Mazano kubva kuU.S. Public Health Service
Muna 1996, US Public Health Service (USPHS) yakabudisa nhungamiro yekutanga yekushandisa ma antiretroviral drugs (ARVs) se -post-exposure prophylaxis (PEP) mumamiriro ekushanda kwehutachiwana hweHIV nevashandi vehutano (HCP).
MunaAugust 2013, USFS yakagadzirisa mazano echina, zvichivhura mazano avo pamusoro pekuwanikwa nekubudirira kwema ARVs matsva ekuzvarwa, pamwe chete nedzimwe nyaya dzekuchengetedza kwenguva refu dzema ARV dzakambotenderwa kushandiswa.
Pakati pekufungidzirwa kwebato rekuongorora:
- Kubudirira kwakakwana kwema ARVs
- Kushushikana uye zvinodhaka
- Kunyanya kushandisa zvinodhaka pamuviri uye pamuviri
- Piritsi mutoro uye nguva yakawanda yekuwedza
Kusarudzira Kuita Basa Rokushanda
Kuve nehutachiwana hweHIV pakati peHCP kunorondedzerwa sekuti inokuvadza kune imwechete (semuenzaniso, hosha yezvigunwe kana kutemerwa kubva kune chinhu chakakosha), kana kusangana nemucheka kana kuti kwete-yakagadzirwa ganda (sechichapped, abraded kana kutambura nedermatitis) neine HIV inotapukirwa neropa , mavara, kana zvimwe zvirwere zvemuviri zvinoonekwa sezviri kutapukira.
Izvi zvinosanganisira kuipa kwemvura, amniotic fluid, pericardial fluid (fluid kubva pamabhanhire akakomberedza kunzwa), synovial fluid (fluid kubva kumativi ose), muromo wemvura (fluid kubva pamakumbo akapoteredza mapapu); uye peritoneal fluid (kubvisa mvura kubva mukati mechipfuva chemuviri).
Zvisungo, zvinyararire, marara, jira, misodzi, urini uye marutsi hazvifungidziri kuti zvinogona kutapurirwa kunze kwekuonekwa kuine ropa.
Uyezve, kunyange kurira kwevanhu kunofanirwa kuongororwa pachavo, hakuna kumbove nezvinyorwa zvakanyorwa zvehutachiwana hweHIV kuburikidza nekurumwa kwevanhu munzvimbo yekuchengetwa kwehutano.
Kuchinja Kukuru muZvirevo zve USPHS
Nhungamiro yapfuura, yakabudiswa muna 2005, yakakurudzira kuti kuoma kwekutsvaga kuongororwe kuongororwa kusarudza kana kushandisa maviri kana akawanda maARV.
Iko kukurudzira kwakawa zvachose, uye USPHS ikozvino inotsigira kushandiswa kwematatu kana makumi maviri emishonga yeAIDS nokuda kwekusarudzwa kwebasa rose.
Aya mazano anongororwa anoratidza kuti kushandiswa kwechina-generation antigen / antibody test zvinogona kuderedza kushandiswa kwemashure ekurapwa kubva pamwedzi mitanhatu kusvika kumwedzi mina.
Kuratidzwa kweZvirevo
Muchiitiko chekushanda kwehutachiwana hweHIV:
- PEP inofanira kushandiswa pakarepo, zvakanaka mumaawa mashoma ekutsvaga. Nyanzvi yekukurukurirana inofanira kugara ichitsvaga, asi kwete pamutoro wekuregererwa kwerapi.
- Chiyero chekutanga che HIV chinozopiwa kugadzirisa hutachiona hweHIV hweHCP. Kana zvichikwanisika, hutachiona hweHIV hwomunhu anorwara hunofanira kunge huchitsvakwa kuti ubatsire kutungamirira kushandiswa kwakakodzera kwePEP.
- Zvitatu kana kupfuura zveARV zvingarongedzerwa, zvichienderana nekunakidzwa kwepasipiramu yakaitika uye purogiramu yakakodzera yekuita. (Ona Kukurudzirwa Drug Options , pasi apa.) Anozivikanwa kana kuti akafungidzirwa kuti pamuviri (kana kuyamwisa) yaizowedzera kusarudza kusarudzwa kwemishonga kune vamwe.
- Mukuwedzera kune hutachiona hwekutanga hweHIV, HCP inofanira kupiwa zvakakosha zvidzidzo zvebasa rekuongorora zvinodhaka zvinodhaka. Miedzo inofanira kusanganisira, zvishoma, ropa rakazara kuverenga (CBC), uye pamwe neutsvo uye chiropa chekushanda kwemashoko.
- PEP inotanga uye ichienderera mberi kwemazuva makumi mana. Kutanga kurapa mazano ekupa mazano kunofanirwa kupiwa kuitira kutarisa zvakakodzera kutengesa , zvinogona kuitika pamigumisiro, uye zvinogona kuitika pakubatana kwemishonga.
- Kuchengetedza zvigadziro kunofanira kutanga mukati maawa makumi manomwe nemaviri ekutsvaga, uye kunosanganisira kutevera kuongororwa kwe HIV nekupa mazano. Chechi yechipiri yekuongororwa kwezvinodhaka zvezvinodhaka zvinofanira kuitwa mumavhiki maviri.
- Zvadaro, kuongororwa kweHIV kunofanirwa kuitwa pamavhiki matanhatu, vhiki gumi nembiri, uye mwedzi mitanhatu mushure mekunge vatarise. Kana chikamu chechina chinosangana neHIV p24 antigen / HIV anti-antibody chinoshandiswa, kuongorora kutevedza kunogona kuitwa pamasvondo matanhatu uye mwedzi mina mushure mekutsvaga.
Yakakurudzirwa Drug Options
IU USPHS inokurudzira kushandiswa kweViread (tenofovir) uye Emtriva (emtricitabine) -kubatanidzwa kwemishonga miviri mukugadzirisa imwe-mapiritsi, Truvada -plus Isentress (raltegravir) yePEP muzviitiko zvehupenyu hwekushanda.
Zvimwe zvinodhaka zvemishonga iyi zvinogona kushandiswa mukuitika kwechirwere chechirwere chechirwere kana zvimwe zviitiko zvinogona kupesana nekushandiswa kwemishonga yakataurwa.
Viramune (nevirapine) haifaniri kutongororwa kuti iwane PEP, asi maARV haasati akurudzirwa kuti PEP irege kudziviswa. Izvi zvinosanganisira Videx (didanosine) uye Aptivus (tipranavir), pamwe nekubatanidzwa kweZerit (stavudine) uye Videx.
> Kwakabva:
> Kuhar, D .; Henderson, D .; Struble, K .; et al. "Yakavandudzwa kuU.S. Public Health Service Guidelines for the Management of Occupational Exposures to Human Immunodeficiency Virus uye Zvirongwa zvePostexposure Prophylaxis." Chirwere Chetachiona uye Chipatara Epidemiology. August 6, 2013; 34 (9): 875-892.