HIV: ukuxilongwa kanye nokwelashwa, zokuvimbela

atholwe immunodeficiency syndrome iminyaka engaphezu engamashumi amane, ingenye izinkinga ukhiye emphakathini wanamuhla. Ngakho-ke, ukuthi une-HIV manje iheha kakhulu ukunakwa kanye nezinsiza. Phela, igciwane ngokushesha ke iyoba ukutholwa esibhubhisa izivikeli mzimba zomzimba, ayanda kuyoba amathuba sokugwema ukufa.

Ingqikithi inkinga

Ngaphansi esithi HIV efihla incazelo human immunodeficiency virus - omunye esiyingozi kakhulu phakathi ekhona njengamanje. Ngosizo lwawo kukhona ngaba nokucindezeleka okukhulu izakhiwo okuvikela umzimba. Lokhu-ke kuholela ukuvela komdlavuza ehlukahlukene izifo.

Qhubekisa ngokuthwebula ukutheleleka nge-HIV kungakusiza ngokuhamba ngezindlela ezahlukene. Ngezinye izikhathi lesi sifo obulala umuntu 3-4 iminyaka, kwezinye izimo ingahlala iminyaka engaphezu kwengu-20. Kuwufanele ukwazi ukuthi igciwane engazinzile futhi ngokushesha uyafa lapho umzimba iphelelwe esiphathiswa.

HIV kungenziwa eziqukethwe isidoda, igazi, menses futhi lwesitho sangasese sowesifazane uketshezi nezindlala. Njengoba izimbangela ukutheleleka kudingeka sikhumbule la izinkinga ezifana nesifo periodontal, imihuzuko, nezinye ukulimala.

HIV angadluliselwa okwenziwe futhi esebenzisa bloodborne biokontaktnogo indlela.

Uma kwakuba khona oyedwa oxhumana ne othwala igciwane, ingozi yokutheleleka liphansi, kodwa ukuxhumana njalo liphuma kakhulu. Ukuxilongwa yokutheleleka nge-HIV - yilokhu akunakugwenywa, ikakhulukazi lapho beshintsha ocansini

Nakani izindleko kanye nemizila parenteral ukutheleleka. Kungaba kwenzeke phakathi ukumpontshelwa igazi wegazi angcolile, imijovo kanye izinaliti ukuthi ingcoliswe ngegazi abantu abanegciwane lesandulela-ngculaza, kanye nezinqubo zezokwelapha ze-non-oyinyumba (okudweba ukubhoboza, izinqubo zamazinyo usebenzisa amathuluzi ingelashwa kahle).

Kufanele bazi ukuthi ukudluliswa contact-yasendlini akudingeki besabe. Kodwa iqiniso liwukuthi umuntu ezifweni okusezingeni eliphezulu HIV. Futhi uma umuntu onegciwane abangaphezu kweminyaka engu-35, ukuqhubeka ingculaza kwenzeka kakhulu ngokushesha kunokuba labo angakawamukeli unqobe emashumini amathathu phesheya.

Izimpawu main

Yiqiniso, indlela engcono kakhulu ukukhomba inkinga noma itlhogeko - kuyinto ukuxilongwa nge-HIV. Kodwa yini ebangela ukuba kungaba umuntu, okuholela ngendlela enempilo, ukuya futhi zihlole eqinisweni ukutheleleka? Kungokwemvelo ukuba isinyathelo esinjalo kufanele ngandlela-thile nyama. Ngakho-ke kubalulekile ukwazi ukuthi izimpawu zingase zibe Indlela izinqubo elimazayo nesimiso somzimba sokuzivikela.

Stage bayashintshana ekufukameleni igciwane ngaphandle ukuhlolwa igazi ukumambula akunakwenzeka ukuba iphumelele, ngoba emzimbeni ngalesi sikhathi namanje akasabeli izakhi nobutha.

Isigaba sesibili (bonisa okuyinhloko) ngaphandle kosizo udokotela nako engabonwa. Kodwa ngezinye izikhathi kukhona igceke asebenzayo igciwane futhi umzimba uqala abasabela ngayo - uthi umkhuhlane ezahlukene ukuqubuka polymorphic, syndrome splenic kanye pharyngitis. In the isinyathelo sesibili singahlangana izifo yesibili ezifana herpes, izifo fungal, inyumoniya kanye nabanye.

