Ikoko mhuka inodzidza uye kuongororwa kutsvakurudza kunotiudza
Izvo zvakagara zvichinetseka kuti vakadzi vanotora mishonga inorwisa mabhakitiriya panguva yekuzvitakura kunogona kuwedzera njodzi yekuremara kwekuberekwa. Kutsvakurudza kazhinji kunopesana uye kunetseka pamusoro pezviitiko zvinogona kuitika dzimwe nguva zvinogona kukanganisa maonero edu pamusoro pemishonga 'kunyatsochengeteka.
Mushonga Sustiva (efavirenz) ave kwenguva refu aine pfungwa yekufungisisa nemitemo yekare yakaratidza kuti inofanira kudzivirirwa, kunyanya munguva yekutanga chetatu, nekuda kwengozi inogona kuitika yekutakura (kuberekwa kwepabonde).
Zvinorayirwa zvabva kubvira zvashandurwa uye zvino zvinobvumira kushandiswa kwe efavirenz mumutatu wekutanga kunofanira kunge amai vasina chinhu chisingaoneki chetachiona .
Nezvo izvo zvichitaurirwa, mitemo imwechete inoratidza kuti vakadzi vasiri pamuviri vane makore ekubereka vanozvidzivirira chero zvipi uye zvose zvinodhaka zvinodhaka zvine efavirenz.
Saka izvi zvinonyatsorevei? Imwe nhengo yehutano yeUnited States iri kungovhara mabheji avo pamusoro pemishonga inogona kana kuti isingakuvadzi, kana tinofanira kufunganya pamusoro peizvi nezvimwe zvinodhaka?
Zvidzidzo zveMhuka Zvinoratidza Ngozi Dambudziko
Mukuongorora hutachiwana hweHIV nemishonga yekuberekwa, zvizhinji zvekutsvakurudza ikozvino hazvina kubva pakudzidza kwevanhu asi kubva pakutsvakurudza kwemhuka (zvakajeka nokuti haukwanisi kuisa pachena kutengesa kwevanhu mumishonga inogona kutyisa).
NezveSustiva, kunetseka nezvetatogogenicity yakatanga kusimudzwa apo vatatu vemakumi maviri e20 ejnomolgus mbongoro vakazarura mishonga iyi yaiva nevana vane ruzivo rwechirwere uye nehutachiona hwehutano husina kunaka. Zvakare, mishonga yezvinodhaka yaingova ne 1.3 chete kupfuura yakashandiswa kuvanhu.
Zvichakadaro, makonzo akaratidzwa naSustiva ane ruzivo rwekuberekwa kwevana, chimwe chiitiko umo macheche akafira panguva yekuita chibvumirano akadzorerwazve nevana vasara.
Kwakange kusina zvirema zvakaberekwa zvakaonekwa mumaraghi.
Statistical Studies in Human
Nhamba dzakatorwa kubva kuReistreviristvirus (Preretancy Pregnancy Registry) (APR) dzakanyora mufananidzo wakafanana.
Kunyange zvazvo APR ichiratidza kukanganisa kwevana mumakore 18 kubva pa766 vana vakazarurirwa naSustiva munguva yekutanga yechitatu, nhamba yakaderera ye-neural tube kukanganisa-mhando dzinoonekwa mumigadziro yezvipfuwo-dzinoita kusava nechokwadi sekuti misiro yevanhu ingave yakafanana neyemonke uye rats.
Kuongororwa kunotevera kwezvidzidzo 19 zvakasiyana-siyana, kusanganisira APR, kubvira panguva yakaratidza kusakwana kwekuberekwa kwe 39 kubva pavana 1 437 vakazarurirwa naSustiva. Kubva pane izvozvi, chiyero chinoratidzika kunge chisina kusiyana kune izvo zvakaonekwa muhuwandu hweUnited States.
Pasinei nenhamba shoma yehutachiona hwakasimbiswa, vashandi vehutano vakaramba vachizeza kupa Sustiva zviduku-up.
Kuberekwa Muchechi Mungozi mune dzimwe hutachiona hweHIV
Muna 2014, vatsvakurudzi vanobva kuFrench Perinatal Cohort vakabudisa chidzidzo chakatarisa kuwanda kwenhepfenyuro yekuberekwa inowanikwa muvana vakagadzirwa nemhando dzakasiyana-siyana dzezvinodhaka zvepabonde panguva yekuzvitakura. Kudzidza munyika dzakawanda kwakabatana nevana 13 124 vanoberekwa nevakadzi vane HIV kubva muna 1986.
