HIV / AIDS

ʻO ka maʻi hoʻomaʻemaʻe kanaka (HIV) ka maʻi hoʻomaʻemaʻe e loaʻa ai ka maʻi ʻaʻai. Ke hele a maʻi ke kanaka me ka maʻi HIV, hoʻouka ka maʻi ʻino a hoʻonāwaliwali hoʻi i ka ʻōnaehana pale. Ke hoʻonāwaliwali nei ka ʻōnaehana pale, makaʻu paha ke kanaka i ka loaʻa ʻana i nā maʻi hoʻoweliweli a me nā maʻi ʻaʻai. Ke hiki mai kēlā, kapa ʻia ka maʻi ʻo AIDS. Ke loaʻa ka maʻi i kekahi kanaka, noho ia i loko o ke kino no ke ola.

Hoʻolahalaha ʻia ka maʻi (i lawe ʻia) i kekahi kanaka i kekahi kanaka i kekahi wai o ke kino:

• Koko
• Semen a me ka wai preseminal
• Nā wai liki
• Nā wai lū
• Waiū umauma

Hiki ke hoʻolaha ʻia ʻo HIV inā pili kēia mau wai i:

• Nā membrane mucous (ma loko o ka waha, peni, ʻāpā, peleko)
• Nā mea ʻinoʻino (nā ʻoki i ʻoki a ʻoki ʻia paha)
• Hoʻokomo i loko o ke kahe o ke koko

ʻAʻole hiki ke hoʻolaha ʻia ʻo HIV ma o ka hou, saliva, a me ka mimi.

Ma ʻAmelika Hui Pū ʻIa, hoʻolaha nui ʻia ka maʻi HIV:

• Ma o ka moekolohe a anal paha me ka mea loaʻa ka maʻi HIV me ka hoʻohana ʻole ʻana i ka condom a i ʻole lawe ʻole i nā lāʻau e pale ai a mālama iā HIV
• Ma o ka hoʻokaʻawale ʻana o ka nila a i ʻole nā ​​pono hana ʻē aʻe i hoʻohana ʻia e hoʻopili i nā lāʻau me kekahi mea loaʻa iā HIV

Emi pinepine, laha ka maʻi HIV:

• Mai ka makuahine a i ke keiki. Hiki i ka wahine hāpai ke pāhola i ka maʻi i kāna pēpē ma o kā lākou kahe ʻana o ke koko, a i ʻole hiki i kahi makuahine hānai ke hāʻawi iā ia i kāna pēpē ma o kāna waiū umauma. Ua kōkua ka hoʻāʻo ʻana a me ka mālama ʻana i nā mākuahine HIV-maikaʻi e hoʻohaʻahaʻa i ka helu o nā pēpē e loaʻa ana i ka maʻi HIV.
• Ma o nā koʻokoʻo kui kele a i ʻole nā ​​mea ʻoi e hoʻopili ʻia me ka maʻi HIV (ʻo ka poʻe limahana mālama ola).

ʻAʻole hoʻolaha ʻia ka maʻi ma:

• Hoʻokaʻaʻike maʻamau, e like me ka ʻapo a me ka honi waha paʻa
• Nā namu a i ʻole nā ​​holoholona hānai
• Ke komo nei i nā haʻuki
• Hoʻopā i nā mea i hoʻopā ʻia e kekahi kanaka i loaʻa i ka maʻi
• ʻO ka ʻai ʻana e mālama ʻia e ka mea me ka maʻi HIV

ʻO ka maʻi HIV a me ke koko a i ʻole nā ​​mea kōkua:

• ʻAʻole hoʻolaha ʻia ka maʻi HIV i ke kanaka nāna e hāʻawi i ke koko a i ʻole nā ​​ʻoka. ʻO ka poʻe e hāʻawi manawaleʻa i nā ʻōnaehana ʻaʻole loa lākou e launa pū me nā poʻe e loaʻa ana iā lākou. Pēlā nō, ʻaʻole pili ka mea nāna e hāʻawi ke koko i ka mea e loaʻa ana iā ia. I kēia mau kaʻina hana a pau, hoʻohana ʻia nā nila kuʻikuʻu a me nā mea kani.
• ʻOiai he kakaikahi loa ia, i ka wā i hala aku nei ua pāhola ʻia ka maʻi HIV i kekahi kanaka e loaʻa ana i ke koko a i ʻole nā ​​lālā mai ka mea hāʻawi maʻi Eia nō naʻe, ʻuʻuku loa kēia makaʻi no ka mea ʻo nā panakō koko a me nā polokalamu hāʻawi meaola e nānā pono i ka poʻe hāʻawi, ke koko, a me nā aʻa.