Ngokuba wesithathu, isigaba esicashile, elinesimo ukwenyuka kancane immunodeficiency. Ngenxa yokuthi amaseli yesimiso sokuzivikela afe, Dynamics of umkhiqizo wabo luyanda, futhi lokhu liyakwazi balahlekelwa kakhulu. Kuleli qophelo ambalwa lymph node okuqondene izinhlelo ezahlukene bangaba avuvukele. Kodwa ubuhlungu obukhulu is hhayi waphawula. Isilinganiso isikhathi esicashile ihlala engu-6 kuya 7, kodwa zingase zephuze, no-20.

Esigabeni sesibili yesifo, okuyinto yesine, co-izifo avele fungal, protozoan webhaktheriya, umsuka ezibangelwa amagciwane kanye komdlavuza. Konke lokhu okwenzekayo ngokumelene isizinda immunodeficiency ezinzima.

Izindlela ukuxilongwa ukutheleleka nge-HIV

Ukukhuluma zokucindezela ngokujulile izindlela ukuzivikela komzimba ngenxa yokuchayeka igciwane, kuyafaneleka ukuthi ikusasa isiguli kulesi simo incike uphethwe okufika ngesikhathi futhi kunembile.

Ukuze wenze lokhu, kwezokwelapha zanamuhla, izinhlelo ehlukahlukene test, okuncike immunohemilyuminestsentny kanye enzyme immunoassay igazi. Lezi zindlela enze kube nokwenzeka ukuba sithole khona amasosha omzimba okuqondene amakilasi ezahlukene. Lo mphumela kuyasiza ukwandisa okuqukethwe Imininingwane yezindlela kohlaziyo, ngokucacile emitholampilo ukuzwela lapho sisebenzelana izifo ezithathelwanayo.

Abathandwayo futhi Kuyaphawuleka ukuthi indlela polymerase chain reaction bavunyelwe ukuletha Ukutholwa kwesandulela ngculazi ezingeni elisha. Ngenxa impahla isifundo bamba ezihlukahlukene izinto yemvelo: i-plasma, biopsy, nokususa, serum, cerebrospinal noma uketshezi pleural.

Uma sikhuluma izindlela izifundo laboratory, basuke ngokuyinhloko igxile ukuhlonza eziningi izifo ukhiye. Sikhuluma-HIV, isifo sofuba, zonke izifo ezithathelwana ngobulili, njengengculaza kanye ne-hepatitis ezibangelwa amagciwane.

Ukuhlonza igciwane immunodeficiency nazo asetshenziswa yamangqamuzana ukuhlolwa zofuzo serological. Esimweni sokuqala kunqunywa RNA ezibangelwa amagciwane kanye DNA proviral, esimweni sesibili, ukuhlaziya amasosha omzimba kuya antigen HIV P24 futhi itholwa.

Emitholampilo, ekusebenziseni, ngomqondo ongokomfanekiso, izindlela classical zokuxilonga, ikakhulukazi esetshenziswa olandelwayo indinganiso yokuhlola serological.

ekuhlonzweni kwe-HIV

Lolu hlobo ukuzimisela ukutheleleka Eqinisweni ezidingekayo ukuze ukukhomba ingozi izivikeli mzimba kusenesikhathi. Lena, okokuqala, ukuze ugweme ukusabalala ukutheleleka, okwesibili, ezithinta lesi sifo ngendlela efanele usaqala.

Uma sicabanga ngesibonelo Russia, ngezigaba emitholampilo yokutheleleka nge-HIV yethulwa Army futhi Navy we Russian Federation. Wabanikeza imiphumela emihle: inqubo ekuseni ukuxilongwa emitholampilo sekulula kakhulu.

Njengoba izimpawu ezivamile ekhombisa ziwohloke kungenzeka kwesimiso somzimba sokuzivikela ezifweni, kungenzeka ukunquma ikhanda, ukujuluka ebusuku nokukhathala unmotivated. Kungenzeka futhi ukuthuthukiswa imfiva ephelezelwa izimpawu of namathansela. Lokhu kusho ukuthi izinga lokushisa likhuphuka degrees 38 noma ngaphezulu, futhi ngaleyo ndlela andise amalaka LasePalatine, futhi avele ubuhlungu ngesikhathi singagwinyi. Konke lokhu is kwahambisana by okusheshayo kwesisindo. Ngesikhathi esifanayo, lezi izimpawu kaningi eziyinkimbinkimbi.

