Isikhokelo seLayman sokuqonda ukuhlolwa koGawulayo kwiintsana
Ukuvavanya kwe-HIV kwiintsana kunye nabantwana abaselula (ubuncinane kwiinyanga ezili-18 okanye ngaphantsi) kuyahluka kakhulu ukusuka kwindlela abadala abavavanywa ngayo. Kunokuba uvavanyo lwe-antibodies ze-HIV (iprotheni eveliswa ngumzimba wamasosha phambi koGawulayo ), oogqirha baya kuhlola uqobo lwe-HIV usebenzisa oko kubizwa ngokuba yi- qualitative viral test .
Oku kwahluke kwizilingo zentsholongwane ye-viral (aka "umthamo wentsholongwane") esetyenziselwa ukulinganisa i-HIV kumntu wegazi.
Kunoko, uvavanyo lwekhwalithi luqinisekisa ukuba intsholongwane ikhona okanye ayikho.
Uvavanyo lwe-Antibody , olubandakanya iimvavanyo zentsholongwane ezintsha, alukwazi ukusulela usuleleko lwe-HIV kwiintsana kuba iintsholongwane zingabonwa ngumama-zidluliselwe ukusuka kumama ukuya kumntwana nge-placenta ngexesha lokukhulelwa. Kubalulekile ke ngoko ukuqonda ukuba ubukho beli "anti" ezibonakaliswayo alubonakali ukusuleleka ngoGawulayo. Ngokuqhelekileyo, iintsholongwane zomama ziya kupheka ngokukhawuleza, ngokuqhelekileyo xa umntwana eneminyaka eyi-14 ubudala (nangona ingaba ziphakamileyo ezinyangeni ezingama-24).
Ukuze kuncitshiswe umngcipheko wokusuleleka, iintsana zifakwe ngokuqhelekileyo kwinkqubo yokukhusela (prophylactic) yezidakamizwa ze- antiretroviral kwisithuba seveki ezine ukuya ezintandathu. E-US nakumazwe amaninzi athuthukileyo, izikhokelo zokukhulelwa zincoma ukuba ukunyelwa kwengcipheko kuphephe ukukhusela ukuhanjiswa kwentsholongwane kaGawulayo ngokusebenzisa ubisi lwebele.
Iimvavanyo ze-HIV ezisetyenzisiweyo kwiintsana nabantwana
Izilingo ze-virologic ezisetyenziselwa iintsana zinokuba yi- polymase-reaction response (PCR) ebizwa ngokuba yi- polymerase chain (i-PCR) , ebonisa ukuba khona kwe-HIV DNA, okanye isilingo se-HIV RNA, esichaza ngokucacileyo i-RNA ye-HIV.
Nangona i-specificity of each of these tests is high ngexesha lokuzalwa, ukuqonda kwabo (ukukwazi ukuchonga ngokuchanekileyo i-HIV) kunokuba kubephantsi kwi-55% ye-PCR kunye ne-25% ye-HIV RNA.
Nangona kunjalo, ngelixa ixesha elitsha liza kufika kwiinyanga ezintathu, ukuchaneka kweemvavanyo ngokubanzi kufikelela kwi-100%.
Kwiimeko ezithile, iimvavanyo zentsholongwane kaGawulayo zingasetyenziselwa abantwana phakathi kweminyaka eyi-6 neye-18 ukukhuphela ngokuqinisekileyo ukusuleleka koGawulayo. Nangona kunjalo, akufanele isetyenziswe ukuqinisekisa ukusuleleka ngu-HIV ngenxa yokukhathazeka malunga namanqatha omzimba asele.
Ukuqinisekiswa kosuleleko lwe-HIV kufuneka kusekelwe kwiziphumo ezibini zokuvavanya ezithathwe kwiisampula zegazi ezahlukileyo.
Ngokwahlukileyo, iimvavanyo ezintle zibhekwa njengento echanekileyo ngokusekelwe kuyo
- Izilingo ezimbini okanye ngaphezulu ezingenangxaki ze-virologic ezithatha inyanga enye neenyanga ezine, okanye;
- Iimvavanyo ezimbini ezichasayo zokukhusela i-sampuli ezithathwe kwiisampuli zegazi ezahlukileyo kubantwana abangaphezu kweenyanga ezintandathu.
Kubantwana abangaphezu kweenyanga ezili-18, izikhokelo zokuhlola i-HIV eziqhelekileyo ziyasebenza.
