Umukoresha:ELHAMiiD/Virusi itera SIDA/SIDA
| HIV/AIDS | |
|---|---|
| Other names | HIV disease, HIV infection[1][2] |
 | |
| The red ribbon is a symbol for solidarity with HIV-positive people and those living with AIDS.[3] | |
| Specialty | Infectious disease, immunology |
| Symptoms | Early: Flu-like illness[4] Later: Large lymph nodes, fever, weight loss[4] |
| Complications | Opportunistic infections, tumors[4] |
| Duration | Lifelong[4] |
| Causes | Human immunodeficiency virus (HIV)[4] |
| Risk factors | Exposure to blood, breast milk, sex[4] |
| Diagnostic method | Blood tests[4] |
| Prevention | Safe sex, needle exchange, male circumcision, pre-exposure prophylaxis, post-exposure prophylaxis[4] |
| Treatment | Antiretroviral therapy[4] |
| Prognosis | Near normal life expectancy with treatment[5][6] 11 years life expectancy without treatment[7] |
| Frequency | 1.7 million new cases (2018)[8] 37.9 million living with HIV (2018)[8] |
| Deaths | 770,000 (2018)[8] |
Virusi itera SIDA ni agakoko kambura umubiri ubudahangarwa. Virusi ya SIDA ica umubiri intege ikawambura ubudahangarwa maze igatera ubwandu bw’indwara. Iyo itavuwe hakiri kare Virusi ya SIDA itera indwara zitandukanye bikarangwa no gucika intege k’umubiri ku buryo uba utakibasha guhangana n’indwara. Abantu barwaye SIDA iyo nta miti bafata igabanya ubukana bwayo bashobora kumara imyaka itatu gusa. Iyo umurwayi wa SIDA afashwe n’izindi ndwara kandi nta miti igabanya ubukana anywa, icyizere cy’ubuzima ni umwaka umwe. Abantu barwaye SIDA baba bagomba gufata imiti kugira ngo bakumire gupfa vuba. Nyuma yo kwandura kwambere umuntu ashobora kutabona ibimenyetso byayo, cyangwa ashobora guhura nigihe gito cyindwara zimeze nk'ibicurane (grippe). Ubusanzwe, ibi bikurikirwa nigihe kirekire nta bimenyetso. Iyo ubwandu bugenda bwiyongera mu mubiri, bubangamira cyane ubudahangarwa bw'umubiri, bikongera ibyago byo kwandura indwara zisanzwe nk'igituntu, kimwe n'izindi ndwara zibasira umubiri mu buryo butunguranye, ndetse n'ibibyimba bitamenyerewe ku bantu basanzwe bafite ubudahangarwa buhagije mu mubiri wabo. Ibi bimenyetso byigaragaza nyuma yaho ari nabyo bikomeye nibyo bituma umurwayi bivugwa ko yanduye SIDA kenshi bigaragazwa cyane no gutakaza ibiro byinshi kuburyo bugaragarira ijisho.
Virusi itera SIDA ikwirakwizwa cyane cyane n'imibonano mpuzabitsina idakingiye (harimo no guhuza n'ibikorwa byo gutingana bashyira ibitsina mu kibuno nababishyira mu kanwa), guterwa amaraso yanduye, inshinge zikoreshwa kwa muganga batera imiti mu mubiri w'umurwayi, umubyeyi utwite akaba yayanduza umwana atwite iyo adafashe imiti ku gihe, iyo umubyeyi abyaye, cyangwa binyuze mu konsa. Amatembabuzi asanzwe nk'amacandwe, ibyuya n'amarira, ntabwo byanduza virusi itera SIDA. Virusi itera sida ni imwe muri za virus zibarizwa mu itsinda rya ry'amavirusi azwi ku izina rya "retrovirus".
Uburyo bwo kwirinda virusi itera SIDA burimo imibonano mpuzabitsina ikingiye, gahunda zo gukoresha neza inshinge, kuvura abanduye, hamwe no gukoresha imiti nka "prophylaxis" mbere na nyuma yo gukora iminonano mpuza bitsina idakingiye. Iyo ari umwana uvutswe yanduye SIDA we na nyina umubyara bahabwa imiti igabanya ubukana SIDA. Nta muti cyangwa urukingo rwa virusi itera SIDA ruhari; ariko, imiti igabanya ubukana bwa virusi itera SIDA ishobora gutuma umuntu abaho igihe kirekire byenda kungana kimwe nk'abantu basanzwe bazima batayanduye. [5] Nibyiza gutangira gufata imiti no kwivuza no kwisuzumisha buri gihe ukimara kumenya ko wanduye. Hatabayeho kuvurwa, impuzandengo yo kubaho nyuma yo kwandura ni imyaka 11.
Muri 2018, abantu bagera kuri miliyoni 37.9 babanaga na virusi itera SIDA bituma hapfa abantu 770.000. Abagera kuri miliyoni 20.6 muri bo baba mu burasirazuba no mu majyepfo ya Afurika. Hagati y'igihe SIDA yamenyekanye (mu ntangiriro ya za 1980) na 2018, iyi ndwara yateje urupfu rw'abantu bagera kuri miliyoni 32 ku isi hose. VIH / SIDA ifatwa nk'icyorezo - icyorezo cy’indwara kiboneka ahantu hanini kandi kigenda gikwirakwira.
