane ezifuywayo
• Ukubamba iqhaza kwezemidlalo
• Ukuthinta izinto ezithintwe ngumuntu onaleli gciwane
• Ukudla ukudla okuphethwe ngumuntu one-HIV

I-HIV negazi noma umnikelo wesitho:

• Igciwane lesandulela ngculaza alidluliseli kumuntu onikela ngegazi noma izitho zomzimba. Abantu abanikela ngezitho zomzimba abakaze baxhumane ngqo nabantu abazitholayo. Ngokufanayo, umuntu onikela ngegazi akaze axhumane nomuntu olitholayo. Kuzo zonke lezi zinqubo, kusetshenziswa izinaliti nezinsimbi eziyinyumba.
• Yize kuyivelakancane kakhulu, esikhathini esidlule i-HIV ibisakazeka kumuntu othola igazi noma izitho kumuntu onikele ngaleli gciwane. Kodwa-ke, le ngozi incane kakhulu ngoba amabhange egazi nezinhlelo zokunikela ngezitho zihlola ngokucophelela (zihlola) abanikeli, igazi nezicubu.

Izingozi zokuthola i-HIV zifaka:

• Ukuba nocansi olungavikelekile lwangasese noma lwesitho sangasese sowesifazane. Ucansi lwendunu olwamukelayo luyingozi kakhulu. Ukuba nabalingani abaningi kukhulisa ubungozi. Ukusebenzisa ikhondomu entsha kahle njalo uma uya ocansini kusiza kakhulu ekwehliseni le ngozi.
• Ukusebenzisa izidakamizwa nokwabelana ngezinaliti noma imijovo.
• Ukuba nomlingani ocansini ne-HIV ongathathi imithi ye-HIV.
• Ukuba nesifo esithathelwana ngocansi (STD).

Izimpawu ezihlobene nokutheleleka nge-HIV okunamandla (lapho umuntu etheleleke okokuqala) zingafana nomkhuhlane noma ezinye izifo ezibangelwa amagciwane. Kubandakanya:

• Umkhuhlane nezinhlungu zemisipha
• Ubuhlungu bekhanda
• Umphimbo obuhlungu
• Ukujuluka ebusuku
• Izilonda zomlomo, kufaka phakathi ukutheleleka kwemvubelo (thrush)
• Izindlala ze-lymph ezivuvukile
• Uhudo

Abantu abaningi abanazo izimpawu lapho betheleleka okokuqala nge-HIV.

Ukutheleleka okunamandla kwe-HIV kuqhubeka ngaphezu kwamasonto ambalwa kuya ezinyangeni ukuze kube ukutheleleka nge-HIV okungenazimpawu (akukho zimpawu). Lesi sigaba singahlala iminyaka eyi-10 noma ngaphezulu. Ngalesi sikhathi, umuntu kungenzeka angabi nasizathu sokusola ukuthi une-HIV, kepha angalisabalalisa leli gciwane kwabanye.

Uma bengalashwa, cishe bonke abantu abangenwe yi-HIV bazoba nengculazi. Abanye abantu baba ne-AIDS eminyakeni embalwa nje yokutheleleka. Abanye bahlala bephilile ngokuphelele ngemuva kweminyaka eyi-10 noma eyi-20 (ebizwa nge-nonprogressors yesikhathi eside).

Abantu abanengculazi amasosha abo omzimba alimalelwe yi-HIV. Basengozini enkulu kakhulu yokuthola izifo ezingajwayelekile kubantu abanamasosha omzimba aphilile. Lezi zifo zibizwa ngezifo ezingosomathuba. Lokhu kungabangelwa amagciwane, amagciwane, isikhunta, noma i-protozoa, futhi kungathinta noma iyiphi ingxenye yomzimba. Abantu abane-AIDS nabo basengozini enkulu yomdlavuza othile, ikakhulukazi ama-lymphomas nomdlavuza wesikhumba obizwa ngeKaposi sarcoma.

Izimpawu zincike ekuthelelweni okuthile nokuthi iyiphi ingxenye yomzimba ethelelekile. Ukutheleleka kwamaphaphu kuvamile ku-AIDS futhi kuvame ukudala ukukhwehlela, umkhuhlane nokuphefumula okuncane. Ukutheleleka emathunjini nakho kuvamile futhi kungadala isifo sohudo, ubuhlungu besisu, ukuhlanza noma ukugwinya izinkinga. Ukwehla kwesisindo, ukushisa komzimba, ukujuluka, ukuqubuka, nezindlala ezivuvukele zamangqamuzana kujwayelekile kubantu abane-HIV kanye ne-AIDS.

