Kuchengetedza Ukama Pakati Pezvokudya uye Kubatsira Kwazvo
Zvimwe zvidzidzo zvechangobva kuitwa hazvina kungotarisa muhupenyu hwehupenyu hwehutano hweHIV asi hutengo hunobudirira mune dzimwe nyika dzakasiyana-siyana dzehutachiona.
Chimwe chidzidzo chakadaro kubva kuSouth Centers of Disease Control uye Kudzivirira (CDC) chinotarisirwa kuenzanisa kuwandisa kwemari yeupenyu nguva dzose yeHIV-zvose kuvanhu vanotanga ma antiretroviral therapy (ART) kutanga ( CD4 nhamba yemasero 500 / mL kana pasi) uye avo vanotanga nguva (200 masero / mL kana pasi).
Zvigumisiro zvakasimbisa izvo zvidzidzo zviduku zvakawanda zvave zvichitaura kwenguva yakareba: kuti kutanga kwekutanga kweAART kuwirirana kusvika kune zvakaderera zvoupenyu hwemari.
Maererano nekutsvakurudza, kune avo vanotanga kurapwa pamatunhu akawandisa eCD4, inofungidzirwa yega yeupenyu inotengeswa inosvika $ 250,000. Kusiyana neizvi, avo vanotanga pa200 masero / mL kana vashoma vangangodaro vanopedza kaviri iyo iyo-kubva chero kupi zvako pakati pe $ 400,000 uye $ 600,000.
Pakati pezvikonzero zvinotsanangurwa kuti mari yepamusoro ndiyo ngozi yakawanda yehutachiona hwehutachiona hweHIV uye husina hutachiona hweHIV kune avo vane maitiro ekudzivirira zvirwere. Uyezve, mukana wekuti munhu achakwanisa kudzorera maitiro ekudzivirirwa kwezvirwere kusvika pedyo-zvinoenderana nemazinga (kureva kuti, maCD4 ema 500-800 masero / mL) inenge ishoma kana imwe gare inotanga kurapwa.
Kudzokorora kunotsvaga kubva kuWeill Cornell Medical College yakatsigirawo zvakagadziriswa. kutevera vanhu vane HIV kubva kune makore makumi matatu kusvika pakufa.
Kunyange zvazvo mari yekurapa kune avo vakatanga chirongwa chekuongororwa ($ 435,200) yaive yakakwirira kudarika avo vakanonoka kurapwa ($ 326,500), kuponeswa maererano nehutachiwana uye kuregererwa kwechipatara kwakaonekwa kwakakosha.
Vatsvakurudzi vakakwanisazve kugumisa kuti nguva yehupenyu yakachengetedza kuchengetedza utachiona hweHIV mune mumwe munhu waiva pakati pe $ 229,800 kusvika ku $ 338,400.
Kuisa Mari yeHupenyu nguva dzose yeAIDS
Kunyange zvazvo nguva yehupenyu yekurapa inogona kuonekwa, pamusoro pepamusoro, inowedzera-inoratidza kuti inokonzerwa nehutachiwana hweHIV huripo kana kuti mari yekuchengetedza hutano hweAmerica-zvakakosha kutarisa zvinodiwa maererano nezvimwe zvinokonzerwa nezvinetso zveutano.
Funga, somuenzaniso, kuti muvhareji wehupenyu hwekushaya fodya kwemurume wemakore makumi maviri nemana nemana ane makore $ 183,000, asi mukadzi ane makore 24 anogona kutarisira kupedza avhareji ye $ 86,000. Kunze kwezvinodhura zvemidzanga pachavo, mararamiro ehurumende kune Medicare, Medicaid, Social Security, uye inshuwarhu yehutano inofanirwa kuva yakareba zvikuru-ingave ichibva pakurega kusvuta , emphysema, kenza yemapapu, nezvimwewo.
(Aya mafananidzo akawedzerwa nekuti kusvuta, sekuzvimiririra, kunozivikanwa kuderedza mararamiro ehupenyu nemakore anenge 12.3 kuvanhu vane HIV.)
Panguva ino, mari yeupenyu yekudhakwa zvinwiwa zvinodhaka masikati pazuva inouya $ 263,000 anoshamisa kwehupenyu hwose, iyo inopindirana ne 41% inowedzera dambudziko rekenza mune varume, pasinei neHIV-kana kuti haina HIV.
Zvinokonzerwa neContain Strategies
Hapana chimwe cheizvi, chokwadi, chinoreva kuderedza kushanda kwemari kweHIV, zvose pane mumwe nomumwe uye hurongwa hwehutano hwehutano hwakakwana.
