Iingcebiso ezivela kwiNkonzo kaRhulumente yezeMpilo yase-US
Ngo-1996, i-US Public Health Service (USPHS) yanikezela isikhokelo sokuqala malunga nokusetyenziswa kwezidakamizwa ze-antiretroviral (ii-ARVs) njenge- post-exposure prophylaxis (PEP) kwiimeko zokungena kwi-HIV ngabasebenzi bezempilo (HCP).
Ngo-Agasti 2013, i-USPHS ihlaziye izikhokelo zexesha lesine, isekelwe iingcebiso zabo malunga nokufumaneka kunye nokusebenza kwezixhobo ze-ARVs ezitsha, kwakunye nolwazi olufikeleleko kwixesha elide lokukhusela ii-ARVs ezivunywe ngaphambili.
Phakathi kweengqwalasela zepaneli yokuhlaziya:
- Ukusebenza ngokubanzi kwama-ARV omviwa
- Ukunyanzeliswa kunye neetyhefu
- Ukhuseleko lweziyobisi ngexesha lokukhulelwa kunye ngexesha lokukhulelwa
- Umthwalo wepilisi kunye nokuphindaphinda kwama-dosing
Ukucacisa ukuValiswa koMsebenzi
Ukubonakaliswa kwe-HIV phakathi kwe-HCP kuchazwa njengento eyingozi yodwa (umzekelo, i- needletick okanye igawulwe kwinto ebukhali), okanye udibaniselwano lwekhanda lomlenze okanye isikhumba esingenakunyaka (umz. , izicubu, okanye ezinye izifo zomzimba ezinokuthathwa njengezifo.
Ezi ziquka i-cerebrospinal fluid, i-amniotic fluid, i-pericardial fluid (i-fluid esuka kumlenze ojikeleze i-hear), i-synovial fluid (i-fluid evela kumacandelo onke), i-pleural fluid (i-fluid esuka kwiimbumba ezijikeleze imiphunga); kunye ne-peritoneal fluid (i-lubricating fluids ukusuka ngaphakathi kwesisu esiswini).
Izibonda, izifihla zamanzi, i-salive, i-sputum, i-sweat, iinyembezi, umchamo kunye nokuhlanza azicingelwa ukuba zichaphazeleke ngaphandle kokuba zibonakala zigazini.
Ngaphezu koko, ngelixa ukubetha kwabantu kufuneka kuhlolwe ngabanye, akuzange kubekho amaphepha afakwe kwi-HIV ngokudluliselwa kwabantu kwiindawo zokunakekelwa kwezempilo.
Iinguqu eziphambili kwiikhokelo ze-USPHS
Izikhokelo zangaphambili, ezikhutshwe ngo-2005, zacetyiswa ukuba ubunzima bokungcola bahlolwe ukuba baqeshwe ukuba baqeshe ii-ARV okanye ezimbini.
Esi sincomo siphelile ngokupheleleyo, kwaye i-USPHS ngoku ivumela ukusetyenziswa kwee-ARVs ezintathu okanye ngaphezulu kuzo zonke iindawo zokungabikho emsebenzini.
Izikhokelo ezihlaziyiweyo zibonisa ukuba ukusetyenziswa kwesilingo sesine-antigen / antibody test kunganciphisa ixesha lokuvavanya emva kokunyanga kwinyanga ezintandathu ukuya kwiinyanga ezine.
Ubume beZikhokelo
Xa kwenzeka ukufumaneka kwe-HIV:
- I-PEP ifanele iphunyezwe ngokukhawuleza, ngokufanelekileyo kwiiyure ezili-hours. Ukubonisana ngongcali kufuneka kuhlale kufunwa, kodwa kungekhona kwindleko yokulibazisa unyango.
- Uvavanyo olusisiseko lwe- HIV luya kunikwa ukuba lunqume isimo se-HIV se-HCP. Xa kunokwenzeka, imeko ye-HIV yomthombo wesigulane kufuneka ifune ukukunceda ukukhokela ukusetyenziswa okufanelekileyo kwe-PEP.
- Ama-ARVs amathathu okanye ngaphezulu aya kunikwa, ngokusekelwe kwiprofayili yempembelelo yecala kunye neshedyuli efanelekileyo yokulandelela. (Jonga iinkqubo ezixhaswayo zeDrug , ngezansi.) Uyaziwa okanye ukhunjulwa ukukhulelwa (okanye ukuncelisa) kuya kuqhubeka ukukhetha ukhetho lwezidakamizwa kwezinye.
- Ukongeza kwinqanaba lokuhlola uvavanyo lwe-HIV, i-HCP kufuneka inikezelwe iimvavanyo zebhanki eziyimfuneko ukuba zikulindele ukutywala iziyobisi. Iimvavanyo kufuneka zibandakanye, ubuncinci, inani legazi elipheleleyo (CBC), kwakunye neesilingo zomsebenzi wezintso kunye nesibindi.
- I-PEP iya kuqala kwaye iqhubeke kwikhosi yeentsuku ezingama-28. Ukucetyiswa kwangaphambili kwonyango kufuneka kunikezelwe ukulungisa ukulandelelana okufanelekileyo , iziphumo ezichaphazelekayo kunye nokusetyenziswa kwamachiza okunokwenzeka.
- Ukuqokwa kwabafundi kufuneka kuqalwe kwiiyure ezingama-72 zokungcola, kwaye kubandakanye ukuhlolwa kovavanyo lwe-HIV kunye nokucebisa. Ukubekwa kweliso lesibini kweeyobisi kufuneka kwenziwe kwiveki ezimbini.
- Emva koko, uvavanyo lwe-HIV lufanele lwenziwe kwiiveki ezintandathu, iiveki ezili-12, kunye neenyanga ezintandathu emva kokuvezwa. Ukuba isisombululo sesine-HIV yesifo se-HIV ip24 yesifo se-antigen / sentsholongwane kaGawulayo sisetyenzisiwe, ukuhlolwa okulandelelanayo kunokwenziwa kwiiveki ezintandathu kunye neenyanga ezine emva kokuvezwa.
Izinketho zeDrug ezikhuthaziweyo
I-USPHS icebisa ukusebenzisa i-Viread (tenofovir) kunye ne-Emtriva (emtricitabine) -kunxulumene namachiza amabini kwindlela yokwenza iipilisi enye, i- Truvada -plus Isentress (raltegravir) ye-PEP kwiziganeko zokungabikho emsebenzini.
Ezinye iindlela zokusebenzisa iziyobisi zingasetyenziselwa xa kwenzeka isifo se-renal okanye ezinye iimeko ezingaphikisana nokusetyenziswa kweziyeza ezicetywayo.
I-Viramune (i-nevirapine) ayifanele ifakwe kwi-PEP, ngelixa i-ARVs ingaxhaswa rhoqo ukuba i-PEP ifanele igwenywe. Ezi ziquka iVidex (didanosine) ne- Aptivus (tipranavir), kwakunye nokudibanisa kweZerit (stavudine) kunye neVidex.
> Umthombo:
> Kuhar, D .; Henderson, D .; I-Struble, K .; okqhubekayo. "Ukuhlaziywa kweZikhokelo zeeNkonzo zeMpilo zoLuntu ze-US zoLawulo lweeMisebenzi yokuHlaba kweeMpilo kwi-Human Immunodeficiency Virus kunye neNcomelo zePostexposure Prophylaxis." Ulawulo lwe-Infection kunye ne-Epidemiology yezibhedlele. Agasti 6, 2013; 34 (9): 875-892.