Kunezivivinyo ezenziwayo ukubheka ukuthi ngabe ungenwe yini yileli gciwane.

IZIVIVINYO ZOKUTHOLA

Ngokuvamile, ukuhlolwa kuyinkqubo yezinyathelo ezimbili:

• Ukuhlolwa kokuhlola - Kunezinhlobo eziningi zokuhlolwa. Okunye ukuhlolwa kwegazi, okunye ukuhlolwa uketshezi lomlomo. Bahlola amasosha omzimba egciwane le-HIV, i-antigen ye-HIV, noma zombili. Ezinye izivivinyo zokuhlola zinganikeza imiphumela ngemizuzu engama-30 noma ngaphansi.
• Ukuhlola okulandelwayo - Lokhu kubizwa nangokuthi isivivinyo sokuqinisekisa. Kuvame ukwenziwa lapho ukuhlolwa kokuhlolwa kutholakala.

Ukuhlolwa kwasekhaya kuyatholakala ukuhlola i-HIV. Uma uhlela ukusebenzisa eyodwa, hlola ukuqinisekisa ukuthi kuvunyelwe yi-FDA. Landela imiyalo ekuphaketheni ukuqinisekisa ukuthi imiphumela inembe ngangokunokwenzeka.

I-Centers for Disease Control and Prevention (CDC) incoma ukuthi wonke umuntu oneminyaka yobudala eyi-15 kuye kwengama-65 ahlolwe i-HIV. Abantu abanokuziphatha okuyingozi kufanele bahlolwe njalo. Abesifazane abakhulelwe nabo kufanele bahlolwe ukuhlolwa.

IZIVIVINYO NGEMVA KOKUTHOLAKALA NE-HIV

Abantu abane-AIDS bavame ukuhlolwa igazi njalo ukubheka isibalo sabo se-CD4:

• Amaseli e-CD4 T angamaseli egazi ahlaselwa yi-HIV. Abizwa nangokuthi ama-T4 cell noma "ama-T cell asizayo."
• Njengoba i-HIV ilimaza amasosha omzimba, isibalo se-CD4 siyehla. Isibalo esijwayelekile se-CD4 sisuka kumaseli angama-500 kuye kwayi-1,500 / mm³ wegazi.
• Abantu bavame ukuba nezimpawu uma isibalo sabo se-CD4 sehla sibe ngaphansi kwama-350. Izinkinga ezinkulu kakhulu zenzeka lapho isibalo se-CD4 sehla saya kuma-200. Uma isibalo singaphansi kwama-200, umuntu kuthiwa une-AIDS.

Ezinye izivivinyo zifaka:

• Izinga le-HIV RNA, noma umthamo wegciwane, ukuhlola ukuthi ingakanani i-HIV esegazini
• Ukuhlolwa ukumelana ukuze kutholakale ukuthi ingabe igciwane alinazinguquko yini kukhodi yezofuzo ezingaholela ekumelaneni nemithi esetshenziselwa ukwelapha i-HIV
• Qedela ukubalwa kwegazi, ukuhlolwa kwegazi, nokuhlolwa komchamo
• Ukuhlolwa kwezinye izifo ezithathelwana ngocansi
• Ukuhlolelwa i-TB
• Pap smear ukuhlola umdlavuza wesibeletho
• I-Anal Pap smear yokuhlola umdlavuza wendunu

I-HIV / AIDS yelashwa ngemithi evimba ukuthi igciwane lingaziphindaphindeli. Le ndlela yokwelashwa ibizwa ngokuthi yi-antiretroviral therapy (ART).

Esikhathini esedlule, abantu abane-HIV bebezoqala ukwelashwa ngezidambisigciwane ngemuva kokuba isibalo sabo se-CD4 sehlile noma baba nezinkinga ze-HIV. Namuhla, kunconywa ukwelashwa kwe-HIV kubo bonke abantu abane-HIV, noma ngabe isibalo sabo se-CD4 sisesejwayelekile.

Ukuhlolwa kwegazi njalo kuyadingeka ukuqinisekisa ukuthi izinga legciwane egazini (inani legciwane egazini) ligcinwa liphansi noma licindezelwe. Inhloso yokwelashwa ukwehlisa igciwane le-HIV egazini liye ezingeni eliphansi kakhulu ukuthi isivivinyo asikwazi ukulithola. Lokhu kubizwa ngokuthi umthamo wegciwane elingatholakali.

Uma isibalo se-CD4 sesivele sehlile ngaphambi kokuqala ukwelashwa, ngokuvamile sizokwenyuka kancane. Izinkinga ze-HIV zivame ukunyamalala njengoba amasosha omzimba elulama.