Zvigumisiro zvaive zvinonakidza: apo kuwedzerwa kwekuremara kwekuberekwa kwakabatanidzwa nemamwe ma antiretroviral drugs, zvakadai seCrixivan (indinavir) , muyero wakanga usingati wakasiyana nezvakaonekwa muhuwandu hwevanhu. Uyezve, hapana chimiro chaiyo mumhando kana kuoma kwekuremara kwekuberekwa kunogona kuwanikwa.
Munguva iyi, vevana 372 vakaratidzwa kuSusva mumutambo wekutanga, hapana sangano raigona kuwanikwa pakati pezvinodhaka nekuremara kwekuzvarwa.
Izvozvo hazvirevi kuti madhiragi haatauri ngozi. Vatsvakurudzi veFrance vakacherechedza kuwedzera kwemaviri kushaya mwoyo kwevana vachiparidzirwa kuA AZT (zidovudine) . Yakawanda inobatanidza chiremera chinokonzerwa ne-ventricular septal, chinowanzoremera chinokonzera mukati umo pane imwe nzvimbo inowanikwa pakati pemakamuri mazasi emoyo.
Kutsvakurudza kubva kuHarvard School of Public Health, yakabudiswa muna 2014, kwakasimbisa zvizhinji zvezvakawanikwa zveFrench. Kudzidza, kwakabatanidza 2 580 vana vokuAmerica vakaparadzirwa nemishonga inorwisa mabhakitiriya munguva yekutanga kwemitatu, vakawana kuti vashoma vanoshandisa zvinodhaka uye kwete boka rekushandisa madhiragi vakabatanidzwa nehuwandu hwekukanganisa kwekuzvarwa.
Zvisinei, vatsvakurudzi veHarvard vakacherechedza njodzi yakakwirira yeganda uye kushungurudzika kwemashuloskeletal kuvana vakatarisana neRitonavir -yakasimudzirwa Reyataz (atazanavir) munguva yekutanga kwemitatu. Kunyange zvazvo vatsvakurudzi vakaratidza kuti kutsvakurudza kwakawedzerwa kunogona kudiwa kuti uongorore dambudziko reReyataz mukudzivirira, vachiri kugumisa kuti njodzi yakawanda inoramba iri pasi.
uye akagumisa kuti, apo humwe hutsva hutsvakiridzo hunofanirwa muReyataz kushandiswa panguva yekuzvitakura, "akapiwa dambudziko rakaderera (congenital anomaly), zvinobatsira zvinorayirwa mushonga weHIV munguva yekuzvitakura zvichiri kukunda njodzi dzakadaro."
> Sources:
> Dhipatimendi reUnited Health of Health and Human Services (DHHS). "Zvirongwa zveKushandisa Antiretroviral Zvinodhaka Madzimai Akaberekwa neHIV-1-Akabatwa neHana hweMadzimai uye Matongerwo Ekuita Kuti Kuderedza Kuparara kweAIDS kuPininatal kuUnited States." Washington, DC; yakarongwa musi waMarch 28, 2014.
> Antiretroviral Pregnancy Registry Steering Committee. "Mushumo weRitretroviral Pregnancy Pregnancy Pregnancy International mutepfenyuro wepamukati wekutanga 1 Januwari 1989 kusvika 31 January 2017." Wilmington, North Carolina; yakarongedzwa naJanuary 2017.
> Sibiude, J .; et al. "Kushamwaridzana pakati peKuberekwa Kwekuberekwa kweAntraretroviral Therapy uye Matambudziko Okuberekwa: Kuongororwa kweFrench Perinatal Cohort Yokudzidza (ANRS CO1 / CO11)." PLoS | Medicine. April 29, 2014; DOI: 10.1371 / magazini.pmed.1001635.
> Williams, P .; Crain, M .; Yildirim, C ;; et al. "Congenital Anomalies uye MuUtero Antiretroviral Kuonekwa muHuman Immunodeficiency Virus-Yakaratidzwa Makana Asina Kuonekwa ." JAMA Pediatrics . 2014; DOI: 10.1001 / jamapediatrics.2014.