Virusi itera sida yavuye mu zindi nyamaswa yerekeza ku bantu bo muri Afurika yo mu burengerazuba bwo hagati mu ntangiriro kugeza no hagati mu kinyejana cya 20. SIDA yamenyekanye bwa mbere n’ikigo cya Leta zunze ubumwe z’Amerika gishinzwe kurwanya no gukumira indwara (CDC) mu 1981 kandi hamenyekana igitera SIDA - ubwandu bwa virusi itera SIDA - byagaragajwe mu ntangiriro y’imyaka icumi ya mbere y'uwo mwaka.
VIH / SIDA yagize uruhare runini muri sosiyete, iba indwara ndetse n'isoko y'ivangura. Iyi ndwara kandi igira ingaruka zikomeye mu bukungu. Hariho imyumvire myinshi itavugwaho rumwe ku birebana na VIH / SIDA, nko kwizera ko yanduzwa gusa no guhuza ibitsina mu buryo busanzwe. Iyi ndwara yateje impaka nyinshi mu banyamadini, harimo n’umwanya wa Kiliziya Gatolika yo kudashyigikira ikoreshwa ry’agakingirizo mu rwego rwo kuyirinda. Yatumye habaho ubuvuzi budasanzwe ku rwego rwa kiganga, mpuza mahanga ndetse igenerwa n'inkunga nyinshi zitandukanye kuva yamenyekana mu myaka ya za 1980.
Ibimenyetso biranga agakoko gatera SIDA[hindura | hindura inkomoko]
Hariho ibyiciro bitatu by'ingenzi bigaragaza ubwandu bwa virusi itera sida: kuremba bikabije, kuremba bikurikiranye no kurwaragurika kenshi bidakira, no kugera mu cyiciro cyaho umubiri ubura ubudahangwara mu buryo bukabije. [9]
kuremba bikabije[hindura | hindura inkomoko]
Mu ikubitiro kwandura virusi itera sida icyo cyiciro cyitwa "Acute HIV/igihe virus iba ifite ubukana bwinshi mu mubiri" cq kwandura mu gihe cy'ibanze aho virus iba ifite ingufu nyinshi mu mubiri irimo gushaka gukwirakwira mu mubiri hose. [24] Abantu benshi barwara ibicurane cyangwa indwara isa na "mononucleose" nyuma y'ibyumweru 2-4 nyuma yo guhura naho abandi nta bimenyetso bifatika bafite. [26] Ibimenyetso bibaho muri 40-90% byabantu kandi mubisanzwe harimo umuriro, ibibyimba mu kanwa, kumuka no kuryana mu muhogo, guhubuka, kubabara umutwe, kunanirwa, cyangwa ibisebe byo mumunwa no mu/ku gitsina. [25] [27] Indwara z'uruhu zizana ibiheri bigaragara muri 20-50% y'abayanduye, cyigaragaza mu buryo bw'uduheri twinshi turi kumurongo umwe kandi twinshi tubyimbye gakeya kandi tudasanzwe. Abantu bamwe na bamwe barwara indwara zifatika muriki cyiciro. Ibimenyetso byo mu gifu, nko kuruka cyangwa impiswi bishobora kubaho. Ibimenyetso nko kurwara imitsi, ingingo zigacika inege. Igihe ibimenyetso byiyerekana biratandukanye, ariko mubusanzwe ni icyumweru kimwe cyangwa bibiri.
Bitewe n'imiterere yabyo idasanzwe, ibi bimenyetso ntibifatwa nkibimenyetso simusiga byabanduye virusi itera SIDA. Ndetse nibibazo bibonwa na muganga wumuryango cyangwa ibitaro bikunze gusuzumwa nabi nkimwe mundwara zandura zifite ibimenyetso byinshi byenda gusa. Niyo mpamvu, birasabwa ko virusi itera sida yakekerwa cyane mu bantu bagaragaza umuriro mwinshi udasobanutse ushobora kuba ufite isano n'ingaruka zo kwandura. [10]
kuremba bikurikiranye no kurwaragurika kenshi bidakira[hindura | hindura inkomoko]
Ibimenyetso byambere bikurikirwa nicyiciro cyitwa "clinical latency" cyangwa virusi idakira. Hatabayeho kuvurwa, iki cyiciro cya kabiri ku bantu banduye virusi itera sida bisanzwe ariko bativuje habe namba gishobora kumara imyaka igera kuri itatu [29] kugeza ku myaka 20 [30] (ugereranije, imyaka umunani). Mugihe mubisanzwe hari ibimenyetso bike cyangwa bitagaragaye mbere, hafi yiki cyiciro kirangiye abantu benshi bahura numuriro mwinshi udasanzwe, guta ibiro, ibibazo byigifu no kubabara imitsi. Hagati ya 50% na 70% byabantu nabo barwara utubyimba two mu kwaha duhora twizana, ibice by'umubiri byaguka cyangwa bibyimba mu buryo budasobanutse, kwaguka kurenze uburyo busanzwe kw'imyanya ndangagitsina (uretse mu kibuno) mumezi arenga atatu kugeza kuri atandatu. [9]
Nubwo abantu benshi banduye virusi itera SIDA bafite virusi itagaragara kandi mugihe hatabayeho kuvurwa amaherezo bizatera SIDA (kubura burundu ubudahangwarwa bw'umubiri kwirwanaho ku ndwara), umubare muto (hafi 5%) ugumana urugero rwinshi rw'utunyabuzima twubatse ubudahangarwa bw'umubiri w'umuntu twitwa CD4 + T (T Helper Cells) udafite imiti igabanya ubukana bwa virusi irenze imyaka itanu. [27] [32] Abo bantu bashyizwe mu rwego rwa "HIV Controllers" cyangwa "long-term nonprogressors" (LTNP). Irindi tsinda rigizwe nabagumana uko virusi zigaragaza mu mubiri wabo muburyo butajya bumenyekana habe namba cyangwa butigaragaza byihuse kandi badakoresha imiti igabanya ubukana bwa virusi ari nabo bakunze kwitwa "elite controllers" cyangwa udashobora kumenyekana udafite imiti igabanya ubukana bwa virusi itera SIDA bene abo bari ku kigero kiri kuri 1 kugeza kuri 300 banduye.
