Chirwere cheBacterial Infection Chingave Chinouraya Mukuwedzera Kwirwere hweHIV
Mycobacterium avium complex, inozivikanwawo seMAC, chirwere chakakomba chebhakitiriya chinowanzoonekwa kuvanhu vane hutachiona hweHIV. Kunyange zvazvo chero munhu aigona kutapukirwa neCAC, zvirwere zvinongowanzopa kune avo vane maitiro ekudzivirira zvirwere zvakanyanya.
Saizvozvowo, MAC inoratidzirwa sehosha inofanirwa neAIDS , inobatsira chero kupi zvako kubva kune 20-40% yevanhu vane AIDS-inoshandiswa kuderedza zvirwere zvekudzivirira zvirwere zveAIDS kana kutora mishonga inodzivirira prophylactic.
MAC inowanzoenda kune yakawanda inowanzobata mapapu, kunyange mazhinji ehutachiona aya asingaoneki sehupenyu hunotyisa.
Zvisinei, apo CD4 count yemunhu inowira pasi pe50 cell / mL, MAC inogona kupfuura mapapu uye inosanganisira mamwe masangano makuru ehurumende, kusanganisira chiropa, spleen, uye marora. Ikozvino apo kutapurika kweMAC kunogona kuva kwakanyanya kuhupenyu hunopisa.
Ndezvipi Zviratidzo zveMAC?
Utachiona hweMAC hunowanzowanikwa mumapapu kana mumatumbo uye inogona kuwanana nehuwandu, kana huripo, zviratidzo. Zvisinei, apo inopararira (inopararira) kunze kwemapapu uye kupinda muropa, inogona kukonzera utachiona hwakapararira. Zviratidzo zvekutanga zveMAC zvakaparidzirwa zvinosanganisira:
- Fever
- Night sweats
- Chills
- Kuneta (kazhinji nokuda kwekushaya ropa)
- Diarrhea
- Kurasikirwa kweuviri (cachexia)
- Marwadzo emudumbu
MAC Inowanikwa Sei?
MAC chirwere chinowanikwa neongororo ye laboratory iyo inokwanisa kuona mabhakitiriya eMAC muzvikamu zveropa kana marora marora. Mafupa emasero emafuta anowanzobudiswa kubva muchiuno chemukoko ane nheyo, apo zviratidzo zveropa zvinounganidzwa muropa rinoswededzwa.
Semuenzaniso s zvinozogadzirwa mukuedzwa kwemashubhu kuti aone kana mabhakitiriya eMAC aripo kana kwete. Izvi zvinotora kumativi manomwe kwemazuva.
Vanhu Vanowana Sei MAC?
MAC zvipenyu zvinogara matipoteredza, kusanganisira ivhu, mune zvekudya, uye mumazuva ose emombe. Bhakitiriya reMAC inogona kuwanika mumhando zhinji dzemvura yekunwa, kusanganisira zvirongwa zvemvura zvinotapurirwa, uye kunyange mudziva remumba.
Saka, saka, zvakaoma zvikuru kudzivisa. Kune rumwe rutivi, MAC haifaniri kunge ichipfuura kubva kune mumwe munhu kumunhu.
Ndingadzivisa Sei MAC?
Sezvo kuregerera kweMAC kwakaoma kusingaiti, nzira yakanakisisa yekudzivirira zvirwere ndeyekuita kuti hutachiona hwemuviri hwako hurambe hwakasimba. Izvi zvakanakisisa zvakaitwa nekurapa HIV hutachiwana ne antiretroviral therapy (ART) . Kushandiswa kweART hakugoni kungoita kuti zvirwere zvenyu zvemasimba zvirambe zvakasimba, kuchengetedza ma CD4 akawandisa, inogona kudzorera zvirwere zvekudzivirira muviri kunyange kune vanhu vane mwero wekudzivirira muviri.
Pari zvino, ART inokurudzirwa kune vanhu vose vane HIV panguva yekuongororwa. Kutanga kuongororwa uye kurapwa hakuzoiti chete kudzivirira MAC nedzimwe zvirwere zvisingabatsiri, zvinosanganiswa nehupenyu hurefu uye hutachiwana hutachiona hweHIV uye husina HIV.
Mune vanhu vane HIV-positive vane maCD4 pasi pemakumi mashanu masero / mL, zvinodhaka zveprophylactic zuva nezuva zvinorayirwa kuti zvive nani kudzivirira kusimbiswa kweMAC. Mishonga inowanzoshandiswa inosanganisira:
- Clarithromycin, rudzi rwemishonga inorwisa mabhakitiriya inogona kukurumidza kujekesa MAC kubva muropa
- Azithromycin yakaonekwa seimwe nzira yakanaka kune clarithromycin
- Rifabutin, imwe nzira inobatsira (kunyange ichizivikanwa kuti inobatana nemamwe mishonga yeHIV)
MAC Inotarirwa Sei?
MAC chirwere chinowanzobatwa nekubatanidzwa kwe clarithromycin uye ethambutol , kana pasina rifabutin. ART ingadai yakatangwawo kune avo vasati vava kurapwa.
Zvisinei, kune vanhu vane maCD4 akawandisa, kune mukana wekuti zviratidzo zveMAC zvinogona kupera kana ART inotanga. Ichi ndicho chiitiko chinozivikanwa se "immune reconstitution inflammatory syndrome" (IRIS), iyo yakagadzirisa zvirwere zvekudzivirira zvirwere zvisinganzwisisiki, zvichiita kuti muviri wose unopesana nemhinduro. Kana izvi zvikaitika, corticosteroids inogona kurairwa kuti iite zviratidzo zve IRIS-zvinosangana kusvikira mushure momuviri wemusikirwo unowanzoita.
Kana imwe CD4 yemunhu inopfuura 100 masero / mL uye yakasimudzika pamusoro peyizinga kwemwedzi mitanhatu, kurapa kweprophylactic kunogona kumira.
Sources:
National Institutes of Health (NIH). "Nhungamiro Yekudzivirira uye Kurapwa Kwezvirwere Zvichida Mukurwara neHIV-Vakabatwa Vakuru Nevana Vachiri Kuyaruka - Vakaparadzirwa neMycobacterium Avium Complex Disease." Bethesda, Maryland; yakarongwa musi waMay 17, 2013.
US Preventive Services Task Force (USPSTF). "Kuchengetedzwa kweHIV: US Preventive Services Task Force Recommendation Statement." Rockville, Maryland; April 2013.
NIH. "Kutanga Antiretroviral Therapy Early Inovandudza Migumisiro yevanhu vanotapukirwa neHIV." Bethesda, Maryland; yakabudiswa musi waMay 27, 2015.