Ukutshintshwa okunokwenzeka kwintlobo yesifo sengculaza esingabonakaliyo
Ukuba unesifo se-HIV kwaye uthatha iziyobisi njengoko kuchaziwe, uya kucinga ukuba umngcipheko wokudlulisa intsholongwane kwabanye uya kuba sezantsi, kunene?
Kwiimeko ezininzi, uya kuchaneka, kodwa kukho iziganeko xa abantu abanomthamo wentsholongwane engabonakaliyo kwigazi labo ngokukhawuleza banentsholongwane ebonakalayo kwimbewu yabo okanye emicimbini yabo. Le yinto eyaziwa ngokuba yi-viral shedding.
Ngelixa sithatha ngokubhekiselele ekuphalazeni xa kwenzeka kwindoda yesini okanye yobhinqa (ukucinywa komzimba), kuya kwenzeka nasemlonyeni (ukuchithwa komlomo).
Ukwenyuka kwemisebenzi yentsholongwane-ngokukodwa kwimbewu okanye kwimfihlelo yamanzi-ukuguqulwa kwindlela enkulu yokudluliselwa kwe-HIV kumlingane ongasathanga.
Indlela UkuKhutshwa kweThutho lweGenesis kwenzeka ngayo
Ngokwenzululwazi, igama elithi "ukuphalaza" lithetha kwinkqubo apho inqakraza ikhutshwe khona, okanye ichithwe, ukusuka kwiseli yesistim eye isulele. Iindlela ezimbini ezinokuthi zenzeke ngoku ngeenkqubo ezibizwa ngokuba yi- budding kunye ne- apoptosis:
- Ukuhlawula ibhekiselele kwisigaba somjikelezo wentsholongwane kaGawulayo apho intsholongwane igawula iimbumba kwiseli elithelelekileyo ukudala igobolondo yalo yangaphandle. Ingakwazi ukuhluma ukusuka kwimpathi njengentsholongwane ye-virus.
- I-Apoptosis , eyaziwa nangokuzibulala , isenzo apho isisele esiya kuzibulala khona xa sifakwa phantsi kwengcinezelo. Ngethuba losulelo lwesifo, i-apoptosis iya kutshabalalisa igciwane elichaphazelayo kunye neseli yolwazi. Nentsholongwane kaGawulayo, nangona kunjalo, intsholongwane iya kunyanzelisa iseli kwi-apoptosis ukwenzela ukukhulula inzala yayo kwi-circulation.
Ingaba kukho nto yezinto ezichazayo ukuba kutheni inkunkuma ye-HIV ingenzeka kwiphepha lomzimba kodwa kungekhona kwigazi apho kungenakwenzeka ukuba ingabonakali.
Ubu bungqina bubonisa ukuba izinto ezinokubangela ukuba: ukuguquka kwe-HIV ngaphakathi kweeseli zomzimba wethu kunye nokuhlukahluka kwezigulane ze-HIV ngaphakathi kwezicubu zomzimba wethu.
UkuHlulwa koThutho lweGciwane kunye neNtsholongwane kaGawulayo
Esinye seembonakaliso sokuqala senzeke ngo-2000 xa kuthe kwafumanisa ukuba udidi lwe-HIV luyahlukahluka kwenye inxalenye yomzimba ukuya kwenye. Ngokomphando ovela kwiSifundo se-Multicenter AIDS Cohort Study (MACS) esikude, abanye abantu abane-HIV baboniswe ukuba babe neentsholongwane ezahlukeneyo zentsholongwane egazini labo kunye nesinye sembewu yabo.
Uphononongo olongezelelweyo lubhekisele kwiipatheni zokuchitha phakathi kwabathathi-nxaxheba. Kwezinye iimeko, ukuchithwa kwakuyinkqubo eqhubekayo eyenzekayo kwimbini negazi. Kwabanye, bekuphakathi kwaye kwenzeka ngokuyinhloko kwindlela yokuzala. Kwabanye bekunjalo, kwakungekho nto yokuchitha.