Umubiri kubura ubudahangwara mu buryo bukabije[hindura | hindura inkomoko]
"Acquired immunodeficiency syndrome (AIDS/SIDA)" bisobanuye icyiciro aho umubiri w'uwanduye virusi itera SIDA yaba yageze aho abura ubudahangarwa bw'umubiri mu buryo bukabije kugeza aho abasirikare barinda umubiri we indwara bitwa "CD4 + T" baba bari munsi ya 200 ku gipimo gikoreshwa cya µL cyangwa kuba hari indwara zihariye ziterwa no kwandura virusi itera SIDA zamaze kwigaragaza mu buryo bufatika. Mugihe hatabayeho ubuvuzi bwihariye, ibi nibyo byigaragaza hafi kimwe cya kabiri cyabantu banduye virusi itera sida mu myaka icumi ya mbere. Ibintu byambere bikunze kugaragara byerekana ko umurwayi yageze muri iki cyiciro cyaho umuntu afatwa ko yanduye SIDA harimo :pneumocystis pneumonia" / UMUSONGA (40%), gutakaza ibiro byinshi mu buryo budasanzwe "cachexia" (20%), na "candidiasis esophageal" / indwara nutubyimba no kubabara mu kanwa ndetse no mu muhogo. Ibindi bimenyetso bikunze kugaragara harimo kwandura indwara zifata imyanya y'ubuhumekero.
Ashobora ndetse no kwibasirwa n'indwara zitunguranye ziterwa n'udukoko nka bacteria, virusi, ibihumyo, n'udukoko dutandukanye zisanzwe zikumirwa zikarindwa na bwa budahangarwa bw'umubiri mu bantu bazima. Indwara zandura ziterwa ahanini n’ibinyabuzima bikunze kubaho mu bidukikije by’umuntu. Izi ndwara zirashobora kwanduza umubiri wose zikawibasira zikawuca inege.
Ababana n'ubwandu bwa SIDA bafite ibyago byinshi byo kwandura kanseri zitandukanye ziterwa na virusi, harimo na sarcoma ya Kaposi, lymphoma ya Burkitt, lymphoma y'ibanze yo hagati, na kanseri y'inkondo y'umura. Sarcoma ya Kaposi ni kanseri ikunze kugaragara, iboneka ku 10% kugeza kuri 20% by'ababana na virusi itera SIDA. Kanseri ya kabiri ikunze kwibasirwa cyane ni lymphoma, ikaba ari yo nyirabayazana w'urupfu rw'abantu bagera kuri 16% banduye SIDA kandi ni cyo kimenyetso cya mbere cya SIDA muri 3% kugeza kuri 4%. Izi kanseri zombi zifitanye isano na herpesvirus ya 8 (HHV-8). Kanseri y'inkondo y'umura igaragara cyane ku bafite sida kubera ko ifitanye isano na "papillomavirus" ya muntu (HPV). Kanseri ifata (ya layer/urububi ruhuza igice cy'imbere cy'amaso n'igice cyera cy'ijisho) nayo ikunze kugaragara ku banduye virusi itera SIDA.
Byongeye kandi, ababana na sida bakunze kugira ibimenyetso byo kwibasirwa n'umuriro mwinshi udasanzwe uzamuka buri kanya utajya ugabanyuka, ibyuya byinshi (cyane cyane nijoro), kubyimba "lymph node" / utubyimba two mu kwaha, guhorana ubukonje bukabije (imbeho, gutitira), intege nke, no gutakaza ibiro byinshi cyane. Indwara y'impiswi iza buri kanya ni ikindi kimenyetso gikunze kugaragara, kiboneka ku bantu 90% banduye SIDA. Bashobora kandi kwanduzwa n'ibimenyetso bitandukanye byo mu mutwe ndetse no mu mitsi bidafite ubwandu bwa kanseri na kanseri.