Ukujoyina iqembu lokusekelwa lapho amalungu abelana ngokuhlangenwe nakho okuvamile kanye nezinkinga kungasiza ekwehliseni ukucindezeleka okungokomzwelo kokugula isikhathi eside.

Ngokwelashwa, abantu abaningi abane-HIV / AIDS bangaphila impilo enempilo futhi ejwayelekile.

Izindlela zokwelashwa zamanje azilaphi igciwane. Imithi isebenza kuphela uma ithathwa nsuku zonke. Uma imithi imisiwe, inani legciwane egazini lizokhuphuka bese isibalo se-CD4 sehla. Uma imishanguzo ingaphuzwa njalo, igciwane lingazwela kumuthi owodwa noma ngaphezulu, futhi umuthi uzoyeka ukusebenza.

Abantu abathole imishanguzo badinga ukubona abahlinzeki babo bezempilo njalo. Lokhu kwenzelwa ukuqinisekisa ukuthi imithi iyasebenza nokubheka imiphumela engemihle yemithi.

Shayela isikhathi sokubonana nomhlinzeki wakho uma unezinto ezinobungozi ekuthelelekeni nge-HIV. Thintana nomhlinzeki wakho uma uba nezimpawu zengculazi. Ngokomthetho, imiphumela yokuhlolelwa i-HIV kufanele igcinwe iyimfihlo (eyimfihlo). Umhlinzeki wakho uzobuyekeza imiphumela yakho yokuhlolwa nawe.

Ukuvimbela i-HIV / AIDS:

• Hlola. Abantu abangazi ukuthi banegciwane lesandulela ngculaza futhi ababukeka futhi bezizwa bephilile yibo abangahle bakudlulisele kwabanye.
• UNGAYisebenzisi imishanguzo engekho emthethweni futhi ungahlanganyeli nezinaliti noma imijovo. Imiphakathi eminingi inezinhlelo zokushintshana ngezinaliti lapho ungasusa khona imijovo esetshenzisiwe bese uthola ezintsha, eziyinyumba. Abasebenzi kulezi zinhlelo bangakuthumela nakwezokwelapha umlutha.
• Gwema ukuthintana negazi lomunye umuntu. Uma kungenzeka, gqoka izingubo zokuzivikela, isifihla-buso nezigqoko lapho unakekela abantu abalimele.
• Uma kutholakala ukuthi une-HIV, ungalidlulisela kwabanye. Akufanele unikele ngegazi, i-plasma, izitho zomzimba, noma isidoda.
• Abesifazane abane-HIV abangakhulelwa kufanele bakhulume nomhlinzeki wabo ngengozi enganeni yabo engakazalwa. Kufanele futhi baxoxe ngezindlela zokuvimbela ukuthi ingane yabo ingatheleleki, njengokuthatha imishanguzo yegciwane lesandulela ngculaza ngesikhathi sokukhulelwa.
• Ukuncelisa ibele kufanele kugwenywe ukuvikela ukudlulisela i-HIV ezinganeni ngobisi lwebele.

Imikhuba yocansi ephephile, njengokusebenzisa amakhondomu e-latex, iyasebenza ekuvimbeleni ukusabalala kwe-HIV. Kepha kusenengozi yokuthola ukutheleleka, noma ngabe kusetshenziswa amakhondomu (ngokwesibonelo, amakhondomu angadabula).

Kubantu abangenalo igciwane, kodwa basengozini enkulu yokuthola, ukuthatha umuthi onjengeTruvada (emtricitabine kanye ne-tenofovir disoproxil fumarate) noma i-Descovy (emtricitabine ne-tenofovir alafenamide) kungasiza ukuvimbela ukutheleleka. Lokhu kwelashwa kwaziwa njenge-pre-exposure prophylaxis, noma i-PrEP. Khuluma nomhlinzeki wakho uma ucabanga ukuthi i-PrEP kungenzeka ikulungele.

Abantu abane-HIV abathatha imishanguzo yokuthithibalisa igciwane futhi abangenalo igciwane egazini labo abalidluliseli leli gciwane.

Ukuphakelwa kwegazi laseMelika kuphakathi kokuphephe kakhulu emhlabeni. Cishe bonke abantu abatheleleke nge-HIV ngokumpontshelwa igazi bathola ukumpontshelwa ngaphambi kuka-1985, unyaka okuqala ngawo ukuhlolwa kwegciwane lengculazi kubo bonke igazi elinikelwe.

