Kuva nechirwere kurwisa zvirwere chikamu chinokosha cherongwa hwehutano hwehutano hwevanhu vane chirwere chinoputira chirwere (IBD) . Kuramba-kusvika-kune-nguva pamajekiseni kunokosha kune zvikonzero zvakawanda, asi zvakanyanya kudaro apo mishonga ye biologic inogona kushandiswa munguva yemberi. Nenzira yakawanda, nguva inobatsira yekupa vachizinesi isati yasvika, biologic inotanga, asi dzimwewo dzinogona kupiwa mushure mezvinodiwa.
Vanhu vane IBD vanofanira kutarisa navanachiremba nezvehutano hwavo. Vakuru, kunyanya, vangada chirongwa chokupinda muzvirongwa zvose zvinorayirwa zvavanoda. Kuva nehutano pamusoro pekudzivirira kuchava ndiyo nzira yakanakisisa yekuzvidzivirira kune zvirwere zvinodzivirirwa munguva yemberi.
Kazhinji, zvirwere zvinokurudzirwa musati mutevedzeri atangotanga pane biologic therapy. Kuzvidzivirira kurwisana nehutachiona hunowanzodiwa nekuti biologic therapy inoderedza hutachiona hwemuviri. Izvi zvinoreva kuti munhu anogamuchira mishonga ye biologic angave akakwanisa kuwana utachiona. Zvirwere zvinogona kukonzera kukuvadza kukuru uye zvinoreva kuti biologic inofanira kumira kwechinguva apo utachiona hwagadziriswa. Icho hachisi mhedzisiro iyo inobatsira mukurapa iyo inonzi IBD, uye ndizvo zvikonzero zvirwere zvinowanzopiwa musati watanga mishonga ye biologic, kana dzimwe nguva pashure.
Kurapa Kwechi Biologic Kunofanira Kudzorerwa Kuvhara?
Chiremba achave ari mhando yakanakisisa yekupindura mubvunzo uyu, asi mumatambudziko mazhinji, zvichida kwete.
Mishonga yakawanda inogona kupiwa mushure mekutanga biologic therapy. Mhando iyo inowanzofanira kudzivirirwa ndiyo zvirwere zvinorarama zvinochengetedzwa, kana maLIV, ane zvirwere zvine virusi benyu. Panoitika biologics inokurukurwa senzira yekurapa, zvirwere zvinofanira kuva chikamu chekukurukurirana.
Mishonga Inokurudzirwa Kune Avo Vanowana Biologic Therapy
Urongwa hwehutano hwemurwere wese huchava hwakasiyana, huchibva pane vachizinesi dzave vatambira uye dzengozi dzavo dzekuwedzera zvirwere. Chiremba anotungamirira mishonga inofanira kushanda nemurwere weBDD kuti ape urongwa hunoita kuti hutachiwana hwekuvhara muviri huzere. Kune dzimwe nzira dzekupa zvirwere panzvimbo yevaya vari kutotora chirwere ichi ne biologic agent.
- Hib vaccine . IHaemophilus influenzae inokonzera b (Hib) utachiona hunogona kukonzera meningitis, pneumonia, nezvimwe zvirwere. Ichi chirwere chinowanzopiwa kuvana uye chinokurudzirwa kune vanhu vakuru vasina kumbochigamuchira, kusanganisira ani zvake anogamuchira biologic.
HPV vaccine . Mushonga wepillomavirus (HPV) wevanhu ndeye hutatu hwemashoko matatu anopiwa kudzivirira utachiona neHIVV. HPV yakabatanidzwa mukugadzirwa kwemhando dzakasiyana-siyana dzekenza yekubereka vana pamwe nekenza nekenza yemuviri. HPV inokurudzirwa kusvika kusvikira makore makumi maviri nemaviri kuvanhu vasina immunocompromised (iyo inosanganisira varwere veBD vanogamuchira biologic therapy).