Uburyo virusi itera SIDA ikwirakwizwamo[hindura | hindura inkomoko]
Virusi itera SIDA ikwirakwizwa n'inzira eshatu z'ingenzi: guhuza ibitsina mu buryo budakingiye, ibice by'umubiri w'uwanduye indwara ya SIDA twahungabanye nk'ibisebe bivamo amatembabuzi n'amaraso, ndetse no kuva amaraso ku mubyeyi iyo atwite; ndetse no mu gihe umubyeyi atwite umwana ashobora kumwanduza, mu gihe cyo kubyara umubyeyi wanduye ava amaraso arimo abyara akivanga n'amaraso y'umwana binyuze ku mukonda, cyangwa konsa uruhinja ku mubyeyi wanduye. Nta kaga ko kwandura virusi itera sida binyuze mu mazirantoki, ururenda rw'amazuru/ibimyira, amacandwe, ibyuya, amarira, inkari, cyangwa kuruka keretse iyo byanduye n'amaraso. [49] Birashoboka kandi ko umuntu yakwandura impurirane y'ubwoko bwa virusi itera sida burenze bumwe bikunze kwitwa "HIV superinfection".
Imibonano mpuza bitsina[hindura | hindura inkomoko]
Uburyo bukunze kwanduriramo virusi itera SIDA ni uburyo bwo guhuza ibitsina n'umuntu wanduye hakorwa imibonano mpuza bitsina idakingiye. Icyakora, umuntu wanduye virusi itera sida ufite virusi itagaragararira ibyuma biyipima bitewe no kuvurwa igihe kirekire, nta byago afite byo kwanduza abandi virusi itera SIDA binyuze mu gukorana nabo imibonano mpuza bitsina idakingiye. [51] Kuba hari abantu banduye virusi itera SIDA itagaragarira ibyuma biyipima byamenyekanye cyane mu itangazo ry’Ubusuwisi ryo mu 2008 biteza impaka no kutabivugaho rumwe, kuva icyo gihe byaje gukorerwa ubushakashatsi bwimpitse biremezwa ko bibari ndetse bishoboka.
Ku isi hose, uburyo bukunze kwanduriramo virusi itera SIDA ni uburyo bwo guhuza ibitsina n'umuntu wanduye hakorwa imibonano mpuza bitsina idakingiye hagati y’abo mudahuje igitsina; [12] ariko, uburyo bwo kwandura buratandukanye mu bihugu. Kugeza mu 2017, abantu benshi banduye virusi itera SIDA muri Amerika babaye mu bagabo baryamanye n'abagabo (82% by'abanduye virusi itera SIDA ku bagabo bafite imyaka 13 n'abayirengeje na 70% by'indwara nshya). [54] [55] Muri Amerika, abagabo bahuje ibitsina n'abagabo bahuje ibitsina bafite imyaka 13 kugeza kuri 24 bangana na 92% by'abanduye virusi itera sida mu bagabo bose bari mu kigero cyabo na 27% by'indwara nshya mu bagabo bose bahuje ibitsina ndetse n'ibitsina byombi. Abagabo bagera ku 15% b’abagabo bahuje ibitsina n’abahuje ibitsina banduye virusi itera sida, mu gihe 28% by’abagore bahindura ibitsina "transgender" banduye muri Amerika.
Ku bijyanye n’imibonano mpuzabitsina idakingiye, ibigereranyo by’ingaruka zo kwandura virusi itera sida ku gikorwa cy’imibonano mpuzabitsina bigaragara ko byikubye inshuro enye kugeza ku icumi mu bihugu byinjiza amafaranga make ugereranyije no mu bihugu byinjiza amafaranga menshi. Mu bihugu byinjiza amafaranga make, ibyago byo kwandura abagore ku bagabo bingana na 0.38% kuri buri gikorwa, naho kwanduza abagabo ku bagore ni 0,30% kuri buri gikorwa; ibigereranyo bihwanye n'ibihugu byinjiza amafaranga menshi ni 0,04% ku gikorwa cyo kwanduza abagore ku bagabo, na 0.08% kuri buri gikorwa cyo kwanduza abagabo n'abagore. [58] Ibyago byo kwandura bivuye mu mibonano mpuzabitsina ni byinshi cyane, bivugwa ko 1,4-1.7% kuri buri gikorwa haba mu mibonano mpuzabitsina idahuje igitsina ndetse n'abaryamana bahuje igitsina. [58] Nubwo ibyago byo kwandura biva mu mibonano mpuzabitsina ku bahuje ibitsina ari bike, biracyahari. Ibyago byo kwakira imibonano mpuzabitsina mu kanwa byavuzwe ko ari "hafi NTABYO"; [61] ariko, byagaragaye ko hari abantu bake banduye binyuze muri ubwo buryo. Ibyago kuri buri gikorwa byagereranijwe kuri 0-0.04% ku bakira imibonano mpuza bitsina mu kanwa "oral sex". Mu bihe birimo uburaya mu bihugu bikennye cyane, ibyago byo kwandura abagore ku bagabo byagereranijwe ko ari 2,4% kuri buri gikorwa, naho kwanduza abagabo ku bagore ni 0,05% kuri buri gikorwa.
Ibyago byo kwandura byiyongera iyo umuntu yanduye indwara zisanzwe zandurira mu mibonano mpuzabitsina [64] hamwe n’ibisebe byo mu gitsina. Ibisebe byo mu gitsina bigaragara ko byongera ibyago inshuro zigera kuri eshanu. Izindi ndwara zandurira mu mibonano mpuzabitsina, nka mburugu, kilamidiya, tirikomunasi, na vaginose ya bagiteri, zifitanye isano no kwiyongera gake mu byago byo kwandura.