ʻO nā kumu pilikia no ka loaʻa ʻana o ka maʻi HIV.

• Loaʻa i ka wahine anal a wahine ʻole i pale ʻole ʻia. ʻO ka sex anal receptive ka riskiest. ʻO ka loaʻa ʻana o nā hoa he nui a hoʻonui i ka makaʻu. ʻO ka hoʻohana ʻana i kahi condom hou me ka pololei i kēlā me kēia manawa ke moe kolohe nui ʻoe i mea e hōʻemi loa ai i kēia pilikia.
• Ke hoʻohana nei i nā lāʻau a me ke kaʻana ʻana i nā nila a me nā ʻaukā.
• Loaʻa i kahi moekolohe pilikino me HIV ʻaʻole lawe i nā lāʻau HIV.
• Loaʻa i ka maʻi lele i ka moekolohe (STD).

ʻO nā ʻōuli e pili ana i ka maʻi HIV koʻikoʻi (ke maʻi mua ke kanaka) hiki ke like me ka maʻi flu a i ʻole nā ​​maʻi viral ʻē aʻe. Pākuʻi ʻia lākou:

• ʻO nā maʻi fiva a me nā mākala
• ʻEha poʻo
• Eha ka 'ā'ī
• Hoʻoulu ka pō
• Nā ʻeha waha, me ka maʻi hū (thrush)
• Liʻiliʻi kelepaʻi
• Pohā

He nui nā kānaka i loaʻa ʻole nā ​​ʻōuli ke loaʻa mua i ka maʻi HIV.

Holomua ka maʻi HIV ma mua o kekahi mau pule i kekahi mau mahina e lilo i maʻi maʻi asymptomat (ʻaʻohe ʻōuli). Hiki ke hoʻopau i kēia pae he 10 mau makahiki a ʻoi paha. I kēia wā, ʻaʻohe kumu o ke kanaka e manaʻo ai he maʻi HIV kā lākou, akā hiki iā lākou ke hoʻolaha i ka maʻi i nā poʻe ʻē aʻe.

Inā ʻaʻole mālama ʻia lākou, kokoke i nā poʻe āpau e hoʻopili ʻia me ka maʻi HIV e hoʻomōhala iā SIDA. Hoʻolālā kekahi poʻe i ka maʻi AIDS i loko o kekahi mau makahiki o ka maʻi. Noho maikaʻi nā poʻe ʻē aʻe ma hope o 10 a 20 mau makahiki paha (i kapa ʻia ʻo nonprogressors lōʻihi).

ʻO nā poʻe me ka maʻi AIDS ua hōʻino ʻia ko lākou ʻōnaehana pale e ka maʻi HIV. Kūpono nui lākou i ka loaʻa ʻana o nā maʻi i maʻa mau i ka poʻe me ka ʻōnaehana pale ola olakino. Kapa ʻia kēia mau maʻi i nā maʻi ʻaukā. Hiki ke kumu ʻia kēia mau mea e ka bacteria, nā mea hoʻomaʻi, fungi, a i ʻole ka protozoa, a hiki ke hoʻopili i kekahi ʻāpana o ke kino. ʻOi aku ka makaʻu nui o ka poʻe me ka maʻi AIDS no kekahi maʻi ʻaʻai, ʻo ia hoʻi nā lymphomas a me kahi maʻi ʻaʻai ʻili i kapa ʻia ʻo Kaposi sarcoma.