Pneumococcal vaccine. Izvi zvirwere zvinopikisa Streptococcus pneumoniae mabhakitiriya, izvo zvinogona kukonzera marudzi mazhinji ehutano. Zvakakosha kuti murwere wese anogamuchira chirwere ichi, nemashandiro ese akaitwa kuti apiwe asati atanga biologic therapy. Ichi chirwere chinonyanya kuoma nokuti chakasiyana kune avo vakagamuchira izvo uye avo vasina kumbochigamuchira. Vaya vakagamuchira chirwere munguva yakapfuura vangada zvirwere zviviri, izvo zvinowanzo (asi kwete nguva dzose) zvakapiwa gore rimwe chete. Kune vashandi veBIB vasina kumbobvira vagamuchira chirwere chinonzi pneumococcal, panogona kuva nezvirwere zvitatu zvinodiwa. Chikurudziro kwemakore ose mashanu chinokurudzirwa zvakare.
Nyaya yemvura inoputika . Iyo nguva inoputira futi inokurudzirwa kune vanhu vane IBD, kunyange avo vari kugamuchira kurapwa kwebiologic kana vari kutora mamwe mishonga inodzivisa masimba ezvirwere. Chirwere chinopfungaira hachina hutachiona hwehupenyu huri kurarama. Mhepo inoputika (iyo isingawaniki panguva yegore ra2017-2018) haina kukurudzirwa nokuti iLIV.
Tetanus . Kune vanhu vane IBD, kuputika kwetetanus kunokurudzirwa zvakafanana sezvazviri muhuwandu hwevanhu. Tetanus shots inofanira kupiwa zvishoma nemakore gumi nerimwe, uye kakawanda kana njodzi inopera, sekufamba pamusungo unooma. Chirwere chetetanus chinosanganiswawo nemimwe zvirwere, iyo diphtheria uye tetanus toxoids uye acellular pertussis (DTaP) vaccine. Ichi chinyorwa chinodzivirira kutetanus, pertussis (kunopera kukwezva), uye diphtheria. Vakuru vasina kumbogamuchira chirwere chinonzi pertussis vanogona kuda DTaP, iyo inogona kupiwa mumutsara wezvirwere zvitatu.
Mishonga Inokurudzirwa Mune Zvimwe Mamiriro Ezvinhu
- Chirwere cheHepatitis A. Utachiona hweH hepatitis A hunogona kukonzera chiropa chirwere chetachiona hepatitis. Ichi chirwere chinokurudzirwa kuvanhu vanopfuura makore ane gore avo vari pangozi yekutengesa utachiona, kunyange avo vari kugamuchira biologic.
- Chirwere cheHepatitis B. Hutachiona hweH hepatitis B inogona kukonzera hutachiwana muropa, iyo inogona kuva yakasimba. Ichi chirwere chinokurudzirwa kune avo vanofungidzirwa vari pangozi yekugadzirisa chirwere che hepatitis B.
- Meningococcal vaccine. Mushonga we meningococcal unochengetedza utachiona nehutachiona hunonzi Neisseria meningitidis . Izvi zvinogona kudiwa kune vanhu vari pangozi yakakura ye meningococcal disease, iyo inosanganisira vacheche, vana, uye vechidiki (kunyanya avo vanoenda kuchikoro).
- Chirwere cheporiyo. Chirwere cheporiyo hachina kupiwa nguva dzose muUnited States. Inowanzokurudzirwa chete kune avo vari pangozi yekugadzirisa hutachiona hunokonzera chirwere cheporiyo nekuda kwekuenda kunzvimbo yenyika apo chirwere chepori chinenge chichiripo.
Urarame Zvirwere Zvisina Kurumbidzwa Paunowana Biologic Therapy
Chirwere chezvirwere izvo hazvibvumirwi nevarwere veBD vari kugamuchira mishonga yebiologic ndeyeya ine mavairasi anorarama. Zvakanaka, kana aya majekiseni achidiwa, anofanirwa kupiwa asati atanga kurapwa nea biologic. Izvi zvinoda zvimwe kufungidzira mberi: vanachiremba nevarwere veBDI vanofanira kutarisa muhutano hwekudzivirira kana vachikurumidza kuongorora kana kugadzirira zuva iro murwere angada bhaologic.