Ubwikorezi bwinshi bw'ubukana bwa virusi y’umuntu wanduye "viral load" ni ikintu cy’ingaruka zikomeye mu kwanduza imibonano mpuzabitsina ndetse no mu na nyina ku mwana. Mu mezi 2.5 ya mbere yanduye virusi itera sida ubwandu bw'umuntu bwikubye inshuro cumi n'ibiri bitewe n'ubwikorezi bwinshi bw'ubukana bwiyo virusi itera sida afite mu mubiri we. Niba umuntu ari mu cyiciro cye cyanyuma yaho yanduriye virusi itera SIDA, ibipimo byanduza bikubye inshuro umunani.
Abakora imibonano mpuzabitsina bicuruza mu bikorwa by'uburaya (harimo n'abacuruza imibiri yabo by'umwuka byemewe "pornography") bafite amahirwe menshi yo kwandura virusi itera SIDA. [66] Imibonano mpuzabitsina ikabije mu buryo bwo gukubana kw'ibitsina nta bunyerere cyangwa ububobere buhagije mu gitsina "rough sex" irashobora guteza amahirwe yo kwiyongera kwandura. Ihohoterwa rishingiye ku gitsina rikubiyemo ibikorwa byo gufata kungufu no gusambanya abana bakiri bato "sexual assualt" naryo rishobora guteza ibyago byinshi byo kwandura virusi itera sida kubera ko udukingirizo tudakunze kwambarwa bigatera gukomereka mu gitsina ku bagore no ku gitsina ku bagabo cyangwa gukomereka mu kibuno bikongera amahirwe yo kwandura virusi itera SIDA ndetse bikaba byanatera ibyuririzi by'indwara zindi zandurira mu gukora imibonano mpuza bitsina akabirwarira hamwe n'ubwandu bwa virusi itera SIDA.
Amatembabuzi[hindura | hindura inkomoko]
Uburyo bwa kabiri bukunze kwanduriramo virusi itera sida ni uburyo bunyuze mu maraso yanduye no mu bintu bivanzwemo nayo maraso yanduye. Kwandura biciye muri ubu buryo birashobora guterwa no gusangira inshinge mugihe cyo gukoresha ibiyobyabwenge bacisha mu kwitera inshinge mu mitsi, gukomeretswa n'inshinge mu gihe ruri guterwa ufite ubwandu bwa virusi itera SIDA, guterwa amaraso yanduye cyangwa ibikomoka ku maraso, cyangwa inshinge zubuvuzi hamwe n’ibikoresho bidafite ubuziranenge "bidafite umutekano uhagije wo kubibika mu buryo bwiza mu byuma bibihanaguraho imyanda "sterilizers". Ibyago byo kwandura virusi itera SIDA hakoreshejwe uburyo bwo gusangira urushinge mugihe cyo gutera ibiyobyabwenge hagati y'abakoresha ibyobya bwenge ubwabo biri hagati ya 0,63% na 2,4% kuri buri gikorwa, ugereranije ku gipimo cyo hagati "average" ni 0.8%. Ibyago byo kwandura virusi itera sida ku binyuze k'urushinge rwatewe umuntu wanduye virusi itera sida bivugwa ko ari 0.3% (hafi 1 kuri 333) kuri buri gikorwa kandi ibyago byo kwandura virusi itera SIDA binyuze ku rurenda rw'amatembabuzi ruvanzemo amaraso yanduye virusi itera SIDA ni 0.09% (hafi 1 kuri 1000) kuri buri gikorwa. [49] Izi ngaruka zirashobora ariko kugera kuri 5% mugihe ayo maraso ari muri urwo rurenda rw'amatembabuzi yaturutse kumuntu ufite ubwikorezi bwinshi bwa virusi itera SIDA n'umwenge cyangwa igisebe ari kinini mu mubiri. Muri Leta zunze ubumwe za Amerika abakoresha ibiyobyabwenge bagejeje kuri 12% by'abanduye virusi itera SIDA mu 2009, [72] ndetse no mu turere tumwe na tumwe abantu barenga 80% bitera ibiyobyabwenge banduye virusi itera SIDA.
Virusi itera SIDA yanduza hafi 90% binyuze mu guterwa amaraso yanduye "blood transfusion". Mu bihugu byateye imbere ibyago byo kwandura virusi itera SIDA ni bike cyane (munsi ya kimwe cya kabiri cya miliyoni) aho hakorwa uburyo bwo gutoranya abaterankunga no gusuzuma virusi itera sida mu maraso atangwa "blood donations"; [12] urugero, mu Bwongereza ibyago bivugwa ko ari umwe muri miliyoni eshanu [73] naho muri Amerika yari imwe muri miliyoni 1.5 muri 2008. [74] Mu bihugu bikennye cyane, kimwe cya kabiri cy’amaraso ni yo yonyine ishobora gupimwa mu buryo bukwiye (guhera mu 2008), [75] kandi bikaba bivugwa ko abagera kuri 15% banduye virusi itera SIDA muri utwo turere baturuka ku guterwa amaraso yanduye n'amatembabuzi avanze nayo maraso yanduye, bigereranywa kuri 5% na 10% byanduye kwisi. [12] [76] Birashoboka kwandura virusi itera sida mu guhinduranya ingingo z'umuburi zitangwa kwa muganga "implants", nubwo ibi bidasanzwe kubera kwipimisha.
