Kuchechera Njodzi Muvanhu VemuAfune Vakagadziriswa
Musi waMay 26, 2006, US Food and Drug Administration (FDA) yakabvumira chirwere cheZostavax kudzivirira herpes zoster , chirwere chetachiona chinowanzonzi shingles. Kunyange zvazvo pakutanga kwaibvumirwa kune vanhu vakuru 60 nekure, yakanyatsosanganisira avo vane HIV .
Izvo zvinorayirwa zvakazogadziriswa muna 2011 kuti zvive nevarume vakuru 50 nevekare kana vasingatauri mazano anotaura nezvekushandiswa kwevaya vane HIV.
Zostavax chirwere chinoraramira, chinoreva kuti chakaitwa nehupenyu hwehutachiona husina simba. Iko chirwere chakakura chekuvhara chickenpox inenge nguva 14 iyo potency. Kutsvakurudza kwakaratidza kuti Zostavax inogona kuderedza dambudziko rekushaya zvipembenene ne 51 muzana panguva yekuderedza kukwirira uye nguva yekusangana ne 67 muzana.
Zvinokonzera Shingles
Shingles inoratidzwa nekuputika kunorwadza ne blisters iyo inowanikwa mubhande kana ruvara kune rumwe rutivi chiso kana muviri. Inokonzerwa nekugadziriswa kwevaricella zoster virus (VZV) kune vanhu vakuru vaimbova nehokupox.
Kunyange zvazvo hutachiona hunoti hunova hwakanyanya pamasero emasero pedyo nepamusoro pemusana, zvinogona kukonzera kuputika paunoshandiswazve. Kuputika kunomanikidzwa kune imwe nhayo midzi, inozivikanwa sedermatome , iyo inowira kuruboshwe kana kuruboshwe rwemuviri.
Inofungidzirwa kuti mumwe wevanhu vatatu munyika yose achaita shingles pamusoro pehupenyu hwose.
MuUnited States, mamiriyoni anopfuura mamiriyoni anotaurirwa gore negore. Dambudziko rekukwikwidza rinozivikanwa kuti rinowedzera semunhu ane makore, kupfuura kudarika kaviri nezera remakore makumi matanhatu nemashanu.
Shingles muvanhu vane HIV
VZV reactivation inogona kuitika kana munhu akadzivirirwa nemaviri. Izvi zvinogona kuitika semunhu ane makore asiwo kana hutachiona hweHIV huchibvisa masero ezvirwere mumuviri anonzi CD4 T-cells .
Iyo yakakura kurasikirwa kweT-cells, iyo inowedzera shingles ngozi (kunyanya sezvo CD4 count inodonha pasi pe 350). Mahombekombe makuru ehutachiona akabatanidzwawo nekuwedzera shingles ngozi.
Kunyange zvazvo kurapwa kweHIV kwakaita kuti vanhu vagara nehutachiwana hweHIV vasvike nechetatu, njodzi inoramba iri yakaenzana neyevanhu vakuru vanopfuura 65. Vose vakataurira, dambudziko rekukwikwidza neHIV rinowedzera ka10 pane rimwe vanhu vakawanda.
Uyezve, hutachiona hweHIV hunobatanidza nehuwandu hwehutano hwemakumbo, kusanganisira kuparidzirwa shingles (inobata zvitatu kana kupfuura mamwe madermomomes), shingles emaziso kana nhengo dzomukati, kana kudzokorora mumwedzi mitanhatu.
Kutsvakurudza kubva kuJohn Hopkins University kwakaratidza kuti vazhinji vanenge 28 muzana yevanhu vane hutachiona hweHIV vane masimba vanogona kutarisana nematambudziko akadaro.
Zvirongwa zvevanhu vane HIV
Kunyange zvazvo FDA isina kuita zvirongwa zvakarongeka pamusoro pokushandiswa kweZostavax kune vanhu vane HIV (kunze kwekutaura kuti vanhu vane "simba rekudzivirira zvirwere" vanofanira kuzvidzivirira). kune uchapupu huri kukura mukusimbisa kwekushandiswa kwayo.
Muna 2012, masayendisiti ane nguva refu yeAIDS Clinical Trials Group akagumisa kuti Zostavax yaive yakachengeteka uye inoshanda kune vanhu vane maCD4 akadzika kusvika mazana maviri.
Kunyange zvazvo zvigumisiro zvaive zvichikurudzira, vazhinji vakaramba vachifunganya pamusoro pehuwandu hwechirwere kune vanhu vane CD4 nhamba pasi pe200. Sezvirwere zvarararama, zvinoramba zvichiitika kuti kunyange hutachiona husina simba hunogona kukonzera chirwere ichocho chairehwa kudzivirira.
Kunyange zvazvo nzvimbo dzekudzivirira nekudzivirira zvirwere zvisingaiti panguva ino Zostavax kune vanhu vane HIV, pfungwa yekliniki inoita kunge ichichinja. Zvizhinji zvehutachiona hwehutachiona hunotsigira kushandiswa kweZostavax vane vanhu vane HIV vane makore makumi mashanu nevekare avo vakatsigira hutachiona hwehutachiona uye CD4 count kupfuura 200. Nenzira imwecheteyo, vazhinji vanobvumirana kuti Zostavax haifaniri kushandiswa kune vanhu vane CD4 zvinyorwa pasi pe200 .
Zostavax inofanirawo kudzivirirwa kune vanhu vasina nhoroondo yekuchipopox kana uchapupu hweVZV masimba. Kune vanhu ava, chete chiziviso chikuru chekudya chizivo (zvakadai se Varivax kana Varilrix) chinofanira kushandiswa.
> Sources:
> US Food and Drug Administration. "FDA inobvumira vachengeti veZostavax kudzivirira shingles mumakore makumi mashanu kusvika kune makumi mashanu emakore." Silver Spring, Maryland; yakabudiswa musi waMay 24, 2011.
> Blanks, L .; Polydefkis, M .; Moore, R. et al. "Herpes zoster pakati pevanhu vanorarama neHIV munezvino ma antiretroviral therapy era." Zvinyorwa zveAkawana Immune Defence Syndromes. October 1, 2012; 61 (2): 203-207. DOI: 10.1097 / QAI.0b013e318266cd3c.
> Benson, C .; Hua, L .; Andersen, J .; et al. "ZOSTAVAX inowanzochengeteka uye inofanana nehutachiona hweHIV + vanhu vanorambidzwa zvechirwere pamusana peART: migumisiro ye > chikamu > 2, randomized, double-blind, trialbo-controlled control." 19th Conference pamusoro peRevroviruses uye Mikana Yakasangana (CROI); Seattle, Washington; March 5-8, 2012; abstract 96.