Iintsana zokuvavanya ukuya kwiinyanga ezili-6 zobudala
Ngenxa yokunciphisa iimvavanyo ngexesha lokuzalwa, iintsana ezityhila nge-HIV zivame ukuvavanywa kwiintsuku ezili-14 ukuya kwezingama-21, emva kweenyanga ukuya kwiinyanga ezimbini, kwaye ekupheleni kweenyanga ezine ukuya ezintandathu.
Ngeveki ezimbini, uvelwano lweemvavanyo luphucula ngokukhawuleza. Ukuba umphumo omuhle kuboniswe kwiintsuku eziyi-14 ukuya kwezingama-21, oogqirha baya kuqhuba ngokukhawuleza uvavanyo lwesibini lokuqinisekisa. Ukuba ngaba, oogqirha babeza kuqalisa unyango lwe-antiretroviral yexesha elipheleleyo kubantwana abaneminyaka eyi-12 okanye ngaphantsi.
Kubantwana abangaphezu kweminyaka eyi-12, ukuqaliswa kuya kuqulunqwa ngokusekelwe kwimeko yekliniki yengane kunye nexabiso le- CD4 / viral load values.
Nangona kunjalo, ukuba uvavanyo luyingozi emva kweentsuku ezili-14 ukuya kwezi-21, uvavanyo lwesibini luya kwenziwa ezimbini kwiiveki ezintandathu emva kokuphelisa unyango lweprophylactic. Uvavanyo lwesibini olungalunganga kule nqanaba luya kubonisa ukuba umntwana uyazikhusela. Ingxaki yesibini kwiinyanga ezine ukuya ezintandathu yayiza kuthathwa njengoluhlu oluthile lokuxilongwa.
Ukuvavanya abantwana phakathi kwe-Ages ye-Six kunye neenyanga ezili-18
Uvavanyo lwe-Antibody lungasetyenziswa kubantwana abangaphezu kweenyanga ezintandathu ukuya kwiinyanga ezili-18.
Ngokuqhelekileyo, ukuvavanywa kweemvavanyo ezimbi ezimbini ezinyangeni ezintandathu ukuya kwezi-12 zanele ukuba zithathwe njengento echanekileyo. Nangona kunjalo, oogqirha banqwenela ukuvavanya phakathi kweenyanga ezili-12 ukuya kwezi-18 ukuqinisekisa ukuba zonke iintsholongwane zomama zinyamalala.
Ukuvavanywa okuqhubekayo kunokubonakaliswa kwiimeko ezizodwa, njengabantwana abancinciweyo okanye abasetyhini abasetyhini abasalindelekileyo. (Olunye uphando lubonise ukuba ukufikelela kwi-14% yabantwana banesifo se-HIV esasalayo emva kweenyanga ezingama-24 emva kokuzalwa.)
Ukuvavanya iintsana eziphezulu zeengozi ekuzalweni
Iintsana zijongene nomngcipheko ophezulu wokusuleleka (umzekelo, oomama abangazange bathathe unyango lwe-antiretroviral ngexesha lokukhulelwa okanye banikezela ngesifo esichukumisayo ) banokuvavanywa xa bezalwa ngenxa yokuba amathuba okusuleleka kakhulu. Kule qela, phakathi kwe-30% kunye no-40% ye-infections ingaqinisekiswa kwiiyure ezingama-48 emva kokuzalwa. Kwiimeko ezinjalo, unyango lweprophylactic luya kugcinwa kwaye unyango olupheleleyo luya kuqalwa.
Imithombo:
ISebe lezeMpilo leSebe lezeMpilo (DHHS). "Izikhokelo Zokusetyenziswa Kwee-Antiretroviral Agents kwi-Pediatric Infection Infection: Ukuxilongwa kweNtsholongwane kaGawulayo kwiintsana nabantwana." Rockville, Maryland; hlaziywa ngoFebruwari 12, 2014; fi kelele ngo-Apreli 14, 2014.
Gutierrez, M; Ludwig, D .; Khan, S; okqhubekayo. "Ngaba unyango olukhuselekileyo lwe-antiretroviral unyango lwandise ixesha lokusebenzisa i-seroreversion kwi-HIV ekhutshwe kodwa abantwana abangakhuselekanga?" Izifo ezithathelwanayo zonyango . Novemba 2012; 55 (9): 1255-1261.