Gutera imiti hifashishijwe inshinge zidafite umutekano bigira uruhare muri virusi itera SIDA muri Afurika yo munsi y'Ubutayu bwa Sahara. Mu 2007, hagati ya 12% na 17% byanduye muri kano karere byatewe no gukoresha inshinge zidafite umutekano zo kwa muganga. Ishami ry'Umuryango w'Abibumbye ryita ku Buzima rivuga ko ibyago byo kwandura biturutse ku gutera inshinge muri Afurika ni 1,2%. Hari n'ingaruka zo kwandura virusi itera SIDA zikomoka ku kubaga indembe, kubyaza, no kuvura no kubaga amenyo muri kano karere.
Abantu baterwaho ibishushanyo ku mibiri yabo "tattooing", gutobora ibice by'umubiri bitandukanye, no gukomeretsa ibice by'umubiri wabo binyuze mu ndasago "scarification" bafite ibyago byo kwandura nubwo nta bushakashatsi buhari bufatika bubyemeza. Imibu ndetse nutundi dukoko ntibishobora kuba impamvu yo gukwirakwiza ubwandu bwa virusi itera SIDA.
Umubyeyi kwanduza umwana[hindura | hindura inkomoko]
Virusi itera SIDA irashobora kwanduza umwana mu gihe umubyeyi amutwite, igihe cyo kubyara, cyangwa binyuze mu mashereka amwonsa, bigatuma umwana na we yandura virusi itera SIDA. Kugeza mu mwaka wa 2008, kwandura virusi itera SIDA mu buryo bwiswe "verticle transmission" binyuze mu dukoko twa bagitiriya na virusi mu gihe umubyeyi atwite umwana cyangwa arimo kubyara ni 90% by'ababana bayandura. Mugihe hatabayeho kuvurwa virusi itera SIDA ku mubyeyi wanduye, ibyago byo kwanduza umwana mbere cyangwa mugihe cyo kuvuka ni 20%, naho kubonsa amashereka ni 35%. Ubuvuzi butangwa ku mubyeyi ukimenya ko yanduye ariko atwite bugabanya ibyago byo kwanduza umwana we akimutwite no mu gihe cyo kumubyara kugeza munsi ya 5%.
Imiti igabanya ubwandu bwa virusi itera SIDA iyo ifashwe na nyina cyangwa umwana bigabanya ibyago byo kwandura ku bonsa. Ibiryo bigaburirwa umwana iyo byivanzemo n'amaraso yanduye virusi itera SIDA mbere yo kubihekenya birashobora guteza ibyago byo kwandura virusi kuri uwo mwana. Niba umugore atavuwe virusi itera SIDA akamara imyaka ibiri yonsa uruhinja nabyo bitera ibyago byo kwandurza umwana we bigera kuri 17%. Bitewe n’ubwiyongere bw’urupfu rw'impinja bukomoka ku kutonsa mu bice byinshi byo mu bihugu biri mu nzira y'amajyambere, Ishami ry'Umuryango w'Abibumbye ryita ku Buzima rirasaba ko konsa byihariye hagati y'umubyeyi n'uwo mwana we umwe gusa cyangwa gutanga kwifashisha amata yo mu bikombe nk'imfashabere. Abagore bose bazwiho kuba banduye virusi itera SIDA bagomba gufata imiti igabanya ubukana ubuzima bwabo bwose.
Ubumenyi n'ubucukumbuzi bujyanye na Virusi[hindura | hindura inkomoko]
Virusi itera SIDA niyo nyirabayazana w'indwara zitera umuburi kubura ubudahangarwa ari nabyo byitwa "SIDA". Virusi itera SIDA ni ubwoko bwa "retrovirus" yibanda cyane mu kwangiza abasirikare barinda umubiri w'umuntu bitwa "CD4 + T Cells", "macrophage" na "dendritic cells" . Yangiriza byimazeyo mu buryo buziguye ndetse n'ubutaziguye abo basirikare batuma umubiri ugira ubudahangarwa bitwa "CD4 + T".