Pili nā ʻōuli i ka maʻi maʻi a me ka ʻāpana o ke kino i maʻi ʻia. Kūleʻa nā maʻi lepa i ka maʻi AIDS a he kumu maʻamau ka puʻu, ke kuni, a me ka hanu ʻole. Kūleʻa pū kekahi nā maʻi ʻōpū a hiki ke hoʻohoihoi i ka maʻi pākī, ʻeha o ka ʻōpū, ka luaʻi, a i ʻole ka ale ʻana i nā pilikia. ʻO ke kaupaona, ka fiva, ka hou, ka ʻupena, a me nā ʻōpena lymph pehu ka mea maʻamau i ka poʻe me ka maʻi HIV a me ka maʻi SIDA.

Hana ʻia nā hoʻokolohua e nānā inā ua loaʻa ʻoe i ka maʻi.

NA HOAILOA DIAGNOSTIC

Ma ka laulaha, ʻo ka hoʻokolohua kahi hana 2-ʻāpana:

• Hōʻoia loiloi - Aia kekahi mau ʻano o nā hoʻokolohua. ʻO kekahi nā hoʻāʻo ʻana i ke koko, ʻo nā hōʻaʻo ʻē aʻe i ka hoʻowai wai. Nānā lākou no nā mea ʻino i ka maʻi HIV, HIV antigen, a i ʻole ʻelua paha. Hiki i kekahi mau hoʻokolohua kānana ke hāʻawi i nā hopena ma 30 mau minuke a ʻoi iki paha.
• Hōʻoiaʻiʻo hāhai - Kēia kekahi i kapa ʻia he hōʻoia hōʻoia. Hana pinepine ia inā maikaʻi ka hōʻike loiloi.

Loaʻa nā hōʻike home e hoʻāʻo no ka maʻi HIV. Inā makemake ʻoe e hoʻohana i hoʻokahi, e hōʻoia e ʻae ʻia e ka FDA. E hāhai i nā ʻōkuhi ma ka ʻōpala e hōʻoia i nā hopena i pololei e like me ka hiki.

Paipai nā kikowaena no ka mālama ʻana i ka maʻi a me ka Kāohi (CDC) i kēlā me kēia makahiki mai ka makahiki 15 a 65 e loaʻa i kahi hōʻike loiloi no ka maʻi HIV. ʻO nā kānaka me nā ʻano kūpilikiʻi e hoʻāʻo pinepine ʻia. Pono nā wahine hāpai e hōʻike i kahi hōʻike loiloi.

Nā hoʻāʻo ma hope o ka hoʻopili ʻia ʻana me ka maʻi HIV

Loaʻa nā kānaka me ka maʻi SIDA i nā hōʻoia koko maʻamau e nānā i kā lākou helu helu CD4:

• ʻO nā pūnaewele CD4 T nā hunaola koko e hoʻouka aku iā HIV. Kāhea ʻia lākou he mau pūnaewele T4 a i ʻole "nā kōkua T kōkua."
• Ke hōʻino nei ʻo HIV i ka ʻōnaehana pale, hāʻule ka helu CD4. ʻO ka helu CD4 maʻamau mai 500 a 1,500 mau hunaola / mm³ o ke koko.
• Hoʻomaʻamaʻa pinepine ka poʻe i nā ʻōuli ke iho ka helu o kā lākou CD4 ma lalo o 350. ʻOi aku ka nui o nā pilikia koʻikoʻi ke iho ka helu CD4 i 200. Ke waiho ka helu ma lalo o 200, ua ʻōlelo ʻia ua loaʻa ka maʻi ʻaʻa iā ia.

