Ake sifunde ngezifo ezichaza i-AIDS.

Uyakhumbula, ngezinye izikhathi lapho sigula ngokungazelelwe, sizibuza ukuthi, "Lesi sifo sivelaphi?" Ikakhulukazi uma amasosha omzimba ephansi, izifo zizama ukungena kalula emzimbeni. Namuhla sizokhuluma ngezifo eziningana ezikhethekile ezingavela uma sitheleleke ngegciwane elibizwa ngokuthi 'i-HIV' (i-Human Immunodeficiency Virus) futhi isimo siba sibi kancane, okungukuthi, lapho abanye bethi sifinyelela esigabeni se-AIDS. Yilokhu odokotela abakubiza ngokuthi 'i-AIDS-Defining Illnesses (ADIs)'. Lokhu kufana nezibani ezibomvu, okubonisa ukuthi amasosha ethu omzimba asebuthakathaka kakhulu ngenxa yokutheleleka 'kwe-HIV' emizimbeni yethu.

Yiziphi lezi zifo ezichaza ingculazi (ama-ADI)?

Kalula nje, lawa ma-'ADI' ayimidlavuza nezifo eziwela esigabeni 'sezifo ezingosomathuba' ezingavela lapho ukutheleleka 'kwe-HIV' kuba kubi kakhulu, okungukuthi, lapho amasosha omzimba wethu eba buthakathaka kakhulu.

Uyazi ukuthi ziyini "izifo ezithathelanayo"? Cabanga ushiya yonke iminyango namafasitela endlu yakho evuliwe futhi kungekho ukuphepha. Khona-ke noma ubani angangena kalula. Kunjalo-ke, lapho amasosha omzimba wethu ebuthakathaka yi-'HIV', ngisho namagciwane amancane kakhulu ngokuvamile angenakubangela ukugula kumuntu ophilile athola kalula 'ithuba' lokungena emzimbeni futhi abangele izifo ezinkulu. Yilokho esikubiza ngokuthi 'izifo ezithathelanayo'. La magciwane ngokuvamile angatholakala endaweni esikuyo, kodwa amasosha omzimba omuntu ophilile ayawalwa nawo futhi awalawule.

Odokotela basebenzisa inani lamaseli e-CD4 kanye nalawa ma-ADI ukukala ubukhali bokutheleleka nge-HIV, okungukuthi, ukuthi kusakazeke kangakanani nokuthi kuyingozi kangakanani. Lawa maseli e-CD4 ayingxenye ebaluleke kakhulu yesimiso sethu somzimba sokuzivikela, njengamaphoyisa akhethekile emizimbeni yethu. Igciwane le-HIV libhubhisa lawa maseli e-CD4. Ngakho-ke, uma utheleleke nge-HIV futhi unalawa ma-ADI, odokotela bakubiza lokhu ngokuthi isigaba sesithathu sokutheleleka nge-HIV, okuyi-AIDS.

Ngezinye izikhathi, kuba yilapho umuntu eba ne-'ADI' kuphela lapho kutholakala khona ukuthi une-'HIV'. Kodwa-ke, kubalulekile ukukhumbula ukuthi akuwona wonke umuntu one-'ADI' one-'HIV'. Nakuba amanye ama-'ADI' evame kakhulu kubantu abane-'HIV' noma labo abanezivikeli mzimba ezibuthakathaka, ama-'ADI' amaningi angavela nakubantu abaphilile abangenazo izifo eziyisisekelo. Ngakho-ke, indlela engcono kakhulu yokwazi ngokuqinisekile ukuthola ukuhlolwa kwezokwelapha.

Yiziphi izinhlobo zezifo ezichaza ingculazi (ama-ADI)?

Kunezinhlobo ezahlukene zalezi 'ADI'. Zihlanganisa kakhulu izifo ezithelelanayo (isikhunta, amagciwane, amagciwane, izifo ezibangelwa amagciwane), ezinye izinhlobo zomdlavuza, kanye nezinye izimo ezihlobene nesimiso sezinzwa. Ake sibone ukuthi ziyini.

