Toxoplasmosis (inozivikanwawo se "toxo") mune chirwere chinopararira chinokonzerwa ne-single-celled parasite inonzi Toxoplasma gondii. Muhuwandu hwemhosva, chirwere chinonzi toxo chichave chiri munyoro uye chichagadzirisa pachako pasina kurapwa. Kana kuchirapa kuchidiwa, kazhinji kacho kunosanganisira imwe kana kupfuura mishonga inorwisa mabhakitiriya kana mishonga yemapirisa inokwanisa kugadzirisa utachiona.
Zvisinei, panguva yekuzvitakura kana kune vanhu vane maitiro ekudzivirira zvirwere, zvirwere zvinorwadza zvinogona kudiwa kuti zvive nekudzivirira kana kudzivirira utachiona uye kudzivisa zvinetso zvakakomba zvehutachiona. Izvi zvinonyanya kuitika mune zviitiko zvekukura kweHIV.
Acute Treatment
Mune vanhu vane masimba ekuzvidzivirira , kusvika 90 muzana yeT. gondii zvirwere hazvina zviratidzo zvachose. Avo vanoita vachawanzova vanyoro uye nyore nyore kukanganisa nehosha, kunyange nechiremba. Pamusana pokuti mukana wekutixo unoratidzwa, chiremba achawanzokurudzira kuvata pamubhedha uye zvichida ye-over-the-counter (OTC) kurwadziwa kunobatsira kufanana neTylenol (acetaminophen) kana Advil (ibuprofen).
Mishonga inonyanya kukurudzirwa kune vanhu vane maitiro ezvirwere zvekudzivirira zvirwere zvemasimba avo vasina maziviro ezvirwere zvekudzivirira zvirwere zvekudzivirira zvirwere. Izvi zvinowanzobatanidza vanhu vane hutachiwana hutachiona hweHIV asi vanogonawo kusanganisira vagari vemukugadzira mutezo uye vanhu vane chirwere chekrase chemotherapy (avo vose vanotora zvirwere zvekuzvidzivirira zvemashuga).
Yakakurudzirwa kurapwa
Kurapa chirwere chinotapira (chinoshanda) chirwere, vanachiremba vacharonga mishonga inorwisa mabhakitiriya nemimwe mishonga inokwanisa kubvisa chirwere ichi uye kudzivirira chirwere ichi kuti chirege kufambira mberi. Mishonga inonyanya kutaurwa inosanganisira:
- Pyrimethamine, mishonga yemapurisa inofungidzirwa inofanirwa kuti inonyanya kushandiswa mukurapa chirwere chinokonzerwa nehutachiona
- Sulfadiazine, mushonga unorwisa mabhakitiriya unoshandiswa pamwe chete ne pyrimethamine
- Clindamycin, imwe nzira inorwisa mabhakitiriya inoshandiswa pamwe chete ne pyrimethamine
- Minocycline, mushonga unorwisa mabhakitiriya unoshandiswa bedzi kana munhu asingagamuchiri sulfadiazine uye clindamycin
- Folinic acid inoshandiswa sechiwedzera kuti kuderedze njodzi ye thrombocytopenia (pasi maplatelet)
Iro remavhiki matanhatu evhiki raizobatanidza chirwere chezuva nezuva che pyrimethamine, maitiro mana ezuva nezuva emishonga inosarudzwa nemishonga inoshandiswa, uye nhamba yezuva nezuva ye folinic acid. Kuti udzivise kudzokorora, mushonga wemishonga inorwisa mabhakitiriya trimethoprim uye sulfamethoxazole (TMP-SMX) inotorwa kamwe chete kwemavhiki mana.
Mushonga mukudzivirira
Kutumira kwaT. gondii kubva kuna amai kusvika kumwana hakusi nyore kunze kwekuti amai vane HIV uye vane simba rakawanda rekudzivirirwa pamuviri. Pakati peava amai, kurapwa kunowanzogadzirirwa kuchengetedza utachiona hwehutachiona.
Masayendisiti anoramba asina chokwadi nezvemadzimai ane hutachiona hwemuviri. Kunyangwe kana chirwere cheshuga chikaitika, pane nharo huru pamusoro pekuti maitiro anobatsira sei ekudzivirira kutapurika, kunyanya sezvo zvingave zvakaoma kufungidzira toxoplasmosis panguva yekuzvitakura.
Kumugumo uyu, kutarisirwa kunyanzvi kunofanira kutsvaga kana iwe uri nepamuviri uye uri mukana wekuwedzera we toxoplasmosis.
Mishonga inowanzopiwa zvakanyorwa sezvizvi:
- Kana hutachiona hwehutachiona hunoitika mukati mekutanga kwemitatu, spiramycin yaizogadziriswa kubva panguva yekuongororwa kusvika panguva yekuberekwa.