Kwezinye izimo zokutheleleka nge-HIV kusaqalwa kungavuka ezihlukahlukene sishintshe isimo ngesikhashana. Sikhuluma izindawo, roseola, abscesses, imihuzuko nabanye. Uphethwe Early-HIV sihlanganisa ukusebenza izimpawu ezifana ukwanda generalized noma ulinganiselwe neuropathy zamanzi.

Uma kukhona ukukhula ngesikhathi esisodwa ISIZINDA eziningana lymph eqhubeka izinyanga ezintathu noma ngaphezulu, futhi amaqembu ahlukahlukene ngaphandle imbilapho, khona-ke zonke isizathu sokusola igciwane of amasosha omzimba womuntu.

Ukukhuluma uphethwe ngolunye usuku, udinga ukuba banake ukubonakaliswa immunodeficiency yesibili, okuyinto ngokuvamile kwenzeka ezicashe izimpawu zokwelashwa ezahlukene. Lezi ezilandelayo ezibonisa:

• unmotivated generalized lymphadenopathy neuropathy;
• arthralgia omsakazo ezingaziwa okuyinto ine zamanje inamagquma;
• Ari (acute nezifo zokuphefumula), ukuvuvukala amaphaphu ushise imigudu yomoya, okuyinto azibonakali njalo ngokwanele;
• imfiva Lokudabuka engaziwa kanye eside ongaphakeme-ebangeni umkhuhlane;
• ubuthi jikelele, okuyinto livezwa ubuthakathaka unmotivated, ukukhathala, ukucobeka, kanye nabanye.

HIV-Ihlahlubo ngesikhathi esizayo ngesikhathi sokuhlolwa kuhlanganisa izifo ezifana Sarcoma Kaposi, ukubukeka amaningi wabonakaliswa neoplasms ngokuvamile engxenyeni engaphezulu kuphela yomzimba abantu abasha, kulandele lwekutfutfukisa futhi Ukudlulela.

Polymerase chain reaction

Uma ucabangela izindlela ezihlukahlukene uphethwe yokutheleleka nge-HIV, lokhu kumele inikezwe ukunakekelwa okukhethekile. Ngokushesha kufanele kuphawulwe ukuthi ukuhlolwa igazi lingase okuhloswe ngazo izici ambalwa kanye qualitative.

Njengoba injongo yale ndlela ukuthola igciwane kungaba azimisele imisebenzi elandelayo:

• ekuhlonzweni yokutheleleka nge-HIV;
• ukucacisa khona imiphumela engabazekayo ukuphela immunoblottingovogo ucwaningo;
• ukuhlonza isigaba esithile lesi sifo;
• ukuqapha ukuphumelela ukwelashwa yokuvimbela igciwane.

Uma sikhuluma ukutheleleka okuyisisekelo, kufanele kuphawulwe ukuthi le ndlela ivumela ukunquma HIV RNA egazini ngemva kwezinsuku ezingu-14 inani labantu ebaphethe. Lena yi kwakukuhle kakhulu. Ngakho ngokwayo umphumela isifundo kuyodingeka inkulumo qualitative, kungaba esihle (igciwane likhona) noma kube kubi.

Quantitative PCR Inkulumo

Lolu hlobo lwe- polymerase chain reaction isetshenziswa lunquma isivinini kungenzeka kwengculaza, ukubikezela bungakanani ubude bokuphila lesiguli.

ukuzimisela quantitative kwe-HIV RNA e egazi kwenza kube nokwenzeka ukuba baqonde lapho isifo engena isigaba emtholampilo.

Kuwufanele benaka yokuthi elabhorethri HIV izindlela zokuxilonga unikeze yi esinembile, uma kudingeka i-ukuhlaziywa biomaterial kunqunywa kahle, futhi kocingo yayo yenziwa kahle.

Ukuze wenze zokuqapha izinga itheleleke ezidingekayo (lapho kungenzeka khona) ukusebenzisa indlela eqotho ekutadisheni isimo somzimba sokuzivikela sesiguli. Sikhuluma ukuzimisela ambalwa kanye nemisebenzi yonke amayunithi kohlelo Ukuvikelwa: yeselula, amasosha omzimba humoral nokuzabalazela nonspecific njengoba enjalo.

ukuxilongwa laboratory

Bayanda e-laboratory yesimanje esetshenziswa indlela multi-esiteji ngoba kucatshangwa isimo izivikeli mzimba. Le nqubo ivame kufaka ekhatsi ngekuchumanisa subpopulation omzimba, ama-lymphocyte egazini. Lokhu kusho ukuthi i-akhawunti esithathwayo isilinganiso-CD4 / CD8 amaseli. Uma yalokho libonisa esingaphansi 1.0, kukhona isizathu immunodeficiency umsolwa.