ʻO nā hōʻike ʻē aʻe kekahi:

• ʻO ka pae HIV RNA, a i ʻole ka hoʻouka viral, e nānā i ka nui o ka maʻi HIV i loko o ke koko
• ʻO kahi hoʻāʻo kūʻē e ʻike inā loaʻa nā hoʻololi o ka maʻi ma ke code genetical e alakaʻi ai i ke kūʻē ʻana i nā lāʻau i hoʻohana ʻia e mālama ai i ka maʻi HIV
• Helu piha o ke koko, kemika koko, a me ka hoʻāʻo mimi
• Nā hoʻāʻo ʻana no nā maʻi ʻino ʻē aʻe i lawe ʻia e ka wahine
• Hōʻike TB
• Pap smear e nānā no ka maʻi ʻaʻai maʻi maʻi
• Pākuʻi ʻia ʻo Anal Pap e nānā ai no ka maʻi ʻaʻai o ka anus

Mālama ʻia ʻo HIV / AIDS me nā lāʻau e hōʻoki ana i ka maʻi mai ka hoʻonui ʻana. Kapa ʻia kēia lapaʻau he antiretroviral therapy (ART).

I ka wā ma mua, hoʻomaka ka poʻe me ka maʻi HIV i ka lāʻau antiretroviral ma hope o ka iho ʻana o kā lākou helu CD4 a i ʻole hoʻomōhala lākou i nā maʻi HIV. I kēia lā, paipai ʻia ka mālama ʻana i ka maʻi HIV no nā poʻe āpau me ka maʻi HIV, ʻoiai inā maʻamau ka helu ʻana o kā lākou CD4.

Pono nā hoʻokolohua koko maʻamau e ʻike pono i ka pae o ka maʻi ma ke koko (viral load) e hoʻohaʻahaʻa ʻia a kāʻei ʻia paha. ʻO ka pahuhopu o ka mālama ʻana e hoʻohaʻahaʻa i ka maʻi HIV i ke koko i kahi pae i haʻahaʻa loa i hiki ʻole i ka hōʻike ke ʻike iā ia. Kapa ʻia kēia he viral viral undetectable.

Inā ua heleleʻi ka helu CD4 ma mua o ka hoʻomaka ʻana o ka mālama ʻana, e piʻi mālie ia i luna. Nalo pinepine nā pilikia HIV ma ke ola ʻana o ka ʻōnaehana pale.

ʻO ka hui ʻana i kahi hui kākoʻo kahi e puʻunaue ai nā lālā i nā ʻike maʻamau a me nā pilikia hiki ke kōkua pinepine i ka hoʻohaʻahaʻa ʻana i ke kaumaha o ka naʻau no ka maʻi maʻi lōʻihi.

Me ka mālama ʻana, hiki i ka hapanui o nā poʻe me ka maʻi HIV / AIDS ke ola i ke ola olakino a maʻamau.

ʻAʻole ho'ōla nā lāʻau o kēia manawa i ka maʻi. Hana wale nā ​​lāʻau i ka wā e lawe ʻia i kēlā me kēia lā. Inā kū ʻia nā lāʻau, e piʻi ka hāpai viral a e heleleʻi ka helu CD4. Inā ʻaʻole lawe pinepine ʻia nā lāʻau, hiki i ka maʻi virus ke kūʻē i hoʻokahi a ʻoi aku paha o nā lāʻau, a e pau ka hana ʻana i ka lāʻau.

Pono ka poʻe e hoʻomaʻamaʻa nei e ʻike pinepine i kā lākou poʻe lawelawe mālama ola. E hōʻoia kēia e hana nei nā lāʻau a nānā i nā hopena o nā lāʻau.

Kāhea i kahi manawa me kāu mea lawelawe inā loaʻa iā ʻoe nā mea pilikia no ka maʻi HIV. E launa pū me kāu mea hāʻawi inā hoʻomōhala ʻoe i nā ʻōuli o ka maʻi SIDA. Ma ke kānāwai, pono e hūnā ʻia nā hualoaʻa o ka hoʻāʻo ʻana i ka maʻi HIV (pilikino). E nānā kāu mea hāʻawi i kāu mau hopena hōʻike me ʻoe.