- Chickenpox vaccine. Iyo chirwere chekuckenpox inobatsira kudzivirira utachiona ne varicella-zoster virus. Ichi chirwere chinowanzopiwa vana, muzviviri zviviri. Iri ndiro reLaIV, saka kazhinji kacho, haringakurudziri kune ani zvake iye zvino achitora biologic. Kutsvakurudza kutsva kunoratidza kuti chirwere ichi chinogona kunge chisina ngozi kune varwere vanowana biologic therapy, asi nokuda kwezvino, zvinorayirwa ndezvekuenderera mberi kuzvidzivirira.
- Herpes zoster vaccine . Iyo herpes zoster virus inokonzera chickenpox uye chimwe chiitiko chinonzi shingles . Vanhu vane chirwere chekudya chinogona kukura shingles, kazhinji pavanopfuura makore makumi matanhatu. Iyo herpes zoster vaccine inogona kudzivirira shingles nehafu yepamusoro uye inodzivirira kwenguva refu zvinetso zvinokonzerwa nehepepe zoster virus. Zvisinei, chirwere ichi cheLaIV uye hachisi kunyatsotarisirwa kune vanhu vari kugamuchira biologic. Zvimwe zvitsva zvinotsvaga zvinoratidza kuti zvingave zvakachengeteka, asi mazano anhasi ndeaifanira kuramba achizvidzivirira.
- Mushonga-mumps-rubella vaccine . Mushonga wemasopi, mumaspipe, uye rubella (Germinus measles) inowanzopiwa vana. Hazvikurudzirwi kune vanhu vari kugamuchira biologic nokuti iLIV.
Shoko Rinobva
Immunology isenzi yakaoma uye inowedzera kunyanya kune vanhu vane chirwere chisingaperi seBD. Kunyange zvazvo pane mazano ekuti zvirwere zvinorayirwa sei kune vanhu vane IBD avo vari kugamuchira biologic, panewo zvisizvo. Zvakakosha kune chero ani zvake ane IBD kuti ave nemusoro kune zvirwere, zvichida asati atanga biologic therapy, nokuti zvinodhaka izvi zvinoderedza masimba ezvirwere.
Zvisinei, zvirwere zvakawanda zvinogona kupiwa kumurwere ari kutora biologic. Chinokosha kune izvi zvose ndekuve nehurukuro yakasununguka pamusoro pekudzivirira nevadzidzisi vezvehutano vasati vashandise zvinodhaka izvo zvinodzivisa masimba ezvirwere zvinodiwa.
> Sources:
> Division of Viral Hepatitis. "Hepatitis A Mibvunzo Nemhinduro dzeVashandi veUtano." Nzvimbo dzeDaase Control uye Kudzivirira. 13 Jul 2016.
> Ferreira I, Isenberg D. "Zvirwere uye biologics." Ann Rheum Dis. 2014 Aug; 73: 1446-1454.
> National Center for Preparedness, Detection, uye Kudzorwa kwezvirwere zvinotapukira. "HPV Zvirwere: Kuvhara Zvokutanga Zvako kana Kuti Zvichiri." Chirwere Chetachiona Chekudzivirira uye Kudzivirira. 26 Jan 2015.
> National Center for Immunization and Respiratory Diseases. "Meningococcal: Ndivanaani Vanofanira Kuchengetwa?" Zvikamu Zvekudzivirira Dambudziko nekudzivirira. 26 Aug 2016.
> National Center for Immunization and Respiratory Diseases. "Tetanus (Lockjaw) Kuchengetwa: Munhu Wose Anofanira Kuziva." Nzvimbo dzeDaase Control uye Kudzivirira. 9 Jan 2013.