Uma ukholwa ukuthi usengozini ye-HIV, funa usizo lwezokwelashwa khona manjalo. UNGALIBALI. Ukuqala imishanguzo yokulwa namagciwane ngemuva nje kokuvezwa (kuze kufike ezinsukwini ezi-3 emva kwalokho) kunganciphisa amathuba okuthi utheleleke. Lokhu kubizwa nge-post-exposure prophylaxis (PEP). Isetshenziselwe ukuvimbela ukudluliswa kwabasebenzi bezokunakekelwa kwezempilo abalimele ngezinti.

Ukutheleleka nge-HIV; Ukutheleleka - i-HIV; Igciwane lomuntu lokuzivikela komzimba; Ukutholakala kwesifo sokuzivikela komzimba: i-HIV-1

• Ukudla okunomsoco - izinkinga zokuphatha izingane
• Ishubhu yokudla ye-Gastrostomy - bolus
• Ishubhu yokudla yeJejunostomy
• I-Oral mucositis - ukuzinakekela

• Ama-STD kanye nama-niches emvelo
• I-HIV
• Ukutheleleka nge-HIV okuyisisekelo
• I-Canker sore (i-aphthous ulcer)
• Ukutheleleka kwe-Mycobacterium marinum esandleni
• Isikhumba - seborrheic ebusweni
• Ingculaza
• Kaposi sarcoma - sondela
• I-Histoplasmosis, isatshalaliswa esigulini se-HIV
• I-Molluscum esifubeni
• Kaposi sarcoma emhlane
• I-sarcoma kaKaposi ethangeni
• I-Molluscum contagiosum ebusweni
• Amasosha omzimba
• Isifo sofuba emaphashini
• I-Kaposi sarcoma - isilonda onyaweni
• Kaposi sarcoma - perianal
• Kusatshalaliswa i-Herpes zoster (shingles)
• Isikhumba seborrheic - ukuvala

Izikhungo Zokulawulwa Nokuvimbelwa Kwezifo iwebhusayithi. Mayelana ne-HIV / AIDS. www.cdc.gov/hiv/basics/whatishiv.html. Kubuyekezwe uNovemba 3, 2020. Kufinyelelwe ngoNovemba 11, 2020.

Izikhungo Zokulawulwa Nokuvimbelwa Kwezifo iwebhusayithi. I-PrEP. www.cdc.gov/hiv/basics/prep.html. Kubuyekezwe uNovemba 3, 2020. Kufinyelelwe ngo-Ephreli 15, 2019. UDiNenno EA, Prejean J, Irwin K, et al. Izincomo zokuhlolwa kwe-HIV kwezitabane, abesilisa nabesifazane, namanye amadoda alala nabesilisa - United States, 2017. IMMWR Morb Mortal Wkly Rep. 2017; 66 (31): 830-832. www.cdc.gov/mmwr/volumes/66/wr/mm6631a3.htm.

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I-Moyer VA; I-US Preventive Services Task Force. Ukuhlolelwa i-HIV: Isitatimende sezincomo se-US Preventive Services Task Force. U-Ann Intern Med. 2013; 159 (1): 51-60. I-PMID: 23698354 pubmed.ncbi.nlm.nih.gov/23698354/.

UReitz MS, uGallo RC. Amagciwane omzimba womuntu. Ku: Bennett JE, Dolin R, Blaser MJ, ama-eds. Mandell, Douglas, kanye neBennett's Principles and Practice of Infectious Diseases. Umhlaka 9. IPhiladelphia, PA: Elsevier; 2020: isahluko 169.

USimonetti F, uDewar R, uMaldarelli F. Ukuxilongwa kokutheleleka kwegciwane lesandulela ngculaza. Ku: Bennett JE, Dolin R, Blaser MJ, ama-eds. Mandell, Douglas, kanye neBennett's Principles and Practice of Infectious Diseases. Umhlaka 9. IPhiladelphia, PA: Elsevier; 2020: isahluko 120.

UMnyango Wezempilo kanye Nezinsizakalo Zabantu e-US, iwebhusayithi yeClinical Info.gov. Imihlahlandlela yokusetshenziswa kwama-antiretroviral agents kubantu abadala nasebasha abaphila ne-HIV. clinicalinfo.hiv.gov/en/guidelines/adult-and-adolescent-arv/whats-new-guidelines?view=full. Kubuyekezwe ngoJulayi 10, 2019. Kufinyelelwe ngoNovemba 11, 2020.

UVerma A, uBerger JR. Ukubonakaliswa kwemizwa yokutheleleka ngegciwane le-immunodeficiency human kubantu abadala. Ku: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, ama-eds. I-Neurology kaBradley ekwenziweni kwemitholampilo. Umhla wesi-7. IPhiladelphia, PA: Elsevier; 2016: isahluko 77.