Laboratory uphethwe yokutheleleka nge-HIV kufanele kufake lokhu test Kuphoqelekile, kusukela igciwane esivamile abakhethayo lesion-CD4-lymphocyte, okuholela ukuphazamiseka okuphawulekayo isilinganiso (esingaphansi 1.0) eshiwo ngenhla.

Ukuze ukuhlola immunological isimo odokotela angase aqhube ukuhlolwa khona "anolaka" noma jikelele uhlelo yokulimala amasosha omzimba humoral kanye neselula. Kumayelana hypogammaglobulinemia hypergammaglobulinemia noma esigabeni esibulalayo, kanye ukunciphisa ukukhiqizwa cytokine, okwandisa lokuhlushwa afundwa izakhiwo mzimba buthaka impendulo-lymphocyte ukuze mitogens futhi antigen.

Kuwufanele benaka yokuthi uphethwe laboratory HIV izigaba ezimbili ezibalulekile:

1. Screening laboratory. Uma kwakukhona yi omuhle ELISA (enzyme-exhumene Assay immunosorbent), it is okuphindaphindiwe kabili ohlelweni olufanayo futhi ngaphandle kokushintsha serum. Esimweni lapho emibili survey ezintathu kwaholela kokutholakala serum igciwane ithonya wathumela ukuze kuqhutshwe uphenyo ukuze isithenjwa laboratory.
2. Eyesibili esiteji, ezihlanganisa izindlela ukuhlola laboratory yokutheleleka nge-HIV, - incazelo izivikeli mzimba. Kunenkolelo e oshiwo ngenhla inkomba laboratory. Nalapha futhi sera omuhle ziphenywe ELISA, kodwa kusetshenziswa test izinhlelo ezahlukene, okuyinto ihlukile Ukwakheka wangaphambili antigen, amasosha noma ifomethi uvivinyo ngokwabo. Ekunqumeni yalokho omubi Kwenziwa ucwaningo eyalandela ngowesithathu test system. Uma umthelela igciwane ngenxa engakaze bengaba nalo, ikhiye ukungabi yokutheleleka nge-HIV. Kodwa nge yi HIV, serum sifundwa kuwo lo isisihla komugqa noma mzimba.

Ekugcineni i-algorithm enjalo kuveza imiphumela emihle, hlangothi noma engemihle.

Esinye nesinye isakhamuzi kufanele uqaphele ukuthi liyatholakala ukuhlola i-HIV. AIDS bungabonakala e ezizimele, kamasipala yezempilo noma umphakathi.

ukwelashwa

Yiqiniso, ukuhlonza igciwane kungaba ukusetshenziswa kancane ngenxa yokuntuleka kwezinhlelo ezibanzi izindlela ezihlukahlukene ukuchayeka ukutheleleka. Futhi nakuba okwamanje namanje awukho umuthi wokugoma ezingase iwukudambisa ngokuphelele leli gciwane, ukuxilongwa abanekhono, ukwelashwa kanye nokulandelela lokuvimbela igciwane lesandulela ngculaza kungaba ngokuphawulekayo ngcono ngezimo zesiguli, kanjalo ngelula ukuphila kwakhe. Lokhu mqondo kuqinisekiswa iqiniso lokuthi isilinganiso sobude bokuphila amadoda ezaqala ukwelashwa kwe-HIV kuyinto engu-38 ubudala. Abesifazane abaqala anti-immunodeficiency virus, baphila isilinganiso iminyaka engu-41.

Uma uphethwe eye eyenziwa, imithi ye-HIV kuyehla kube ukusetshenziswa amasu amaningana. Njengoba omunye okuvame kakhulu kungenzeka ukunquma antiretrovial yokwelapha HAART uyefana. Uma isikhathi futhi ngokuphumelelayo ukusebenzisa lolu hlobo ukwelashwa, kungenzeka ukuba kakhulu ukubambezela ukuqhubeka ngengculaza noma ngisho ukuyimisa.

HAART essence yangempela yokuthi ngesikhathi esifanayo usebenzisa imikhiqizo nezinhlelo ezenza imithi eziningi, ogama njongo iwukuba ukuthonya izindlela ezahlukene immunodeficiency virus.

