Intsholongwane ye-immunodeficiency virus (HIV) iyintsholongwane echaphazela kwaye ichithe iintlobo ezithile zeeseli ezimhlophe zegazi ( CD4 + T-cells ) kubantu. Ukulahlekelwa kwala maseli egazi ezimhlophe kukukhokelela ekuphuhliseni izifo ezahlukeneyo, umdlavuza kunye nezinye iingxaki zomzimba. Namhlanje, kukho abantu abangaphezu kwezigidi ezingama-30 emhlabeni jikelele abaphila noGawulayo, kunye ne-1 yezigidi zabantu abahlala eMelika.
Xa i-HIV yabonakala kuqala ekuqaleni kweya-1980, isifo siphumelele ngokukhawuleza ukuya kwi- immunodeficiency syndrome (i-AIDS) kubantu abaninzi abasulelekileyo. Ngethuba lama-1990, ukuzisa imishanguzo eyahlukeneyo ye- anti- antipiral yanciphisa okanye yathintela ukuqhubela phambili kosulelo lwe-HIV kwi-AIDS. Abantu abane-HIV bahlala ixesha elide kwaye bahlakulela ezinye izifo ezingapheliyo eziqhelekileyo kubantu abanentsholongwane kaGawulayo, njengezifo ezahlukahlukeneyo.
Ngaba abantu abanentsholongwane kaGawulayo bafumana izilwanyana ezininzi?
Abantu abanentsholongwane kaGawulayo bayaziwa ukuba banamanqanaba aphakamileyo aphikisayo (IgE) , ngokukodwa njengoko amanqanaba e-CD4 + T-cell ehla. Ezi nqanaba eziphezulu ze-IgE azibonakali ukuba zibonisa ukunyuka kobuthathaka , nangona kunjalo, kodwa mhlawumbi zibonakalisa ukwanda kwe-immunodeficiency ngenxa ye- B-cell dysfunction. Amagciwane anesifo se-IgE ajoliswe kwiimpawu eziphathekayo ezahlukeneyo (kuquka i-HIV), kunokuba zichasene nezifo.
Abantu abanentsholongwane kaGawulayo bafumana amazinga aphakamileyo eemeko, nangona kunjalo, kubandakanywa i -rhinitis ye-allergen (hay fever) , ukunyuka kweziyobisi kunye ne- asthma .
Oku kungakho ngenxa yokuphazamiseka kwinqanaba le-immune system, oku kungakhokelela ekulahlekelweni kweendlela eziqhelekileyo zokulawulwa kwezifo, kunye nezinye iimpawu zesifo esichaphazelekayo.
I-Hay Fever kubantu abane-HIV
Abantu abanentsholongwane kaGawulayo babonisa imilinganiselo ephakamileyo yempawu zamanzi, kunye nezifundo ezibonisa ukuba zi-66% zikhalaza ngeempawu zengxaki ze- nasal and more than one-third of HIV hospitals having evidence of sinusitis .
Izifundo ezahlukahlukeneyo zibonisa ukuba abantu abanesifo se-HIV banamazinga aphakamileyo okufumana iziphumo zokuvavanywa kwesikhumba , xa kuthelekiswa nabantu abangenayo intsholongwane kaGawulayo.
I-Treatin g i-rhinitis ye-allergen kubantu abanentsholongwane kaGawulayo iyafana nabantu abangenayo i-HIV. Ukuba ukuphepha ukukhusela i- allergen akunakwenzeka, unyango lwe- antihistamines yomlomo , i- nasal steroid sprays kunye namanye amachiza angamayeza angasetyenziswa ngokukhuselekileyo. I-Allergen immunotherapy , okanye ukutshatyalaliswa kwezinto zokungabikho komzimba , inokuphikisana nabantu abanentsholongwane kaGawulayo ukususela kwimiphumo yesikhathi eside yokuvuselela i-immune system ngokusebenzisa i-immunotherapy abaziwayo kubantu abane-HIV.
Ukusetyenziswa kwezidakamizwa kubantu abane-HIV
Abantu abanentsholongwane kaGawulayo banamazinga aphakamileyo okwenyuka kwezidakamizwa, mhlawumbi ngenxa yokuphazamisa imimiselo yesistim yokuzivikela. Oku kuyinyaniso ngokukhethekileyo kwi-trimethoprim-sulfamethoxazole (TMP-SMX), okuyi -antibiotics ene-sulfa . Izimpembelelo ezingalunganga kwi-TMP-SMX zenzeke ngaphezu kwesigamu se-HIV abantu abanesifo (xa kuthelekiswa nabangaphantsi kwe-10% yabantu abangenayo i-HIV). Ngethamsanqa, ukuchithwa kweenjongo ze-TMP-SMX ukungabikho komzimba kudlaleleka, okufunekayo ukukhusela nokuphatha unyango oluqhelekileyo kubantu abane-HIV.
Omnye udla ngokubonakalayo kwezidakamizwa ezibangelwa yi-HIV yi-abacavir.
Abacavir yi- nucleoside reverse transcriptase inhibitor enokubangela ukuba ubomi obusongela ubomi be-hypersensitive reaction kwi-5-8% yabantu abane-HIV. Kukho ukuhlaziywa kwezinto eziphathekayo kwi-abacavir hypersensitivity ekufuneka ihlolwe ngayo kunye nokusetyenziswa kwegazi ngaphambi kokuba umntu athathe abacavir. Ukuba umntu akanalo umzi onxulumene nokuphendula, i-abacavir ingathathwa ngokukhuselekileyo.
Isifo se-asthma kubantu abane-HIV
Ukunyangwa kosulelo lwe-HIV ngemishanguzo ye-anti-anti-inflammation kuye kwabangela ukwanda kweengxaki zemiphunga ezibonwa kwezi zi gulane. Amadoda aphethwe yi-HIV aboniswe kwizifundo ukuba abe namazinga aphakamileyo ahambayo ngokuthelekiswa nabantu abangenayo intsholongwane kaGawulayo, ingakumbi kulabo bashiya imveliso yecuba.
Abantwana abanesifo sengculaza abafumana imishanguzo ye-anti-virus bayabonisa ukunyuka kwamazinga e-asthma xa kuthelekiswa nabantwana abanesifo se-HIV abangathathi unyango lwe-anti-virus.
Ezi zifundo zibonisa ukuba abantu abanentsholongwane kaGawulayo banokuchaphazeleka ngokukodwa kwimiphumo evuthayo yocuba, kwaye ukusetyenziswa kweyeza-antiviral ekunakekeleni i-HIV kukhusela ukulahlekelwa ngumzimba wokuzikhusela komzimba, okwenyusa umngcipheko weemeko eziphazamisayo, ezifana ne-asthma. Ukunyangwa kwesifo se-asthma kubantu abane-HIV bafana noko kubantu abanentsholongwane kaGawulayo, nangona i- corticosteroids yomlomo kufuneka igwenywe xa kunokwenzeka, ngenxa yempembelelo yokunyusa kwi-immune system.
Umthombo:
Stokes SC, iTankersley MS. Intsholongwane kaGawulayo: Impembelelo eSebenzayo yoLwazi lwe-Allergist-Immunologist. Ann Annistry Asthma Immunol. 2011; 107: 1-8.