Duk da ci gaban da suka faru, haddasawa tsakanin mata da kwayar cutar HIV ba ta canza ba
Mutane da ke dauke da kwayar cutar HIV suna da haɗari mai girma na bunkasa wasu ciwon daji, wanda za'a iya ƙididdigewa daga cikinsu a matsayin yanayin SIDA. Daga cikinsu akwai cutar ciwon jijiyar jini (ICC), wani mataki na cutar da cutar ta ci gaba da yaduwa daga jikin kwakwalwa zuwa ga kwayar halitta mai zurfi da sauran sassan jiki.
Duk da yake ICC na iya ci gaba a kamuwa da kamuwa da kwayar cutar ta HIV da kuma wadanda basu kamu da cutar ba, hadarin da ke tsakanin mata masu dauke da kwayar cutar HIV zai iya zama kusan sau bakwai.
A cikin matan da ke dauke da kwayar cutar HIV, ana ganin haɗarin ICC yana karawa tare da ragewa a cikin adadin CD4 , tare da kusan kusan sau shida a cikin mata da ƙididdigar CD4 a ƙarƙashin 200 kwayoyin / mL idan aka kwatanta da waɗanda suke da CD4 suna da ƙari fiye da 500 / ML.
Game da Cercical Cancer
Kwayoyin cutar papillomavirus (HPV) an dauke su ne don bunkasa ciwon sankarar mahaifa, suna lissafta kusan duk abubuwan da aka rubuta. Kamar yadda yake tare da dukan papillomaviruses, HPV ta kafa cututtuka a wasu sassan fata da kuma ƙwayoyin mucosal, mafi yawansu ba su da kyau.
Kusan 40 nau'in HPV da aka sani da za a aika su da jima'i kuma zai iya haifar da cututtuka a kusa da kwayar cutar da al'amuran, a wasu lokuta yana bayyana kamar warts. Daga cikin wadannan, nau'ikan "nau'in haɗari" 15 zasu iya haifar da raunuka masu tasowa. Idan an bar shi ba tare da an hana shi ba, zatsun da suka dace zasu iya cigaba da ciwon ciwon sankarar mahaifa. Ci gaba na ciwo sau da yawa jinkirin, shan shekaru kafin bayyanuwar bayyanar cututtuka ci gaba. Duk da haka, a cikin wadanda ke da tsarin kwakwalwa (CD4 kasa da 200 kwayoyin / ml), ci gaban zai iya zama mafi sauri.
Sakamakon farko ta hanyar gyare-gyare na Pap yau da kullum ya rage karuwar cutar ciwon sankara a cikin 'yan shekarun nan, yayin da ci gaban maganin rigakafi na HPV ya haifar da ƙara ragewa ta hana ƙananan haɗarin da ke tattare da kashi 75 na magungunan mahaifa.
Kimanin kimanin kashi 26.8 cikin kimanin kashi 3.4 cikin dari na kamuwa da cutar HPV a cikin mata na Amurka shine kamuwa da cututtukan HPV mai tsanani 16 da 18, wanda asusun na kimanin kashi 65 cikin 100 na cututtuka na mahaifa.
Ciwon Cervical a cikin Mata da HIV
Duk da wannan ci gaba, ciwon sankarar mahaifa an dauke shi ne karo na biyu na ciwon daji a cikin mata a dukan duniya, yana kimanin kimanin mutane 225,000 a kowace shekara. Yayinda mafi yawan lokutta suna ganin a cikin kasashe masu tasowa (saboda rashin lafiyar Pap da kuma rigakafi na HPV), ciwon sankarar mahaifa har yanzu yana da kusan kusan mutane 4,000 a Amurka a kowace shekara.
Ƙari game da duk da haka shi ne cewa rashin lafiyar cutar ciwon sankara a cikin matan HIV dauke da cutar HIV ba ta canza ba tun lokacin da aka gabatar da maganin antiretroviral (ART) a karshen shekarun 1990. Wannan ya bambanta da sarcoma na Kaposi da lymphoma ba na Hodgkin, duk da yanayin da cutar ta AIDS ke nunawa wanda ya ragu fiye da kashi 50 cikin lokaci.
Duk da yake ba a fahimci dalilan wannan ba, binciken da Fox Chase Cancer Center a Philadelphia ya yi da yafi dacewa da binciken da ya dace da shi ya nuna cewa matan da ke dauke da kwayar cutar HIV ba zasu amfana daga maganin rigakafi na HPV wanda aka saba amfani dashi don hana maganin cutar guda biyu (iri na 16 da 18). Daga cikin matan da ke dauke da kwayar cutar HIV, iri 52 da 58 sun fi yawan gani, duka biyu ana dauke su da mummunar haɗari da rashin tsayayya ga maganin rigakafin yanzu.