Kubva pamunhu pachake, mari yekutarisira utachiona hweHIV inobatanidza zvakananga nekushanda kunoita murwere mukutarisira uye kuti munhu iyeye anokwanisa sei kutevedzera kurapa kwakatemwa. MuMeyi gore ra2014 rekushandurwa kwehutano hwehutano hwehutachiona hweUnited States, Dhipatimendi reZvipatano neHuman Services (DHHS) yakataura nezvezvinetso izvi nekurumbidza kuti vanachiremba "kuderedza varwere" kunze kwemari yezvokushandisa zvinodhaka zvinodhaka chero nguva zvichibvira. "
Izvi zvinosanganisira kushandiswa kwezvimwe zvinokonzerwa nezvinodhaka kana zvichiita kana zvinonzwisisika. Zvisinei, sarudzo inofanira kuendeswa nekuongororwa kwakanyatsogadziriswa kana kuti kuderedzwa mari inogona kuwedzera mutoro wepiritsi kumurwere.
Mumamiriro ezvinhu akadaro, kushandiswa kwemagetsi kunogona kuderedza huwandu hwemari asi nekuda kwekutsungirira kwemwoyo . Uyezve, izvo zvinowanzoita zvemishonga yemishonga yakawanda zvinogona kutungamirira kune imwe yepamusoro yveshuwarisi yekubhadhara mari, ichiwedzera panzvimbo yekuderera kunze kwemari yekudhura.
Nenzira yakafanana, DHHS yakakurudzira kuderedza kuwanda kweCD4 kutarisa kwevarwere vanga vari paAIDS kwemakore maviri uye uye vave vasina kuonekwa, vasingagoni kuonekwa nehutachiona hwehutachiona. Kunyange zvazvo izvi zvichionekwa sezvisingabatsiri zvakanyanya maererano nemari chaiyo inogadziriswa, zviratidzo zvakabatana zvakadai seCD8 neCD19 zviri, chaizvoizvo, zvinodhura; vane anenge asina kliniki inokosha; uye haasi kurumbidzwa senzira yekuchengetedzwa kweHIV.
Kune avo vakaratidza nguva yakareba yehutachiona kudzvinyirira paART, DHHS ikozvino inorumbidza iyo
- CD4 kuongororwa kunoitwa mwedzi gumi nembiri kune avo vane CD4 dzepamusoro pakati pe 300 ne500 masero / mL, uye;
- CD4 kuongororwa inofungidzirwa seyakasarudzwa kune avo vane CD4 dzinopfuura masero 500 / mL.
Maererano nemitemo, maCD4 anotarisa kana kutanga kana kumira kurapa kweprophylactic yakagadzirirwa kuchengetedza zvirwere zvisinganzwisisiki , kana kuongorora kana chirwere chemuviri chemuviri weAIDS chiri chakakwana. (Mhinduro "yakakwana" inotsanangurwa sekuwedzera kweCD4 count ne 50 kusvika ku150 masero mukati megore rokutanga rerapi, ine kuwedzera kwakafanana gore negore kusvikira hukama hwakasimba huripo.)
Kusiyana neizvi, kuongororwa kwehutachiona hunofanirwa kunofanirwa kuonekwa sechinhu chikuru chinoita kuti upiwe kubudirire. Sezvo zvakadaro, DHHS inokurudzira utachiona hwehutachiona hunenge hutatu mwedzi 3-4 kune varwere vane unhu hwakasimba, hwakasimba hutachiona hwehutachiona.
Sources:
Farnham, P .; Gopalappa, C .; Rudzikinuro, S .; et al. "Kuvandudzwa kweHupenyu Time Costs Care and Quality-of-Life Inofungidzira vanhu vane HIV vane utachiona muUnited States: Mazuva Ekupedzisira Kufananidzirwa Kwepakutanga uye Kupinda Mukutarisirwa." Zvinyorwa zveAkawana Immune Defence Syndromes. Gumiguru 2013: 64: 183-189.
Schackman, B ;; Fleishman, J .; Su, A ..; et al. "Kurapa kwoupenyu hwehupenyu hwehutano kubva pakudzivirira HIV muUnited States." 2015 Musangano weRevroviruses uye Opportunistic Infections (CROI). February 23-26, 2015; Seattle, Washington, abstract 1104.
Dhipatimendi reUnited Health (Health Services) uye Human Services (DHHS). "Mirayiridzo yeKushandiswa kweAntiretroviral Agents muHIV-1-Vakabatwa Vakuru Nevana Vari Kuyaruka." Bethesda, Maryland; yakasvika musi waMay 6, 2016.