Ziziphi iziphumo eziphakanyisiweyo kukuba:
- Ukuhlukahluka kwe-HIV kunokuguqulela kwimpendulo eyahlukeneyo kunyango.
- Ukuchithwa kwe-HIV inokuba yimeko apho umntu aphethwe khona ngokofuzo.
Kulabo bantu abafumana ukuphalaza okuphakathi, iziphumo zazingundoqo. Kula madoda, abaphandi be-MACS baqaphele ukuba ukusuleleka kwi-prostate gland kwakusondelene ngokusondeleyo kunye neentlobo ze-virtual activity in the semen. Batshengisa ukuba ukutshaya kwendawo yeprotate (igumbi elivelisa isilwanyana) liye laphazamisa ngokusebenzisa iintsholongwane ezininzi ezifakwe kwiiseli ze-prostate gland kunye nama-vesicles.
Ucwaningo oluthile luye lwaxhasa ngokubanzi ezi ziphumo kwaye zibonise ukuba ukuphalaza kunokwenzeka ngenxa yezifo ezithathelwana ngocansi (STIs) , ukuhlala nezifo, kunye nokuya esikhathini .
Ukuphumelela kwee-Drugs ze-HIV zingadlulela kwiGazi, iisisculi
Sivavanya igazi kwi-HIV kungekhona ngenxa yokuba kuyona nto ifanelekileyo kwintsholongwane kodwa ngenxa yokuba inikezela ukufikelela okulula xa kuthelekiswa, uthi, umongo weethambo okanye iisampuli zamathambo. Oko akuthethi ukuba akuyena umlinganiselo oqinileyo kakhulu-kodwa-ke akusiboneli umfanekiso opheleleyo kwindlela i- antiretroviral izidakamizwa eziyimpumelelo ezingena kwiiseli ezahlukeneyo kunye nezicubu zomzimba wethu.
Sekude saziwa, umzekelo, ukuba iziyobisi ezifana ne-zidovudine (AZT) ziyakwazi ukungenelela ingqondo kunye namaseli omgulane ngokuphumelelayo nangakumbi kwii-concentrations eziphezulu kunokuba zonke ezinye iziyobisi ze-HIV. Yingakho yayisetyenziswe ixesha elide kubantu abaneengxaki zeengculaza ezinzima njengendlela yokuphucula inkqubela yesifo.
Ngokufanayo, kukho ubungqina obukhulayo beziyobisi iTruvada, xa zisetyenziswe njenge-thintelo yonyango ( eyaziwayo njenge-PrEP ), ayifaki ukungena emathanjeni asiswini njengendlela eyenza i-rectum.
Uphando olusuka kwiYunivesithi yaseNorth Carolina kwiChapel Hill lubonise ukuba ukuxilongwa kweTruvada kumathambo angamaqhekeza kunokunikezela ukukhuselwa kweepesenti ezingama-90 kunye neepresenti ezimbini ze-PrEP ngesonto . Ngokwahlukileyo, ukuxinwa kweTruvada kwiisisu zangasese kwakuncinci kakhulu, kunika kuphela ukukhuselwa kweepesenti ezingama-70 kwanokubambelela kwimihla ngemihla.
Oku kuya kusebenza kakhulu kumntu wesini somzimba. Ukuba kunjalo, kunokwenzeka ukuba unyango lwe-HIV luyakunqanda intsholongwane kwenye indawo emzimbeni kodwa aphelelwe kwindlela yokuzala xa kukho isifo.
Kule meko, kukholelwa ukuba inkqubo ye-immune ingaba yinto enokubangela ukuba i-spgger ichithe ukutyhala kwindoda kunye nabasetyhini.