Izifo Zesikhunta

Uma amasosha omzimba wakho ebuthakathaka, izifo ezibangelwa yisikhunta zingasakazeka kalula emzimbeni wakho wonke. Ezinye zalezi zifo zifaka:

• I-Pneumocystis pneumonia (PCP): Lokhu ukutheleleka okukhulu kwamaphaphu.
• I-Candidiasis ye-bronchi, i-esophagus, i-trachea, noma amaphaphu
• I-Coccidioidomycosis - esakazekile/engaphandle kwamaphaphu
• I-Cryptosporidiosis yamathumbu engapheli ehlala isikhathi esingaphezu kwenyanga
• I-Cryptococcosis - i-extrapulmonary
• I-Histoplasmosis - esakazekile/engaphandle kwamaphaphu

Cabanga nje, uma amasosha ethu omzimba enamandla, la ma-fungus awakwazi ukwenza okuningi. Kodwa uma amasosha ethu omzimba ebuthakathaka yi-HIV, aqala ukubangela izinkinga.

Ukutheleleka Kwamagciwane

Amabhaktheriya angabangela nezifo ezahlukahlukene. Ezinye izifo zamabhaktheriya ezibhekwa njenge-'ADI' yilezi:

• Isifo Sofuba (i-Mycobacterium tuberculosis) kubantu abaneminyaka engu-6 nangaphezulu: Lesi yisifo abantu abaningi abake bezwa ngaso, futhi singathinta amaphaphu kanye nezinye izitho zomzimba.
• Ezinye izifo ze-Mycobacterium ezisakazeke ngaphandle kwamaphaphu: Izibonelo zifaka phakathi i-Mycobacterium kansasii kanye ne-Mycobacterium avium complex (MAC).
• Ukutheleleka kwamagciwane okuphindaphindiwe ezinganeni ezingaphansi kweminyaka engu-6 ubudala.
• I-Salmonella septicemia ephindaphindayo engeyona i-typhoid: Kulokhu, ukutheleleka kwe-Salmonella kungena egazini futhi kusakazeke emzimbeni wonke.

Izifo Ezibangelwa Yizinambuzane

Izimuncagazi nazo zingadala 'ama-ADI'. Izibonelo:

• I-Toxoplasmosis ebuchosheni: Kodwa-ke, lokhu akusebenzi ezinganeni ezingaphansi kwenyanga eyodwa ubudala.
• I-cystoisosporiasis yamathumbu engapheli ehlala isikhathi esingaphezu kwenyanga

Ukutheleleka Ngegciwane

I-HIV nayo iyigciwane. Futhi, lapho amasosha omzimba ebuthaka, kulula ukuthi amanye amagciwane ahlasele.

• I-Herpes simplex bronchitis, i-pneumonia, noma i-esophagitis: Lokhu akusebenzi nakubantwana abangaphansi kwenyanga eyodwa ubudala.
• Izilonda ze-Herpes simplex ezihlala isikhathi esingaphezu kwenyanga
• Isifo se-Cytomegalovirus: Ezithweni ezingezona isibindi, udende, noma ama-lymph node (isb., i-cytomegalovirus retinitis - ethinta amehlo). Lokhu akusebenzi nasezinsaneni ezingaphansi kwenyanga eyodwa ubudala.
• I-progressive multifocal leukoencephalopathy (PML): Lesi yisimo esingavamile kodwa esibucayi esithinta ubuchopho.

Umdlavuza

Uma amaseli ethu e-T (amaseli e-CD4 nawo ewuhlobo lwamaseli e-T) ehla, ingozi yokuthola umdlavuza obangelwa amagciwane noma umdlavuza othinta isimiso somzimba ngokwawo iyanda. Izinhlobo zomdlavuza ezibhekwa njenge-ADI kubantu abanegciwane le-HIV:

• I-Kaposi sarcoma: Umdlavuza ongavela ezindaweni ezifana nesikhumba, ama-lymph node, kanye nomlomo.
• I-Burkitt lymphoma
• Umdlavuza womlomo wesibeletho ohlaselayo
• I-immunoblastic lymphoma
• I-lymphoma eyinhloko yobuchopho