Cutar cututtuka na Cutar Cancer
Akwai sau da yawa 'yan tsirarun bayyanar cututtuka a farkon farkon ciwon sankarar mahaifa .
A gaskiya ma, lokacin da zubar da jini da / ko lamba na jini ya auku - biyu daga cikin alamun bayyanar da aka fi sani da-wata mummunan iya riga ya ci gaba. A wani lokaci, za'a iya samun sassaucin wuri, da kuma fitarwa na jiki, zafi ciwo, ƙananan ciwon ciki, da kuma zafi a lokacin yin jima'i.
Cikin ci gaba da ciwon cutar, zubar da jini mai tsanani, asarar nauyi, zafi ciwo, gajiya, hasara na ci, da kuma kasusuwa kashi sun fi lura da alamun bayyanar.
Bincike na Ciwon Cutar Canji
Yayin da Pap yake gwada gwaje-gwajen da aka bada shawarar don dalilai masu ma'ana, ƙananan ƙimar za su iya zama kamar yadda kashi 50%. Tabbatar da ko dai ciwon jijiyoyin mahaifa ko ƙwayar dysplasia na mahaifa (ƙananan ci gaban kwayoyin jikinsu).
Idan an tabbatar da dysplasia na mahaifa, an rarraba shi bisa ga ma'auni na tsananin . Pap shafa siffantawa zai iya samuwa daga ASCUS (ƙananan ƙwayoyin ƙwayoyin jiki wanda ba shi da mahimmanci) zuwa LSIL (raunin intraepithelial ƙananan ƙananan ƙwayar cuta) zuwa HSIL (launi na intraepithelial ƙananan ƙananan ƙwararra). Kwayoyin halitta ko nama suna da nauyin nau'i kamar yadda ya kasance m, matsakaicin ko mai tsanani.
Idan akwai alamar tabbatar da rashin lafiya, an samo shi da mataki na cutar bisa ga binciken jarrabawar mai haƙuri, wanda ya kasance daga Stage 0 zuwa Stage IV kamar haka:
- Sashe na 0: A carcinoma a wuri (wani malignancy da aka lalata wanda bai yada ba)
- Sashe na I: Ciwon daji na ƙwayar cuta wanda ya girma a cikin kwakwalwa, amma bai yada ba
- Sashe na II: Ciwon daji na jiki wanda ya yada, amma ba bayan ganuwar ƙashin ƙugu ba ko ƙananan ƙananan farji
- Sashe na III: Ciwon daji na ciwon daji wanda ya yada bayan kwaskwarima ko bango na uku na farji, ko ya haifar da hydronephrosis (tarawar fitsari a cikin koda saboda hani na ureter) ko kuma rashin aiki na koda
- Sashe na IV: Ciwon daji na ƙwayar cuta wanda ya yada bayan kwaskwarima zuwa gabobin da ke kusa ko na nesa, ko kuma yana da nauyin nama na jikin mafitsara ko adadi
Jiyya na Cercical Cancer
Yin maganin rigakafin ciwon daji ko ciwon sankarar mahaifa an ƙaddara shi a babban ɓangare ta hanyar yin gyare-gyare ko kuma kula da cutar. Yawancin matan da ke fama da dysplasia za su shawo kan yanayin ba tare da magani ba, suna bukatar kulawa ta yau da kullum.
Ga wadanda dysplasia ke ci gaba, ana iya buƙatar magani. Wannan na iya ɗaukar nau'in haɗuwa (lalata) na sel ta hanyar lantarki, laser, ko cryotherapy (daskarewa na sel); ko kuma ta hanyar bincike (cire) daga cikin kwayoyin ta hanyar binciken electrosurgical (wanda aka fi sani da tsawon tsinin wutar lantarki, ko LEEP ) ko rarrabawa (kwayar halitta ta jiki).
Yin maganin ciwon sankarar mahaifa zai iya bambanta ko da yake an fi mayar da hankali a kan maganin ƙwayar haihuwa. Jiyya na iya ɗaukar nau'i daya ko dama daga cikin wadannan, bisa ga mummunan cutar:
- chemotherapy
- radiation far
- Tsarin ƙwayoyin cuta, ciki har da LEEP, gyare-gyare, gyaran kafa (cire daga cikin mahaifa), ko trachelectomy (cire cervix yayin kiyaye mahaifa da ovaries).
Kullum magana, kashi 35 cikin 100 na matan da ke fama da ciwon sankarar mahaifa za su sake dawowa bayan magani.