Indlela Indlela Yakho Yokuzikhusela Ngomzimba Yenza I-Shedding
Ubungakanani bentsholongwane luya kuvuselela isistim somzimba. Xa oku kwenzeka, umzimba uya kuphendula ngokukhulula izinto emzimbeni obizwa ngokuba yi- cytokines eziza kubonisa ukuba zize zikhokele iiseli zomzimba kumthombo wesifo. Nangona ezinye ze-cytokines zikunceda ukulwa nezifo, ezinye zineempembelelo eziphikisanayo ngokuthi "ukuvusa" iHIV efihliweyo kwiiseli ezahlukeneyo kunye nezicubu zomzimba.
Eyaziwayo njengeendawo zokugcina ezikhuselekileyo , ezi ndawo zamaselula zikhusela ngokufanelekileyo i-HIV kumzimba wokhuseleko lomzimba. Ngokuqhelekileyo ngexesha lokugula okunzima, xa isistim somzimba sisebenzisayo, ukuba intsholongwane iya kuvela ngokukhawuleza. Kungenxa yoko abanye abantu banokuhamba iminyaka engenawo unyango kwaye ngokukhawuleza banesigulo esikhulu esihamba kunye ne-spike enkulu kwimisebenzi yentsholongwane.
Iprogram efanayo ibonakala isebenza kwindlela yokuxhatshazwa kwentsholongwane kaGawulayo. Ngaphambi kokusuleleka, tshatisa i-STI okanye i- prostatitis , isimiso somzimba sokuzivikela sisayi kukhupha i-cytokines (inhlobo ehambelana nokuvuvukala). Ukugqabhuka ngokukhawuleza kokuvuvuka kwendawo kuhlanganiswe ngokukodwa nokunyuka kwindalo egazini.
Xa oko kwenzeka, iiseli zegazi ezimhlophe ezikhuselayo (i-leukocytes) ziza kuhlawulela ngokukhawuleza indawo yesifo. Enye ye-leukocyte enjalo, ebizwa ngokuba yi- CD4 T-cell , iyona nto iphambili ye-HIV. Njengoko ezi T-seli zitheleleke ekuhlaselweni kokuqala, amanani e-viral aphakama de kube lixesha elinjalo ukusuleleka kwintsholongwane.
Ngethuba lo msebenzi ogqithisileyo wentsholongwane yintsholongwane enokuthi umntu onentsholongwane kaGawulayo unokunyusa intsholongwane kwabanye. Nangona umthwalo wentsholongwane ungakhula ngegogi enye okanye kunjalo (ukuxhuma ukusuka, uthi, 100 ukuya ku-1,000), kusenokuba ukwanele ukuququzelela usulelo.
Ukukhutshwa kwe-HIV ngexesha lokuya esikhathini
Ukutshatyalaliswa kwentsholongwane kaGawulayo kungenzeka ngenxa yesisu. Ngexa ukuphalaza akunakwandisa kakhulu umngcipheko wokudluliselwa kwabasetyhini kwi-HIV unyango, ngaba abo bangayazi imeko yabo okanye abangazange baphathwe.
Uphando olusuka kwiYunivesithi ye-Oregon yezeMpilo neNzululwazi (OSHU) yophando iqela labasetyhini abaye baxhomekeke ekutyaleni kwamagciwane ngenxa yokuxhatshazwa kwe- herpes simplex (HSV-2) . (I-HSV-2, intsholongwane echaphazelekayo engama-67 ekhulwini labemi behlabathi, iyaziwa kwakhona ngokubangela ukuba isisu siphelelwe sisibini kunye nabesifazane abangabonakaliyo .)
Kule nqela yabasetyhini, ukuchithwa kwe-HIV kwakuqhelekile ngexesha lokuya esikhathini kunye nokunyuka kwamaxesha angama-8 kwindleko yesandulela ngculaza xa kuthelekiswa nomjikelezo wokuqala. Oku kwenzekayo nokuba ibhinqa inempawu ze-HSV-2 okanye ayikho. Nangona le nyukeko ingabonakali kakhulu kubasetyhini abanomsebenzi wokugonywa kwintsholongwane, bekubhekwa njengento ebalulekileyo kulabo abanemithwalo ephezulu yentsholongwane.