Iyo virusi itera SIDA ibarizwa mu bwoko bwa "Lentivirus", nabwo bubarizwa mu cyiciro cyitwa "Retroviridae" . Virusi zo muri ubu bwoko bwa "Lentivirus" zisangiye ibintu byinshi biziranga imiterere yabyo ndetse n'ibijyanye n'ubutabire bw'ibinyabuzima bubiranga. Ibinyabuzima byinshi biri mu cyiciro cy'inyamaswa zonsa zikunze gufatwa no kwandura nama virusi ari muri ubu bwoko bwa "Lentiviruses" ari nabyo bikunze gutera indwara z'igihe kirekire ndetse zimara igihe mu mubiri zirimo gukura. Ubu bwoko bwa virusi zibarizwa muri "Lentiviruses" zigira ububasha bwo kwandura bwinjira mu mubiri ari imbumbe kandi bwiteguye kwanduza bwiyambitse urububi ruzirinda rwa "RNA GENOME". Iyo zinjiye mu mubiri ako kanya, rwa rububi ruzirinda rwa "RNA GENOME" ruhita ruhindagura imiterere yarwo "reverse transcribed" rugahinduka ADN ifite kopi ebyiri ya virusi nyayo itera uburwayi byitwa "reverse transciptase" bizanana na ya "GENOME" virusi mu bigize virusi. Nyuma yo kwihindagura yisanisha na ADN ziri mu mubiri mu buryo bwo gukora kopi zisa neza ihita yinjira mu dutafari twubatse umubiri twitwa "nucleus cells" tugahita twisanisha neza nkatwo mu rwego rwo kwiyorobeka no kwihisha mu mubiri binyuze mu buryo bwitwa "integrase" nibigize umubiri yinjiyemo. Virusi iyo imaze kwinjira neza muri twa dutafari tugize umubiri "cells" ihita yirinda kugira ibitero igaba ku mubiri ako kanya kugirango abasirikare baha ubudahangarwa mu mubiri batayivumbura bagatangira kuyirwanya. Hari nubwo virusi iyo imaze kwinjira mu mubiri ihita ikoresha ubundi buryo bwitwa "transcribed" ari nabwo bwo kubasha kwiyubura ikikoramo kopi nyinshi z'amavirusi bisa kimwe ya "RNA GENOMES" afite naza poroteyine z'ama virusi byishyize hamwe bikirema mu imbere muri za "cells" zigakomeza gutubuka gutyo zikaba nyinshi mu mubiri.
Virusi itera SIDA ubu yamenyekanye ko ikwirakwira iciye mu basirikare barinda umubiri bawuha ubudahangarwa ba "CD4 + T" biciye mu nzira ebyiri zibangikanye: gukwirakwiza mu imbere muri "cells" ubwayo aribyo byitwa "cell-free spread" cyangwa gukwirakwizwa yanduza za "cells" zitandukanye ku bwinshi ari nabyo byitwa "cell-to-cell spread". Mu gukwirakwiza biciye mu buryo bwa "cell-free spread" virusi ziva mu ngirabuzimafatizo "virus particles bud" zituruka mu basirikare banduye ba "T cells", zinjira mu maraso/nandi matembabuzi avanze namaraso hanyuma zikanduza utundi dusirikare turinda umubiri kwandura twa "T cells" uko zijyenda zihura nazo gutyo gutyo kugeza zikwirakwiye mu mubiri hose. Iri kwirakwizwa rya virusi mu mubiri uko rigenda ryikoramo kopi nyinshi biri mu bintu birwanya bigaca inege imiti n'ubuvuzi bujyanye no kuvura amavirusi
Ubwoko bubiri bwa virusi itera sida bwaranzwe na virusi y'ubwoko bwitwa "VIH-1" na "VIH-2". Virusi ya "VIH-1" ni virusi yavumbuwe bwa mbere (kandi yabanje kwitwa "LAV" cyangwa "HTLV-III"). Ni virusi ifite ubukana kandi yandura cyane, kandi niyo nyirabayazana w'ubwandu bwa virusi itera SIDA ku isi yose ugereranije na virusi yo mu bwoko bwa "VIH-2" izwiho kwandurwa n'abantu bake. Kubera ubushobozi buke ugereranije bwo kwandura, ubwoko bwa virusi ya "VIH-2" igarukira muri Afurika y'Iburengerazuba .
Indwara ya Pathophysiology[hindura | hindura inkomoko]
Iyo virusi imaze kwinjira mu mubiri habaho igihe cyo gutubuka kwayo zikaba nyinshi mu buryo bwo kujyenda zikoramo kopi nyinshi byihuse, biganisha kuri virusi nyinshi mumaraso. Mu ikubitiro ryo kwandura virusi, urwego rwa virusi itera sida rushobora kugera kuri miriyoni nyinshi za virusi kuri mililitiro yamaraso mu mubiri. Iki gisubizo kijyana nigabanuka ryagaragaye mumibare y'abasirikare barinda umuburi indwara bitwa "CD4 <sup id="mwAnM">+</sup> T". Virusi ikomeza kugira ubukana kubera imiterere yayo yo gutuma havuka utundi dusirikare "cells" twitwa "CD8 <sup id="mwAnY">+</sup> T" tuza twica burundu twa dusirikare turinda umubiri kutandura indwara tukabyara za "antibody" zirwanya umubiri ziwuca intege, cyangwa "seroconversion" . Igisubizo gifatika mu isuzuma ryutwo dusirikare twa "CD8 + T" nicyo cyerekana uko ubwandu bw'indwara bujyenda bugabanyuka cyangwa bwiyongera mu mubiri nubwo bitarinda burundu virusi itera SIDA.