- Mushure mokunge vatatu vekutanga (kana kana utachiona hwekuberekwa hwave hwakasimbiswa), pyrimethamine, sulfadiazine, uye folinic acid ingashandiswa kubva pakuongororwa kusvika pakuiswa.
Zvirongwa zvevana
Mishonga inokurudzirwa zvakasimba kune vecheche vane vanaamai vane HIV vane hutachiwana vane T. gondii panguva yekuzvitakura. Izvi ndezvechokwadi kana kana amai vasina zviratidzo kana kuti vakapa chirwere chekudzivirira. Nguva yekurapa (pyrimethamine, sulfadiazine, uye folinic acid) inogona kusiyana asi inogona kuramba kwenguva refu semwedzi gumi nemaviri.
Kana mucheche kana mwana akawanikwa ane hoxoplasmosis neHIV, TMP-SMX ingarongedzerwa pamwe nehutano hweHIV . Iyo TMP-SMX ingashandiswa kudzivirira inxoplasmic encephalitis (kunyanya kunetseka kwepenital toxoplasmosis) uye yakaramba ichienderera kusvikira nguva yakadaro semishonga inokonzerwa neHIV ichikwanisa kuisa chimiro chechirwere chemwana.
Muchiitiko che toxoplasmic encephalitis, corticosteroids yaizogadzirirwa kuderedza uropi kuputika. Anticonvulsive mishonga inogonawo kushandiswa kudzivirira kugumburwa .
Kurapa Kune Vanhu vane HIV
Toxoplasmosis muvanhu vane HIV inogona kukonzera, uye inogona kutyisa upenyu, zvirwere zvinokanganisa uropi, meso, nemapapu. Muzviitiko zvakawanda, chirwere chacho chichave chichikonzerwa nekugadziriswa kwepakutapukirwa kwekare kupfuura pane itsva.
Pasina maviri ekudzivirirwa mumuviri kuti atarise utachiona, munhu anogona kukurumidza kukundwa kurwere kunze kwekunge pakarepo matanho anotorwa kuti adzorere maitiro ezvirwere zvemuviri, kujekesa chirwere cheT. gondii , uye kurapa chirwere ichi.
Antiretroviral Therapy
Toxoplasmosis muvanhu vane HIV inonzi inofanirwa nokuti inogona kukonzera zvirwere apo masimba ezvirwere zvezvirwere zvisingakwanisi kumira.
Kumugumo uyu, nzira chete yekudzoka kubva ku toxoplasmosis ndeyokudzorera muviri kudzivirirwa kwezvirwere. Antiretroviral zvinodhaka izvi zvinopindira nekodzero yeHIV yekudzorera. Kunyange zvazvo vasingakwanisi kuporesa chirwere ichi, vanochengetedza hutachiwana hwevanhu sehupamhi sezvinobvira kuitira kuti irege kugona kuuraya uye kuuraya masero ezvirwere zvemuviri anoshandiswa kutidzivirira isu.
Kazhinji inorayirwa mubatanidzwa wemishonga mitatu , antiretroviral therapy inogona kudzorera muviri wezvirwere mumuviri kunyange kuvanhu vanorwara zvikuru, kazhinji mukati memakore mashoma. Kurapa kwaizoenderera mberi kweupenyu hwose uye kunosanganisira nguva dzose vanachiremba vanoshanyira kuti vaongorore mamiriro ako ezvirwere zvekudzivirira muviri uye uone kuti zvinogona kuitika sei.
Antibiotic Therapy
Kurapa kwechirwere chetachiona cheT. gondii chakafanana neicho chetachiona chakaoma uye chinogona kusanganisira:
- Pyrimethamine, sulfadiazine, uye folinic acid
- Pyrimethamine, clindamycin, uye folinic acid
- Atovaquone (anent antifungal) yakashandiswa pamwe chete ne pyrimethamine uye folinic acid
- Azithromycin (imwe mishonga inorwisa mishonga), pyrimethamine, uye folinic acid
- Atovaquone uye sulfadiazine
Kana kamwe utachiona hwagadziriswa, TMP-SMX inenge yakatemwa kuti isadzivirire zvakare uye yakaramba ichienderera kusvikira nguva yakadaro semishonga inorwisa mabhakitiriya inogona kudzorera muviri.
Kurapa Matambudziko Matambudziko
Zvinetso zvitatu zvakajairika zve toxoplasmosis kune vanhu vane HIV vane maitiro e-toxoplasmosis (anokanganisa meso), CNS toxoplasmosis (inokanganisa uropi uye nervous system), uye pulmonary toxoplasmosis. Mushonga wega wega wega waizotungamirirwa nekuoma kwechiratidzo uye hutano hwemunhu akabatwa.