Ka pale ʻana i ka maʻi HIV / AIDS:

• E hoʻāʻo. ʻO ka poʻe ʻike ʻole he maʻi HIV ko lākou a nānā aku a olakino ke olakino ka mea e lawe aku i nā poʻe ʻē aʻe.
• Mai hoʻohana i nā lāʻau kū ʻole i ke kānāwai a mai hoʻokaʻawale i nā nila. Nui nā kaiaulu i nā polokalamu kuʻina kuikui kahi e hiki ai iā ʻoe ke hemo i nā syringes i hoʻohana ʻia a loaʻa i nā mea hou, sterile. Hiki i nā limahana ma kēia papahana ke kuhikuhi iā ʻoe no ka mālama ʻana i ka lāʻau.
• Hōʻalo i ka pili ʻana me ke koko o haʻi. Inā hiki, komo i nā kapa pale, kahi pale maka, a me nā maka maka i ka wā e mālama ana i ka poʻe i ʻeha.
• Inā hōʻoia ʻoe i ka maikaʻi no ka maʻi HIV, hiki iā ʻoe ke hāʻawi i ka maʻi i nā poʻe ʻē aʻe. ʻAʻole pono ʻoe e hāʻawi i ke koko, ka plasma, nā kino o ke kino, a i ʻole ka sperm.
• ʻO nā wahine HIV-maikaʻi e hāpai ana e kamaʻilio i kā lākou mea hāʻawi e pili ana i ka makaʻu i kā lākou keiki hānau. E kūkākūkā pū lākou i nā ʻano hana e pale aku ai i kā lākou pēpē mai ke maʻi ʻana, e like me ka lawe ʻana i nā lāʻau antiretroviral i ka wā hāpai.
• Pono e hōʻalo i ka hānai hānai ʻana i mea e pale aku ai i ka hele ʻana o ka maʻi HIV i nā pēpē ma o ka waiū umauma.

ʻO nā hana kolohe ʻoi aku ka palekana, e like me ka hoʻohana ʻana i nā condom latex, i mea e pale aku ai i ka hoʻolaha ʻana o ka maʻi HIV. Akā aia nō ka makaʻu i ka loaʻa ʻana o ka maʻi, ʻoiai me ka hoʻohana ʻana i nā condom (ʻo kahi laʻana, hiki i nā condom ke haehae).

I ka poʻe i loaʻa ʻole i ka maʻi, akā nui ka makaʻu i ka loaʻa ʻana iā ia, ʻo ka lawe ʻana i kahi lāʻau e like me Truvada (emtricitabine a me tenofovir disoproxil fumarate) a i ʻole Descovy (emtricitabine a me tenofovir alafenamide) hiki ke pale i ka maʻi. ʻIke ʻia kēia lapaʻau ma ke ʻano he prophylaxis pre-exposed, a i ʻole PrEP. E kamaʻilio i kāu mea hāʻawi inā manaʻo ʻoe ua kūpono ʻo PrEP iā ʻoe.

ʻO ka poʻe HIV-maikaʻi e lawe nei i nā lāʻau antiretroviral a ʻaʻohe virus i loko o kā lākou koko mai lawe i ka maʻi.

ʻO ka lako o ke koko US ma waena o nā mea palekana o ka honua. Ma kahi kokoke i nā poʻe āpau i loaʻa i ka maʻi HIV ma o ke kōpō ʻana o ke koko i loaʻa i kēlā mau kōpili ma mua o ka makahiki 1985, ka makahiki i hoʻomaka ai ka hoʻokolohua ʻana o ka maʻi HIV no nā koko āpau i hāʻawi ʻia.

Inā manaʻo ʻoe ua pili ʻoe i ka maʻi HIV, e ʻimi koke i ka lāʻau. MAI hoʻolohi. Ke hoʻomaka nei i nā lāʻau antiviral ma hope pono o ka hōʻike ʻana (a i 3 mau lā ma hope) hiki ke hōʻemi i ka manawa e loaʻa ai ʻoe i maʻi. Kāhea ʻia kēia prophylaxis post-exposed (PEP). Ua hoʻohana ʻia ia e pale ai i ka lawe ʻana i nā limahana mālama ola i hōʻeha ʻia e nā needlesticks.