Ezinye Izimo

Ngaphezu kwalokhu, ezinye izimo eziningana zaziwa nangokuthi 'ama-ADI':

• I-pneumonia ephindaphindayo: Kubantu abadala nezingane ezingaphezu kweminyaka eyi-6 ubudala. I-pneumonia ukutheleleka kwamaphaphu okubangelwa amagciwane, amagciwane, noma isikhunta.
• I-HIV encephalopathy: Kulokhu, igciwane le-HIV lithinta ukusebenza kobuchopho.
• Isifo sokuwa kwe-HIV: Lokhu kubangela ukuthi umzimba ube mncane futhi ube buthakathaka.

Yiziphi izifo ezivame kakhulu ezichaza ingculazi (ama-ADI)?

Akuzona zonke lezi zinto ezenzeka kuwo wonke umuntu. Kodwa-ke, ezinye ze-'ADI' ezivame kakhulu yilezi:

• I-Pneumocystis pneumonia (PCP)
• I-Kaposi sarcoma
• Isifo sokuwa kwe-HIV
• I-candidiasis yesisu
• Ukutheleleka kwe-Mycobacterium avium complex (MAC)
• Isifo sofuba

Ziyini izimpawu zalezi zifo?

Izimpawu ze-'ADI' ziyahlukahluka kuye ngesifo. Kodwa-ke, izifo eziningi zinezici eziningana ezifanayo:

• Imfiva
• Ikhanda elibuhlungu
• Ubuhlungu bomzimba, ubuhlungu bemisipha
• Umphimbo obuhlungu
• Ubunzima bokuphefumula
• Ukuqhuma kwesikhumba
• Uhudo
• Ukudideka noma ezinye izinguquko zengqondo

Uma unesinye noma ngaphezulu salezi zimpawu, ikakhulukazi uma wazi ukuthi une-HIV, kubaluleke kakhulu ukubona udokotela ngokushesha okukhulu.

Kungani lezi zifo ezichaza ingculazi (ama-ADI) zenzeka?

Njengoba sesixoxile kakade, igciwane elithi `HIV` libhubhisa amaseli e-`T` (ikakhulukazi amaseli e-`CD4`) ohlelweni lwethu lokuzivikela komzimba. Lawa maseli e-`T` yiwo asiza ekulweni nokutheleleka. Ngakho-ke, lapho inani lala maseli e-`T` lehla kakhulu, umzimba wethu awukwazi ukulwa nokutheleleka ngokujwayelekile. Ngemuva kwalokho, singagula ngenxa yezinto ezingabangeli ukugula kumuntu onesimiso sokuzivikela somzimba esinempilo. Futhi, lesi yisizathu sokuthuthukiswa komdlavuza ohlobene nesimiso sokuzivikela komzimba noma umdlavuza obangelwa amagciwane.

Ukwelashwa nge-antiretroviral (ART) kusebenza kahle kakhulu ekugcineni amasosha omzimba ethu ephilile. Kodwa-ke, ngezinye izikhathi i-ADI ingakhula ngisho nalapho usebenzisa i-ART. Kunezimbangela eziningana ezingaba khona:

• Uma ungakwazi ukuphuza imithi yakho njengoba uyalelwe futhi ngesikhathi.
• Uma umuthi owuthathayo ungasebenzi kahle.
• Kungenzeka ukuthi uke waba ne-ADI engenazimpawu ngaphambi kokuthi uqale i-ART, futhi ingase ibuye lapho amasosha omzimba wakho ebuyiselwa esimweni sawo ngemva kokuqala i-ART (lokhu kubizwa nangokuthi i-immune reconstitution inflammatory syndrome - IRIS).

Zitholakala kanjani izifo ezichaza ingculazi (ama-ADI)?

Udokotela wakho uzohlonza i-ADI ngokusekelwe ezimpawini zakho. Lokhu kungafaka ukuhlolwa kwegazi noma olunye uketshezi lomzimba, futhi mhlawumbe kwenziwe i-biopsy. Bangase futhi benze izivivinyo ze-imaging, njenge-X-ray noma i-CT scan, ukuze babheke izinguquko emaphashini akho noma kwezinye izitho zomzimba.