Ngokutsho kwabaphandi, ukuchithwa kwe-virus ngexesha lokuya esikhathini kunokuthethelela okwenyuka kuma-65 ekhulwini kwengozi ye-HIV xa umfazi engaphathiswa. Ngokwahlukileyo, unyango lwe-HIV lunokunciphisa, nangona lungasuki ngokupheleleyo, umngcipheko kumlingani wesilisa osulelekileyo.
ILizwi
Ukususela kokungeniswa kwe-PrEP, sibonile ukulahla okulinganayo ekusebenziseni iikhondom. Esinye isiFundo saseFransi, eqinisweni, sabonisa ukuba ngokuqhubekayo umntu uthathe i-PrEP, akunakunokwenzeka ukuba uya kusebenzisa iikhondom (ama-54 ekhulwini angaphantsi ukuba abe ngqo).
Nangona ukuphumelela kwe-PrEP ngokungathandabuzekiyo, ngokukodwa kwizibini ezixubileyo kunye nabantu abasengozini yokusuleleka, akufanelekelise ukuba iikhondom azibalulekanga kangako kunokuba zikhona.
Ekugqibeleni, nayiphi na intsholongwane kaGawulayo yimbangela yezinto ezininzi eziquka, phakathi kwezinye izinto, uhlobo lomsebenzi wesondo ochaphazelekayo kunye nempilo jikelele yabantu abangakhuselekanga. Nangona umthamo wentsholongwane womntu osulelekileyo uphantsi, ezinye izinto ziyakwazi ukuphakamisa enye phezu kwexesha elizayo ukunyusa umngcipheko, ngamanye amaxesha kakhulu.
I-STI engafunyananga nayo ixhamle ne-bacterial vaginosis edibene ne-spike ekhethiweyo kwimisebenzi yentsholongwane ngamanye amaxesha kukho konke okufunekayo ukuguqula "umsebenzi obuncipheko" umsebenzi wesondo ukuya kwithuba lokusuleleka.
Ukuba unokungabaza malunga neqabane lakho lezesondo, kwaye ukuba unamaqabane amaninzi ezesondo, musa ukuthatha ithuba. Sebenzisa iikhondom kunye naziphi na izixhobo zokukhusela ukuzikhusela wena kunye neqabane lakho.
> Imithombo:
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> Patel, E .; Kirkpatrick, A .; Grabowski, M .; okqhubekayo. Ukusebenza kwe-Penile Immune and Risk of Shedding of HIV: A Study Out of the Cohort. " Iiklinikhi ezingenayo. 2017; 64 (6): 776-784.
> Spencer, L .; AmaKristuen, S; U-Wang, uC. I-Journal ye-Immune Deficiency Syndromes. 2016; 71 (2): 155-162.
> Cottrell, M .; Yang, K .; INkosana, H .; okqhubekayo. "Ukuqulunqa izicwangciso zokulandelwa kweTruvada PrEP ngokuphumelelayo kunye nomzekelo we-PK-PD ovelisa ama-metabolites asebenzayo kunye ne-nucleotides endogene (EN)." Inkomfa yoPhando lwe-HIV; EKapa, eMzantsi Afrika; Oktobha 28-31 2014; yomlomo ongabonakaliyo 22.06 LB.
> Teyssier, L .; Suzan-Monti, M .; Castro, D. "I-PrEP kunye neComm Usetyenziso lwe-MSM ephezulu kwi-ANRS IPERGAY Trial." INgqungquthela yeeRevrovirus kunye nezifo ezithintekayo (CROI); EBoston, eMassachusetts; NgoFebruwari 22-25, 2016; 887.