Maʻi HIV Maʻi maʻi - HIV; ʻO ka maʻi hōʻino kanaka; Loaʻa i ka maʻi deficit immune: HIV-1

• Kaʻai hānai komo - keiki - mālama ʻana i nā pilikia
• Tube hānai Gastrostomy - bolus
• Paipu hānai Jejunostomy
• Mucositis oral - mālama pono iā ʻoe iho

• STDs a me nā niches kaiaola
• HIV
• Maʻi HIV maʻi
• Canker eha (aphthous ulcer)
• ʻO ka maʻi Mycobacterium marinum ma ka lima
• Dermatitis - seborrheic ma ka maka
• AIDS
• Kaposi sarcoma - pani
• Histoplasmosis, hoʻolaha ʻia i ka mea maʻi HIV
• Molluscum ma ka umauma
• Kaposi sarcoma ma ka hope
• ʻO ka sarcoma a Kaposi ma ka ʻūhā
• Molluscum contagiosum ma ka maka
• Nā Antibodies
• Tuberculosis i ka akemāmā
• Kaposi sarcoma - lesion ma ka wāwae
• Kaposi sarcoma - perianal
• Hoʻolahalaha ʻia ʻo Herpes zoster (shingles)
• Dermatitis seborrheic - pili kokoke

Nā kikowaena no ka pūnaewele Disease Control a me Prevent. E pili ana i ka maʻi HIV / AIDS. www.cdc.gov/hiv/basics/whatishiv.html. Loiloi ʻia Nowemapa 3, 2020. Loaʻa iā Nowemapa 11, 2020.

Nā kikowaena no ka pūnaewele Disease Control a me Prevent. PrEP. www.cdc.gov/hiv/basics/prep.html. Loiloi ʻia Nowemapa 3, 2020. Loaʻa iā ʻApelila 15, 2019. DiNenno EA, Prejean J, Irwin K, et al. Nā ʻōlelo paipai no ka kānana ʻana o ka maʻi HIV, male kāne paha, a me nā kāne ʻē aʻe i moe kolohe me nā kāne - United States, 2017. MMWR Morb Mortal Wkly Rep. 2017; 66 (31): 830-832. www.cdc.gov/mmwr/volume/66/wr/mm6631a3.htm.

ʻO Gulick RM. ʻO Antiretroviral therapy o ka maʻi pale maʻi kanaka a me ka maʻi i loaʻa i ka maʻi. I: Goldman L, Schafer AI, eds. ʻO ka lāʻau lapaʻau Goldman-Cecil. 26th ed. Piladelapia, PA: Elsevier; 2020: chap 364.

ʻO Moyer VA; ʻO ka Hana Hana Hana Hana Preventive US. Ke nānā ʻana no ka maʻi HIV: ʻōlelo aʻoaʻo a ka US Preventive Services Task Force. ʻO Ann Intern Med. 2013; 159 (1): 51-60. PMID: 23698354 pubmed.ncbi.nlm.nih.gov/23698354/.

ʻO Reitz MS, Gallo RC. Nā mea hoʻomaʻi immunodeficiency kanaka. I: Bennett JE, Dolin R, Blaser MJ, hua pā. ʻO Mandell, Douglas, a me Bennett's Principle a me ka hoʻomaʻamaʻa ʻana i nā maʻi kūpilikiʻi. 9th ed. Piladelapia, PA: Elsevier; 2020: chap 169.

Simonetti F, Dewar R, Maldarelli F. Kānāwai o ka maʻi pale maʻi kanaka maʻi maʻi. I: Bennett JE, Dolin R, Blaser MJ, hua pā. ʻO Mandell, Douglas, a me Bennett's Principle a me ka hoʻomaʻamaʻa ʻana i nā maʻi kūpilikiʻi. 9th ed. Piladelapia, PA: Elsevier; 2020: chap 120.

ʻO ka US Department of Health and Human Services, Clinical Info.gov pūnaewele. Nā ʻōkuhi no ka hoʻohana ʻana i nā agra antiretroviral i nā mākua a me nā ʻōpio e noho nei me ka maʻi HIV. clinicalinfo.hiv.gov/en/guidelines/adult-and-adolescent-arv/whats-new-guidelines?view=full. Hoʻohou i Iulai 10, 2019. Loaʻa iā Nowemapa 11, 2020.

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