Uma ungakaze utholakale une-HIV ngaphambilini, futhi une-ADI kuphela, udokotela wakho angase akuhlolele i-HIV kanye nezinye izimbangela ezingaba khona zokucindezelwa kwamasosha omzimba.

Hlobo luni lokuhlolwa okwenziwayo?

Ezinye izivivinyo udokotela angazisebenzisa:

• Ukuhlolwa kwegazi
• Ukuthatha isampula ekhaleni (i-nasal swab)
• Ukuhlolwa kwebhayoloji
• Ukuhlolwa kwesikhwehlela: Kuthathwa isampula ye-phlegm emaphashini ukuze kuhlolwe ukutheleleka.
• Ukuhlolwa kwesihlalo
• I-X-ray yesifuba
• Ukuskena kwe-CT
• Ukubhoboza/ukumpompa komgogodla
• Ukuhlolwa kwe-HIV

Ziphathwa kanjani lezi zifo?

Izinketho zokwelapha zincike ohlotsheni lwesifo onaso kanye nesimo sakho esithile. Uma ungayithathi i-ART, udokotela wakho angaqala i-ART ngokushesha okukhulu noma zingakapheli amasonto amabili kuya kwamane kusukela eqale ukwelashwa kwezifo ezithathelanayo.

Uma usuvele utholakale une-HIV futhi uthatha i-ART, udokotela wakho angenza izivivinyo ezengeziwe ukuze abone ukuthi imithi yakho isebenza kahle kangakanani.

Ukwelashwa kwe-ADI ethile kungafaka:

• Ama-antibiotic okutheleleka ngamagciwane
• Ama-antifungal okutheleleka nge-fungus
• Imithi yokulwa ne-parasitic yokutheleleka kwe-parasitic
• Ukuhlinzwa, imisebe, noma i-chemotherapy yomdlavuza

Kwenzekani uma nginesifo esichaza ingculazi (i-ADI)?

Ukuba ne-ADI kwandisa ingozi yokufa ngenxa yezinkinga ezihlobene ne-AIDS. Kodwa-ke, izindaba ezinhle ukuthi eminyakeni yamuva nje, inani lokufa okuhlobene ne-AIDS lehle kakhulu ngenxa ye-ART. Nakuba kulinganiselwa ukuthi cishe ingxenye yesine yabantu abangenwe yi-HIV bafa ngenxa yezinkinga ezihlobene ne-AIDS, ngokuqala i-ART kusenesikhathi, abantu abaningi abane-HIV baphila impilo enempilo ngaphandle kokuthola i-AIDS.

Ingabe izifo ezichaza ingculazi (ama-ADI) zingavinjelwa?

Yebo, ngokuqinisekile kungakwenza lokho!

I-ART ingasiza ekugcineni inani legciwane egazini lakho (umthwalo wegciwane) liphansi. Lokhu kwandisa inani lamaseli e-T (amaseli e-CD4). Lokhu kusiza amasosha omzimba wakho ukuthi ahlale ephilile futhi alwe nezifo. Kuphinde kusize ekulweni namagciwane abangela umdlavuza ohlobene ne-HIV.

Kunezinye izindlela eziningana zokunciphisa ingozi yokutheleleka:

• Imithi yokuvimbela:Udokotela wakho angase akunike izinto ezifana nama-antibiotic noma imithi yokukhunta ukuze kuncishiswe ingozi yokutheleleka okuthile.
• Ukugoma: Buza udokotela wakho ukuthi yimiphi imijovo okudingeka uyithole futhi uma ikhona okufanele uyigweme.
• Ukuhlolwa: Udokotela wakho angase ancome ukuhlolwa njalo kwezinhlobo ezithile zomdlavuza nezifo ezithathelwanayo.
• Ungabelani ngemishini yokujova imithi: Uma usebenzisa imithi kadokotela nemithi engabhalwanga ngudokotela, ungabelani ngezinaliti, amasirinji, njll. nabanye.
• Ukuhlanzeka Okuhle: Geza izandla zakho njalo, ikakhulukazi ngaphambi kokulungisa ukudla, ngaphambi kokudla, nangemva kokusebenzisa indlu yangasese. Ungabelani ngokudla, iziphuzo, noma izinto zakho siqu nabanye.
• Ukuphepha kokudla: Gwema amaqanda angaphekiwe kahle, ubisi olungaphekiwe (kufaka phakathi ushizi ne-ayisikhilimu), kanye nejusi yezithelo engaphekiwe kahle. Geza noma ukhiphe izithelo nemifino kahle ngaphambi kokudla.
• Gwema ukusebenzisa amanzi angelashwanga: Gwema ukungena kwamanzi emlonyeni wakho lapho ugeza ezindaweni ezifana namachibi namachibi, futhi ugweme ukuphuza amanzi ompompi angelashwanga. Uma uya endaweni lapho ungaqiniseki khona ngobumsulwa bamanzi, phuza amanzi asemabhodleleni bese usebenzisa amanzi afanayo ukupheka.

Kufanele ngimbone nini udokotela?

Uma une-HIV, qiniseka ukuthi ugcina zonke izikhathi zakho zokuqokwa nodokotela wakho. Tshela udokotela wakho uma unezimpawu ezintsha noma eziba zimbi kakhulu, noma uma unenkinga yokuthatha i-ART yakho. Thola ukuthi yini ongayenza ukuze uvimbele ukutheleleka nokuthi yini ongayenza uma unezimpawu zokutheleleka.

Kufanele uye nini e-Emergency Treatment Unit (ETU) ?

Uma ucabanga ukuthi kungenzeka ukuthi uke wavezwa yi-HIV, noma uma unezinye zalezi zimpawu ezimbi, iya ekamelweni eliphuthumayo ngokushesha:

• Umkhuhlane ongaphezu kwama-degrees Celsius angu-40 (ama-degrees Celsius angu-103).
• Ubunzima bokuphefumula.
• Ukuhlanza noma uhudo olunzima.
• Ubuhlungu besifuba.
• Ukudideka noma ukulahlekelwa ukwazi.
• Uma inxeba lishisa, libomvu, livuvukile, libuhlungu, noma lingapholi.

Yimiphi imibuzo okufanele ngiyibuze udokotela wami?

Kungaba usizo ukubuza udokotela wakho imibuzo efana nale:

• Ngingawuthatha kanjani umuthi wami ngendlela efanele?
• Wenzani uma uphuthelwa isikhathi sokubonana nodokotela?
• Yini engingayenza ukuze ngivimbele ukutheleleka?
• Yiziphi izimpawu okufanele ngiziqaphele?
• Kufanele ngiye nini egumbini lezimo eziphuthumayo?

Ekugcineni, umyalezo okufanele uwuthathe uye nawo ekhaya

Izifo ezichaza ingculazi (ama-ADI) ziyizivivinyo ezisiza odokotela ukuthi banqume ukuthi igciwane le-HIV lithinte kangakanani umzimba wakho. Uma une-HIV, usengozini enkulu yokuthola izinkinga ezinkulu ezivela kunoma yikuphi ukutheleleka.

Kodwa,Okubaluleke kakhulu, ukuthatha imishanguzo yokulwa namagciwane (ART) ngendlela efanele nangokuqhubekayo kungagcina amasosha omzimba wakho ephilile futhi kunike umzimba wakho amandla okulwa nezifo. Le mithi isize ekuvimbeleni ingculazi futhi yenza abantu abane-HIV baphile isikhathi eside njengalabo abangenayo i-HIV.

Ngakho-ke, khuluma nodokotela wakho ngezinye izindlela zokuphepha ongazithatha ukuze uvimbele izifo ezinkulu. Ungakhathazeki, ungalwa nalezi zimo ngolwazi nokwelashwa okufanele.

Ingculazi , i-HIV, ukuxilongwa kwe-AIDS, izifo ezithathelanayo, amasosha omzimba, amaseli e-CD4, ukwelashwa nge-ART