Ukulinganisa Ubungozi Bantu Abaxhamliziwe Ngomzimba
Ngomhla wama-26 kuMeyi 2006, i-US Food and Drug Administration (i-FDA) ivume iSitostavax ukukhusela i- herpe zoster , isifo se-virus esibizwa ngokuba yi-shingles. Nangona ekuqaleni kwavunyelwa abantu abadala abadala nangaphezulu, kubandakanywa ngokukhethekileyo abo abane- HIV .
Ezi ngcebiso zagqitywa ngokutsha ngo-2011 ukuba zibandakanye abantu abadala 50 nangaphezulu ngelixa bengenzi iziphakamiso ezithile malunga nokusetyenziswa kwabo kulabo abane-HIV.
I-Zostavax ngumgomo wokugonywa ngokutsha, oku kuthetha ukuba yenziwe ngentsholongwane ephilayo, ebuthathaka. Ingumthamo omkhulu wegciwane lokukhupha i-inkukhu ngokuphindaphindiweyo ngamaxesha angama-14. Uphando luye lwabonisa ukuba i-Zostavax inokunciphisa umngcipheko weengqungquthela ngama-51 ekhulwini ngelixa kunciphisa ubunzima kunye nobude beqhekeza ngama-67 ekhulwini.
Iimbangela zeeNgqungquthela
Iingqungquthela zibonakaliswa ngokugqithwa okubuhlungu kunye ne-blister ebonakala kwibala okanye umgca kwelinye icala ubuso okanye umzimba. Kubangelwa ukusetyenziswa kwakhona kwegciwane le- varicella yoster virus (VZV) kubantu abadala ababekade benenkukhu.
Nangona intsholongwane ngokubanzi ilala ilala kwiiseli zesisondeza kufuphi nomgudu, ingabangela ukuqhuma xa ivuselelwa. Ukukhuphuka kwimixholongwane ethile, eyaziwa njenge- dermatome , ebeka isalathiso okanye ehlangothini lwesobunxele lomzimba.
Kuqikelelwa ukuba omnye kubantu abathathu behlabathi baya kuhlakulela iingqungquthela kwixesha lokuphila.
E-US, amacala angaphezu kwesigidi anikwa ingxelo ngonyaka. Umngcipheko weengqungquthela uyaziwa nangokunyuka njengomntu omdala, ngaphezu kokuphindwe kabini kwiminyaka engama-65.
Iingqungquthela kubantu abane-HIV
Ukuvuselelwa kwe-VZV kunokukwenzeka xa ukhuseleko lomzimba luphantsi. Oku kunokwenzeka njengomntu oneminyaka engama ubudala kodwa kwakhona xa ukusuleleka kwe-HIV kususa ii-cell phone ezibizwa ngokuba yi- CD4 T-cell .
Okukhulu ukulahlekelwa kwee-T-cell, enkulu ingozi yentsholongwane (ngokukodwa njengoko inani le- CD4 lihlahla ngaphantsi kwe-350). Imithwalo ephezulu yentsholongwane yentsholongwane nayo idibanisene nomngcipheko wokunyuka kwengcipheko.
Nangona unyango lwe-HIV luye lwaphazamisa iziganeko zentsholongwane kubantu abaphila ne-HIV phantse kwisithathu, umngcipheko uhlala ulingana nawabantu abangaphezu kweminyaka engama-65. Bonke baxelele, umngcipheko wokuqhawula nge-HIV unamaxesha angaphezu kwama-10 aphezulu luluntu jikelele.
Ukongezelela koko, ukusuleleka ngoGawulayo kudibaniswa nokuxhamla okunzima kwezibheno, kubandakanywa ukutshatyalaliswa kweentlobo (ezichaphazela ezintathu okanye ngaphezulu kweemermatomes), izibonda zamehlo okanye izitho zangaphakathi, okanye ukuphindaphinda kwiinyanga ezintandathu.
Uphando oluvela kwiYunivesithi yaseJohn Hopkins lucetyise ukuba amanqaku angama-28 abantu abane-HIV abaneengxaki zentsholongwane abaneengxaki zentsholongwane.
Iingcebiso kubantu abane-HIV
Ngoxa i-FDA engenzi iziphakamiso ezisemthethweni malunga nokusetyenziswa kweZostavax kubantu abane-HIV (ngaphandle kokuthi abantu "abanokukhubazeka ngamasosha" kufuneka bakuphephe). kukho ubungqina obuninzi bokuxhasa ukusetyenziswa kwayo.
Ngonyaka ka-2012, izazinzulu ngeqela elide elijongene ne-AIDS Clinical Trials ligqibezela ukuba i-Zostavax ikhuselekile kwaye isebenze kubantu abaneengxelo ze-CD4 ezingaphantsi kwama-200.
Ngelixa iziphumo zikhuthaza, abaninzi bahlala benenkxalabo malunga nendawo yonke yokugonya kubantu abanama-CD4 amanqaku angaphantsi kwama-200. Njenge-vaccine ephilayo, kusekho inokwenzeka ukuba nokuba i-virus ephosakeleyo ingabangela ukuba ugula lube lukhuselwe.
Nangona amaziko okuLawula nokuVimbela ayengakhuthazisi okwangoku i-Zostavax kubantu abane-HIV, umbono weklinikhi ubonakala uguquka. Iingcali ezininzi ezichaphazelekayo zixhasa ukusetyenziswa kweZostavax kubantu abadala abane-HIV abaneminyaka engama-50 nangaphezulu abaye balondoloza umthamo wentsholongwane engabonakaliyo kunye ne-CD4 count ngaphezu kwama-200. Ngendlela efanayo, abaninzi bavuma ukuba i-Zostavax ayifanele isetyenziswe kubantu abanama-CD4 angaphantsi kwama-200 .
I-Zostavax kufuneka igwenywe kubantu abangenawo umlando wenkukhu okanye ubungqina be-antibodies VZV. Kwaba bantu, kuphela ukugonywa kwenkukhu ye-inkukhu (njenge-Varivax okanye i-Varilrix) kufuneka isetyenziswe.
> Imithombo:
> Ulawulo lweZiko lokuTya kunye neDrug. "I-FDA ivumela isitofu sokugonya i-Zostavax ukukhusela izibonda kubantu abaneminyaka engama-50 ukuya kwe-59 ubudala." Silver Spring, eMaryn; kukhutshwa ngoMeyi 24, 2011.
> Iibhloko, uL .; Polydefkis, M .; UMorey, uRa et al. "I-Herpes zoster phakathi kwabantu abaphila ne-HIV kwixesha elikhoyo lokunyango lwe-antiretroviral." I-Journal ye-Immune Deficiency Syndromes. Oktobha 1, 2012; 61 (2): 203-207. INGXELO: 10.1097 / QAI.0b013e318266cd3c.
> Benson, C .; Hua, L .; Andersen, J .; okqhubekayo. "I-ZOSTAVAX ngokubanzi ikhuselekile kwaye i-immunogenic e-HIV + yabantu abadala bancitshiswa ngokugqithiseleyo kwi-ART: iziphumo ze > isigaba > 2, i-randomized, i-double-blind, test-controlled trial." INgqungquthela ye-19 kwi-Retroviruses kunye neeNtsholongwane eziKhuselekileyo (CROI); Seattle, Washington; Matshi 5-8, 2012; ezingabonakaliyo 96.