Amaherezo, virusi itera SIDA irwanya ba basirikare barinda umubiri indwara ikajyenda ibica ibagabanya ubwinshi bakaba bakeya mu mubiri "CD4 + T" kugeza ubwo umubiri ubura ubudahangarwa bigatera indwara z'ibyuririzi kwibasira umubiri muburyo buzorohereye. Abasirikare ba "T Cells" ni ingirakamaro mubisubizo byubudahangarwa bw'umubiri kandi bitabaye ibyo, umubiri ntushobora kurwanya indwara cyangwa kwica udusirikare twamaze kuba kanseri mu mubiri. Uburyo abasirikare ba "CD4 + T cells" bagenda bashira mu mubiri bugiye butandukanye yaba mu ikubitiro umubiri ukinjiramo virusi itera sida ikikoramo kopi nyinshi ndetse no mu bihe bwo kurwaragurika cyane mu byiciro bitandukanye. Mu cyiciro cy'ibanze cyo kwandura virusi itera SIDA, hifashishwa udusirikare twanduye twabaye kanseri mu mubiri twa "CD8 + T" ari natwo tugira uruhare mu kugabanuka k'udusirikare turinda umubiri twa "CD4 + T", nubwo umubiri ubwawo wabigiramo uruhare mu gihe wirwanaho wica udukoko turi mu mubiri mu buryo bwitwa "apoptose" nayo ishobora kubitera. Iyo virusi ziyongereye mu mubiri; umurwayi akagera mu cyiciro cyo kuremba bikabije no kurwaragurika indwara z'ibyuririzi zitandukanye bituma habaho gutakaza buhoro buhoro ubushobozi bwimikorere yubudahangarwa bwo kubyara abasirikare bashya ba "T cells" ari nabyo bituma bagabanyuka cyane"CD4 + T".
Nubwo ibimenyetso byo kubura ubudahangarwa biranga SIDA bitagaragara imyaka myinshi nyuma yuko umuntu yanduye, igice kinini cyo gutakaza abasirikare ba CD4 + T kibaho mugihe cyicyumweru cya mbere cy'ubwandu, cyane cyane mumitsi yo munda, kibamo uturemangingo turwanya indwara zo mu mubiri twita "lymphocytes" mu mubiri. Impamvu virusi itera SIDA yibanda cyane kuri ako gace ko munda "intestinal mucosa" ni ukubera ko virusi itera SIDA ikora za poroteyine z'ubwoko bwa "CCR5" ikoresha mu kwibasira yinjira ihungabanya abasirikare barinda umubiri indwara ba "CD4 + T" kandi ako gace k'imitsi yo munda kagizwe cyane nizo poroteyine kuruta za poroteyine ziba mu maraso. Imihindagurikire yihariye ihindura imiterere ya za poroteyine za "CCR5" iyo ziboneka mu buryo bwombi bwa "chromosomes" birinda cyane kwandura virusi ya VIH-1.
Virusi itera SIDA ishakisha kandi ikarandura byimazeyo CCR5 zigaragaza mudusirikare turinda umubiri twa CD4 + T mu ikubitiro ryo kwandura iyo virusi kuko nibwo iba ifite ubukana bwinshi. Abasirikare barinda umubiri ba CD4 + T ni nako batangira kurwanya iyo virusi itera SIDA ari nako irushaho kubica bikihutisha kujya mu cyiciro cya kabiri cyo kuremba no kurwaragurika buri kanya bidakira "clinical latent phase". Uko virusi itera SIDA irushaho kwikoramo kopi nyinshi ikibasira umubiri wose ni nako umubiri ubura ubudahangarwa kurushaho. Ibyo byose bigateza uruvangitirane rw'ibibazo byo mu mubiri bituma habaho gusohoka kwa "pro-inflammatory cytokines". Ni nabyo ndetse bifitanye isano mu guteza indwara zo munda nk'igifu kubera urububi/igisenge kigize amara gikomeza kujyenda cyangirika cyane iyo habayeho kuremba cyane.
Gusuzuma[hindura | hindura inkomoko]
| Kwipimisha amaraso | Iminsi |
|---|---|
| Ikizamini cya Antibody ( ikizamini cyihuse, ELISA gen 3) | 23–90 |
| Antibody na p24 kwipimisha antigen (ELISA 4 gen) | 18-45 |
| PCR | 10–33 |
uhuza ibitsina[hindura | hindura inkomoko]
[[Category:SIDA]]
- ↑ Cite error: Invalid
<ref>tag; no text was provided for refs namedAIDS2010GOV - ↑ "HIV Classification: CDC and WHO Staging Systems | AIDS Education and Training Centers National Coordinating Resource Center (AETC NCRC)". aidsetc.org (in Icyongereza). AIDS Education and Training Center Program. Archived from the original on October 18, 2017. Retrieved September 10, 2017.
- ↑ "Wear your red ribbon this World AIDS Day | UNAIDS". www.unaids.org. UNAIDS Secretariat. Archived from the original on September 10, 2017. Retrieved September 10, 2017.
- ↑ 4.0 4.1 4.2 4.3 4.4 4.5 4.6 4.7 4.8 Cite error: Invalid
<ref>tag; no text was provided for refs namedWHO2015Fact - ↑ Cite error: Invalid
<ref>tag; no text was provided for refs namedCDC21015Bas - ↑ Cite error: Invalid
<ref>tag; no text was provided for refs namedUN2012Vac - ↑ Cite error: Invalid
<ref>tag; no text was provided for refs namedUNAIDS2007 - ↑ 8.0 8.1 8.2 Cite error: Invalid
<ref>tag; no text was provided for refs namedUN2018 - ↑ 9.0 9.1 Mandell, Bennett, and Dolan (2010). Chapter 121.
- ↑ Mandell, Bennett, and Dolan (2010). Chapter 118.