Zvirwere Zvinosangana neKuisa Njodzi Yokufa, Kuora Kwebongo
HIV inogona kukuvadza muviri wako; izvo zvakawanda zvakajeka. Sezvo HIV inowedzera kushingaira uye inoita mamwe mapepa ega, mhirizhonga inogona kuwedzera kukura, zvichiita kuti huwandu huwedzere hwekuvandudzwa kwezvirwere zvinopfurikidza .
Chimwe chezvinhu zvakakomba chirwere chinonzi progressive multifocal leukoencephalopathy (PML) . Mamiriro acho anotsanangurwa nezita racho chairo: "leuko" rinoreva chichena, "encephalo" zvinoreva uropi, uye "nzira" inoreva zvirwere.
Sezvo akadaro PML ndiyo kukuvadza kunofambira mberi kwebhuku dema reuropi munzvimbo dzakawanda (multifocal).
Mamiriro acho ezvinhu anokonzerwa nekubvisa zvishoma nezvishoma myelin sheath inobata magumo ekupedzisira, kunyanya nyaya yakachena yeuropi. Sechirwere chinoderedza simba, PML inoratidza zvakawanda nenzira yakafanana se multiple sclerosis (MS) , zvisinei nekukurumidza.
Utachiona hunobata PML ndomumwe munhu wese akave akaratidzwa kuti anonzi JC virus (kana John Cunningham virus). Kunyange zvazvo zvichifungidzirwa kuti 70-90% yehuwandu hwevanhu vakapararira nehutachiwana, inogona kungokonzera zvirwere kana munhu ane simba rekudzivirira zvirwere sezvinoitika neAIDS.
PML ine huwandu hwakawanda hwekufa hunoonekwa, uye 30-50% yevanhu vanofa mukati memwedzi yekutanga yekuongororwa. Avo vanopukunyuka kazhinji vane zviyero zvakasiyana-siyana zvehuropi humwe-vamwe vanoenzanisa, vamwe vakaoma.
PML inowanzoitika apo munhu ane HIV ane munhu ane CD4 count yepasi pe100 masero / mL.
Nenzira, AIDS inotsvakurudzwa inogadzirwa apo CD4 inodonha pasi pe 200 masero / mL
Zviratidzo nezviratidzo zve PML
Zviratidzo nezviratidzo zve PML zvinogona kufanana nemamwe mamiriro ezvinhu, kunyanya mumatanho ayo okutanga. Kazhinji, chiratidzo choga chokutambudzika chinogona kusanganisira:
- Utera husina kuchena mumaoko kana pamakumbo
- Dambudziko rokufunga kana kuisa pfungwa
- Kushaiwa kwekubatana kwepamusoro
- Headaches
Kakawanda nguva, vanhu vanokanganisa zviratidzo izvi kuneta, zvinodhaka zvinodhaka, kana kunyange kurohwa kwakanyanyisa kana kushandiswa kwechikafu chinokanganisa . Sezvo PML ichifambira mberi, zviratidzo zvakakomba zvinogona kukura, kusanganisira kutaura uye kuora kwekuona, pamwe nekugumburwa uye hupenyu hunochinja.
Mune zvimwe zviitiko, varwere vanogona kuwana izvo zvinonzi mutorwa ruoko rwechirwere umo ruoko rwunofamba rwaro pachavo pasina munhu wacho kunyange kuchiziva kana kukwanisa kuzvidzora.
Kuongororwa kweMDC
PML anogona kunyanya kuonekwa mune imwe yenzira mbiri:
- Nokuongorora mutsara wemasipinari yehutano hwehutachiona hweJC utachiona hwakatsigirwa neMRI (magnetic resonance Imaging) scan kuti ione zvipembenene munyaya chena yeuropi.
- Zvimwe, uropi hupi hunogona kushandiswa, pamwe nehutano hunosimbisa kuvapo kweJC virus.
Pane Mishonga yePPL?
Isati yasvika pakasvika antiretroviral therapy (ART) , PML yaigara ichiuraya mumavhiki mashomanana kana mwedzi mishoma yekuongorora. Nepo pane iye zvino hapana madhiragi anokwanisa kuvhara kana kuporesa PML, kutanga kweART kunogona kuderedza zviratidzo zvizhinji nekudzorera zvimwe zvekudzivirira kwemunhu.
Yakaratidzwa ART inogona kuwedzera hupenyu hwemunhu ane PML kwemakore akawanda.
Pamusoro peflip side, njodzi ye PML inogona kudzivirirwa zvikuru nekuvimbisa kushandiswa kweAIDS pakutanga, panguva chaiyo yekuongororwa uye kusati kwasara kwekudzivirira muviri.
Mishonga yakawanda yekuedza yakave ichitsvakurudzwa, kunyange zvazvo mitsva yakavhenganiswa kana kuti inecdotal zvakanakisisa. Zvinosanganisira kushandiswa kwema anti-malarial drug mefloquine uye kurapa ne interleukin-2 (protein inotungamirira masero eropa rega).
Kusvika parizvino, kwave kuine munhu muduku zvishoma wevanhu vanoita sokuti vakaporeswa PML vachishandisa mefloquine, apo varwere vaviri vakaonekwa kuti vadzoke zvakare vachishandisa ma immune protein, interleukin-2.
Zvinosuruvarisa, muzviitiko zvose izvi, huwandu hwehutano hwehutano hunobatanidza nekushandisa zvinodhaka kunobatanidza kurapa kune avo vane PML.
Sources :
National Institutes of Health (NIH). "Progressive Multifocal Leukoencephalopathy Information Page" Washington, DC; yakarongedzwa naFebruary 14, 2014; yakasvika musi waFebruary 24, 2016.
Shackelton, L .; Rambaut, A .; Pybus, G ;; et al. "JC Virus kushanduka uye kushamwaridzana nevanhu". Journal of Virology . 2006; 80 (20): 9928-9933.
Gofton, T .; Al-Khotani, A .; O'Farrell, B .; et al. "Mefloquine mukurapa kwekufambira mberi kweizvitifence leukoencephalopath y". Nyaya yeNeurology, Neurosurgery uye Psychiatry. June 2010; 82 (4): 452-455.
Buckanovich R. Liu, G ;; Stricker, C; et al. "Nonmyeloablative allogeneic stem cell transplantation yeHractgkin's lymphoma inokonzerwa ne-interleukin-2 inopindira inofambira mberi yevetiencephalopathy." Gore negore reHematology. July 2002: 81 (7): 410-413.