Ngemva izindlela ezihlukahlukene Ukutholwa kwesandulela ngculazi ezikhonjwe yokuthi ukutheleleka, kungasetshenziswa imithi, ezithinta imithelela ezilandelayo:

• Immunological. Misa izivikeli mzimba, elele ezingeni T-lymphocyte, nokululama Ukuvikelwa ezifweni ezihlukahlukene.
• Clinical. It kuvimbela ukuthuthukiswa lengculaza zako, ngelula impilo iziguli kulondolozwe yonke imisebenzi yomzimba.
• Virological. It kwenzeka ekuvimbeni igciwane ukubuyabuyelela, ngaleyo ndlela kuncishiswe ubuningi begciwane futhi kamuva fixed ezingeni eliphansi.

Kunzima overestimate ukubaluleka izinyathelo ezinjalo nomthelela isifo, njengoba isifo sami sitholakele, ukwelashwa kanye nokuvimbela ukutheleleka nge-HIV. Ngakho-ke, into engcono ongayenza emva imiphumela emihle ye Ucwaningo oluthile ngale ndaba ukutheleleka - kuyinto ngokushesha baqala ukulwa nalesi sifo. Njengoba enye indlela, okuzokwenza Singakwazi yini ukuthola ukwelashwa virological.

Kulokhu sikhuluma elokusebenzisa izidakamizwa, okuyinto ungavumeli igciwane ukunamathisela T-lymphocyte, futhi ukuze uthole ngaphakathi emzimbeni. izidakamizwa ezinjalo zibizwa ngokuthi ama-entry inhibitor. Ngo "Tselzentri" inganikelwa njengoba isibonelo esikhethekile.

Ukucindezela HIV ingasetshenziswa viral protease inhibitor. Injongo yaleli qembu izidakamizwa ukuvimbela yokutheleleka kwamaseli amasha. It izidakamizwa ezifana "Viracept", "Reyataz", "Kaletra" et al.

Iqembu lesithathu imithi nezokusigcoba - a reverse transcriptase inhibitor. Badinga ukuvimba i-enzyme evumela ukuthi igciwane ukuphindaphindeka RNA e-nucleus ye-lymphocyte. Lezi zindlela uvumela uhlelo umphumela appreciable ezindabeni ezifana nge-HIV. Sifo, ukwelashwa kanye nokuvimbela AIDS - endabeni odokotela abaqeqeshiwe, kanjalo algorithm elokusebenzisa izidakamizwa, kumele benze okungenani.

njengoba imiphumela esimisweni somzimba sokuzivikela futhi emtholampilo lingasetshenziswa uma kunesidingo.

zokuvimbela

I-World Health Organization inikeza izindlela ezilandelayo yokutheleleka nge-HIV:

• Ukuvimbela nezifo ezithathelwana. Kuyinto ubulili, amakhondomu, impatho STD kanye zokuqeqesha ephephile.
• Kwabesifazane abakhulelwe kabani ukutheleleka nge-HIV itholiwe, - uphethwe, zokuvimbela, usebenzisa amakhemikhali afanele, kanye ukwelulekwa lochwepheshe kanye nokwelashwa.
• Inhlangano lokuvikela ngegazi. Kulokhu sikhuluma anti-virus ukucutshungulwa nabaphisanayo kokuhlola.
• usizo Komphakathi kanye zokwelapha iziguli kanye nemindeni yabo.

Ukuze Ukutholwa kwesandulela ngculazi akalushongo khona igciwane, udinga silandela imithetho yokuphepha elula:

• uma ngegazi elinegciwane uthola esikhunjeni, kufanele ngokushesha wageza off ngensipho namanzi, ngemva kwalokho inqubo contact endaweni utshwala;
• Uma umonakalo oye eyatholakala kusukela izakhi isihloko igciwane, kubalulekile ukuba cindezela isilonda, ukumpintsha igazi ukucubungula esikhundleni hydrogen peroxide, emaphethelweni cauterize iodine;
• ungalokothi usebenzise isipetu ukuthi inzalo ifakwe ebucayini;
• ngesikhathi sokuya ocansini ukusebenzisa ikhondomu, futhi kungcono ekuqaleni ukuhlola naye infiltrations.

Imiphumela

Ngenxa yokuthi une-HIV akuyona esikhundleni, izinkulungwane zabantu bayakwazi uqale ukwelashwa ngesikhathi futhi ukwandisa ubude bempilo. Into esemqoka akukona ukuziba Ukusho izimpawu ezisobala futhi ungesabi ukuya kudokotela.