Ulwaphulo-mali kodwa luhlala luqhelekileyo kubantu abane-HIV
Inkathazo ye-AIDS (ADC), eyaziwa ngokuba yi-HIV encephalopathy, yintlupheko yengqondo ebangelwa yi- HIV . Yimimiselo echazwe ngamaziko okuLawula nokuLawula (i-CDC) njenge- AIDS-defining condition kwaye ibonakalisa ukungonakaliswa komsebenzi wokuqonda, umqhubi kunye nokuziphatha, iimpawu ezingabandakanya:
- iingxaki zeememori kunye neengxaki
- nciphisa impendulo yengqondo kunye / okanye yengqondo
- iinguqu zokuziphatha
- kunciphisa amandla / ubuthathaka
- ukulahlekelwa kwezakhono ezifanelekileyo zezithuthi (umz.
- ukulahleka kokuhamba
- ngqondweni
I-Dementia ichazwa njengokuba kunokuphazamiseka okuqhubekayo kweenkqubo zengqondo eziphawulwe yintshintsho yobuntu, ukuphazamiseka kwememori kunye nokucinga okungahambi kakuhle.
Izizathu ze-AIDS Dementia
I-ADC ivame ukuvela kwizifo eziphambili xa isibalo se-CD4 yesigulane singaphantsi kweeseli ezingama-200 / μl kwaye ngokuqhelekileyo sihamba kunye nomthamo omkhulu wentsholongwane.
Ngokungafani neemeko ezininzi ezichazwa nguGawulayo, i-ADC ayiyintsholongwane enomdla ngokubhekiselele ekubeni imeko leyo ibangelwa yi-HIV ngokwayo. Uphando lubonisa ukuba iiseli zegazi ezimhlophe ezine-HIV zibizwa ngokuba yi- macrophages kunye neeseli zesisongomthi ezibizwa ngokuba yi-microglia secrete neurotoxins ezichaphazela kakubi ukukhula kunye novuthiweyo. Ngokuhamba kwexesha, oku kungakhokelela ekuguqweni komsebenzi we- synaptic (oko kukuthi ukuhanjiswa kolwazi phakathi kwe-neurons), kunye nokunciphisa ngokuthe ngqo ukufa kweselfowuni kwi-neurons.
Ukuchonga nokuPhatha i-AIDS Dementia
Akukho vavanyo olulodwa oluya kuqinisekisa ukuxilongwa kwe-HIV encephalopathy. Ukuxilongwa kwenziwa ngokubanzi ngokukhutshwa, ukulawula ezinye iimeko ezibangela ukukhubazeka. Uvavanyo olupheleleyo kufuneka lwenziwe ngunyango onolwazi, ukuhlola imbali yesigulane, iimvavanyo zebhabhi (umz. Ukugquma ), ukuhlolwa kwengqondo (iMRI, CT scan) , kunye nokuhlaziywa kwezinto ezibizwa ngokuba "iimpawu zesigaba."
Iziganeko zesigaba ziqikelela ubunzima bokukhubazeka kwisikali se-0 ukuya ku-4, ngale ndlela:
- Isigaba se-0: Umsebenzi oqhelekileyo kunye nomsebenzi wengqondo.
- Isigaba 0.5: Ukungasebenzi okuncinci kunye neengxaki eziqhelekileyo kunye namandla. Umntu unako ukusebenza kunye nokuqhuba rhoqo imihla ngemihla.
- Isigaba 1: Ukukhubazeka okusebenzayo kwemoto kunye / okanye izakhono zengqondo. Umntu usenokuhamba ngaphandle kokuncedwa kwaye aqhube yonke into kodwa yimfuneko kakhulu yemihla ngemihla.
- Isigaba sesi-2: Ayikwazi ukusebenza kunye neengxaki zokujamelana neengxaki ezinzima zobomi bemihla ngemihla. Nangona kunjalo, loo mntu usenako ukuzinakekela yena ngokwakhe kwaye uyakwazi ukuhamba (nangona ngezinye iinkxaso ngoncedo olulodwa).
- Isigaba sesi-3: Ukukhululeka kwengqondo kunye / okanye ukukhubazeka. Umntu akakwazi ukuzinakekela yena ngokwakhe.
- Isigaba sesi-4: kufuphi nommandla wezityalo.
Nangona ukubonakaliswa okugqithisileyo kwe-ADC kuye kwehla kakhulu kwinani ukususela ekufikeleleni kwe- antiretroviral therapy (ART) , ukukhubazeka okuncinci kwe-neurocognitive kungabonwa malunga neepesenti ezingama-30 zalabo abane-HIV engabonakaliyo kunye nama-50 ekhulwini abo abane-AIDS.
Ngokuqhelekileyo, umngcipheko we-ADC ubonakala uphakamileyo kubantu abangazange baphumelele ukunyanzeliswa kwegciwane, nangona unokuqhubeka kumaphesenti amathathu ukuya kuma-10 abo abanegciwane elilawulwa ngokupheleleyo.
Kucetyiswa ukuba ukungenelela kwangaphambili kwe-ART kunokulibazisa okanye ukunciphisa umngcipheko we-ADC.
Kulabo abanokukhubazeka okubangelwa yi-neurocognitive, i-ART yayiza kubandakanya izilwanyana ezimbini kunye nokungenelela kokungena kweengcambu zegazi. Izinketho ziquka i-nucleoside reverse transcriptase i-inhibitor-class class drugs Retrovir (AZT) kunye neZiagen (abacavir), kunye neprotease-inhibitor-class drug Crixivan (indinavir).
Kwaziwa njenge:
- I-HIV encephalopathy
- I-disorder-neurocognitive disorder (HIV)
- I-dementia echaphazelekayo ne-HIV (HAD)
> Imithombo:
> Heaton, K .; Isibonelelo, mna .; Iibhotela; okqhubekayo. "I-HNRC 500-i-Neuropsychology yokusuleleka kwi-HIV kwizigaba ezahlukeneyo zesifo." I-Journal ye-International Neuropsychological Society. NgoMeyi 1995: 1 (3), 231-251.
> Isibonelelo, mna .; Sacktor, N; McArthur, J .; okqhubekayo. "I-virus immunodeficiency virus-inxulumene neengxaki ze-neurocognitive: Cinga i-gap." Annals of Neurology. Juni 2010; 67 (6): 699-714.
> Robertson, K .; Smurzynski, M .; Iiparsons, T; okqhubekayo. "Ubuninzi kunye nesiganeko sokukhubazeka kwe-neurocognitive kwixesha le-HAART." AIDS. NgoSeptemba 12, 2007; 21 (14): 1915-1921.
> Tozzi, V .; Balestra, P .; Bellagamba, R .; okqhubekayo. "Ukunyamekela kweengxaki ze-Neuropsychologic nxamnye nexesha elide elijongene ne-Antiretroviral ye-Antiretroviral esebenzayo kwizigulane ezine-HIV ezinxulumene neNtsholongwane kaGawulayo. I-Journal ye-Immune Deficiency Syndromes. Juni 1, 2007; 45 (2): 174-182.
> Eden, A .; Ixabiso, R; Hagberg, L .; okqhubekayo. "Ukusinda akuqhelekanga kwizigulane ezinegciwane le-HIV kwi-ART ezinzile." INgqungquthela ye-17 kwi-Retroviruses kunye nezifo ezikhuselekileyo. ESan Francisco, eCalifornia; 2010.