Game da mace-mace, yawan rayuka na rayuwa ne bisa tsarin cutar a lokacin ganewar asali. Yayinda yake magana, matan da aka gano a mataki na 0 da ciwon kasala 93 na rayuwa, yayin da mata a Stage IV suna da kashi 16 cikin dari.
Rigakafin Ciwon Cutar Cervical
Abubuwan jima'i na al'ada da suka fi dacewa , Labaran shafawar Pap, da kuma maganin rigakafi na HPV suna dauke da hanyoyi guda uku na rigakafin ciwon daji. Bugu da ƙari kuma, ƙaddamar da samfurin ART ne a lokacin da aka dauki mahimmanci don rage haɗarin ICC ga mata da HIV.
Ƙungiyar Ayyukan Tsaro na Amurka (USPSTF) a halin yanzu tana ba da shawara cewa Pap nunawa kowane shekara uku ga mata tsakanin shekarun da suka wuce 21 zuwa 65, ko kuma kowace shekara biyar ga mata masu shekaru 30 zuwa 65 tare da gwajin HPV .
A halin yanzu, rigakafin HPV a halin yanzu ana bada shawara ga kowane yarinya ko budurwa wanda yake da jima'i. Kwamitin Shawarar Kwararru kan Yara da rigakafin rigakafin (ACIP) ya bada shawarar maganin rigakafi na yara mata 11 zuwa 12, har da mata har zuwa shekaru 26 ba su da ko sun kammala jerin maganin rigakafi.
An riga an yarda da maganin alurar rigakafi guda biyu don amfani: maganin alurar rigakafi wanda zai iya hana iri 6, 11, 16 da 18 (Gardasil) da kuma maganin maganin da ke iya karewa daga iri 16 da 18 (Cervarix). Kowane yana buƙatar jerin samfurori uku da aka ba a cikin wata shida.
Yayin da alurar rigakafi ba zai iya karewa daga duk nau'ikan HPV ba, masu bincike a Fox Chase Cancer Center sun tabbatar da cewa matan da ke dauke da kwayar cutar ta HIV ba su da wata siffar HPV mai haɗari 52 da 58 fiye da takwarorinsu marar amincewa. Wannan ya karfafa hujjar cewa ART ta farko ita ce mahimmanci don kare dukkanin cututtukan HIV da marasa lafiya na HIV wadanda suke da cutar HIV.
Lafiya da Dabarun Gabas
Dangane da tasowa dabarun, binciken na baya-bayan nan ya nuna cewa maganin maganin rigakafi da aka saba da shi, lopinavir (aka samu a cikin maganin ƙwayar cutar Kaletra), zai iya iya hana ko ma sake cire dysplasia na mahaifa. Sakamakon farko sun nuna babban inganci yayin da aka kai su a cikin sau biyu a kowace rana fiye da watanni uku.
Idan za a tabbatar da sakamakon, mata za su iya shawo kan ciwon ciwon ciwon daji a gida, yayin da wadanda ke dauke da kwayar cutar HIV za su iya yin rigakafin hana HPV a matsayin wani ɓangare na ART.
Sources:
Ibrahim, A; D'Souza, G .; Jing, Y. et al. "Ciwon daji na cututtuka na ciwo ya kamu da cutar a tsakanin matan da ke dauke da kwayar cutar HIV. Rajistar Jirgin Ƙunƙasar Ƙaƙwalwar Lalacewa. Afrilu 1, 2013; 62 (4): 405-413.
Adler, D. "Rashin tasirin HAART a kan cututtukan mahaifa na HPV." Binciken HIV na yanzu. Oktoba 8, 2010; 8 (7): 493-7.
Dames, D .; Blackman, E. Butler, R .; et al. "Babban cututtukan mutum da ke cikin kwayar cutar ta jiki da ke cikin kwayar cutar rashin lafiyar mutum - 'yan mata a Bahamas." PLoS | Ɗaya. Janairu 23, 2014; 9 (1): e85429. Doi: 10.1371.
US Task Force Task Force (USPSTF). "Harkokin Kiwon Lafiyar Harkokin Kiwon Lafiyar Harkokin Kiwon Lafiyar Harkokin Kiwon Lafiyar Harkokin Ciwon Cutar Kwayoyin Cutar Canji: Shaidu sun nuna cewa bincikar ciwon daji yana da tasiri." Rockville, Maryland; bayar da Maris 15, 2013.
Cibiyoyin Kula da Cututtuka da Cututtuka (CDC). "Ciwon maganin rigakafi na mutum wanda ke dauke da kwayoyin cutar: Kwararrun Shawarar Shawara kan Dokokin Taimakon Lissafi (ACIP)." Rashin ƙuntatawa da Mutuwa na Kullum (MMWR). Maris 23, 2007; 56 (RR02) .1-24.