Mishonga yekurapa ye ocular toxoplasmosis inogona kusanganisira:
- Systemic corticosteroids kubatsira kubvisa kupisa
- Injections ye corticosteroids uye clindamycin muziso
- Kuiswa kwekuvhiya kwe clindamycin pellets muziso
Kurapa kweCSS toxoplasmosis kunogona kusanganisira:
- Systemic corticosteroids kugadzirisa kuputika kweuropi uye pakati penheyo system (CNS)
- Anticonvulsive mishonga yekurapa zvinetso
Kurapa kwepermonary toxoplasmosis kunogona kusanganisira:
- Systemic corticosteroids kuderedza kupisa
- TMX-SMP kubata chirwere chinoshanda chepneumocystis yemapapu
Prophylactic Therapies
Kana iwe une HIV, prophylactic (inodzivirira) mishonga inogona kurongerwa kana muviri wako wekuzvidzivirira unopesana.
Izvi zvinogona kutsanangurwa neCD4 count yako iyo inoyera nhamba yekudzivirira CD4 T-seli yako ropa rako. Mune munhu ane utano, CD4 count ingasvika pakati pe800 ne1 500. Mune vanhu vane maitiro ekudzivirira immune, nhamba iyoyo inodonha pasi pe200.
Kuti udzivirire toxoplasmosis, TMP-SMX inogona kurongerwa muwandu hwezuva nezuva sezvo CD4 yako inoswedera pedyo "nengozi" ye100. pamwe chete nemishonga yako yekurwisa maitiro, iwe unoramba uchitora TMP-SMX kusvikira panguva iyo CD4 yako yakawanda iri pamusoro 200 uye anokwanisa kugara imomo. Iwe unogona kumira ipapo mishonga inorwisa mabhakitiriya uye uenderere kutora mishonga yako yeHIV.
Zvishandiso zvekudzivirira
Kana iwe uri nepamuviri kana kuti wakagadzirisa zvirwere zvemuviri, unoda kutora matanho ekudzivisa kutarisana naT. gondii muupenyu hwako hwezuva nezuva. Izvi zvidziviriro zvinogona kukudzivirira kubva ku-toxoplasmosis zviri nani zvikuru kupfuura dzose dzezverapa munyika.
Zvimwe zvekudzivirira zvinoshanda zvinosanganisira:
- Kupfekedza mapaundi emagetsi anogadziriswa paunenge uchichenesa kate yakaita bhokisi kana, zviri nani zvakadaro, kuti mumwe munhu aite izvozvo
- Kupfekedza magirafu kana iwe uri kunze kwekurima
- Kubika nyama yako, huku, uye hove zvakaitwa zvakanaka
- Kuona uye kushambidza mimwe miriwo kana michero inobva mubindu kana murimisi pamusika
- Kuchenesa mapuranga, mapanga, kana zvisikwa nyama yakasviba inogona kunge yakabatana nayo
- Kudzivisa mvura isina kujekeswa chero ipi zvayo
- Kuchengetedza kati yako mumba
- Kudyisa kati yako chete mumakedheni kana zvakaomeswa kudya uye kudzivisa nyama yakasviba kana isina kudya
- Kuvhara sandbox yemwana wako
- Kushambidza maoko ako zvakakwana nemvura inopisa uye sese mushure mekugadzira bindu, kutamba nekate rako, kugadzira zvokudya, kana kuchenesa sandbox
- Kudzidzisa vana vako unyanzvi hwokugadzira maoko
> Sources:
> Centets for Disease Control and Prevention. "Zvirwere - Toxoplasmosis (Toxoplasma Disease): Kudzivirira uye Kudzora." Atlanta, Georgia; yakarongedzwa naJanuary 10, 2013.
> Lee, S. na Lee. T. "Toxoplasmic Encephalitis mu Murwere neAcquired Immunodeficiency Syndrome." Kubata Kwepfungwa Kubata. 2017; 5 (1): 34-36. DOI: 10.1479 / btrt.2017.5.1.34.
> Park, Y. uye Nam. H. "Clinical Features and Treatment ya Ocular Toxoplasmosis." Korean J Parasitol. 2013; 51 (4): 393-399. DOI: 10.3357 / kjp.2013.51.4.393.
> Dhipatimendi reUnited Health yeHurumende neHuman Services. " Mazano ekudzivirira uye kurapwa kwezvirwere zvinopesana nevarwere vane HIV nehutachiona hweHIV neAIDS." AIDSInfo. Rockville, Maryland; yakarongedzwa Gumiguru 28, 2015.