{"id":209559,"date":"2020-11-30T12:49:45","date_gmt":"2020-11-30T11:49:45","guid":{"rendered":"http:\/\/zakrasnejsivimperk.cz\/?p=209559"},"modified":"2020-11-30T12:49:45","modified_gmt":"2020-11-30T11:49:45","slug":"krajska-hygienicka-stanice-1-prosinec-svetovy-den-boje-proti-aids","status":"publish","type":"post","link":"https:\/\/zakrasnejsivimperk.cz\/?p=209559","title":{"rendered":"KRAJSK\u00c1 HYGIENICK\u00c1 STANICE: 1. prosinec – Sv\u011btov\u00fd den boje proti AIDS"},"content":{"rendered":"
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Ilustra\u010dn\u00ed foto: pixabay<\/figcaption><\/figure>\n

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Prvn\u00ed prosinec je od roku 1988 Sv\u011btov\u00fdm dnem boje proti AIDS. Poprv\u00e9 p\u0159ed t\u0159iat\u0159iceti lety \u2013 31. \u0159\u00edjna 1987 – podlehl v tehdej\u0161\u00edm \u010ceskoslovensku syndromu z\u00edskan\u00e9ho selh\u00e1n\u00ed imunity, smrteln\u00e9mu virov\u00e9mu onemocn\u011bn\u00ed HIV\/AIDS, prvn\u00ed \u010deskoslovensk\u00fd pacient. V t\u00e9 dob\u011b bylo v \u010cSSR l\u00e9ka\u0159i odhaleno 46 pozitivn\u00edch ob\u010dan\u016f.<\/h6>\n

Ze 46 pozitivn\u00edch ob\u010dan\u016f \u010cSSR jsou \u010dty\u0159i klinicky nemocn\u00ed AIDS. Jeden mu\u017e (homosexu\u00e1l) 31. \u0159\u00edjna zem\u0159el. V\u011bt\u0161ina ze zbyl\u00fdch 42 osob pat\u0159\u00ed do skupiny klinicky zdrav\u00fdch osob, tzv. nosi\u010d\u016f infekce, napsalo na za\u010d\u00e1tku listopadu 1987 tehdej\u0161\u00ed Rud\u00e9 pr\u00e1vo. V\u016fbec prvn\u00ed HIV pozitivn\u00ed pacient u n\u00e1s zem\u0159el je\u0161t\u011b o \u010dty\u0159i m\u011bs\u00edce d\u0159\u00edve, ale p\u0159\u00ed\u010dinou \u00famrt\u00ed byla dopravn\u00ed nehoda. Nicm\u00e9n\u011b od prvn\u00ed poloviny osmdes\u00e1t\u00fdch let je toto virov\u00e9 onemocn\u011bn\u00ed, popsan\u00e9 poprv\u00e9 v roce 1981, jednou z trval\u00fdch sv\u011btov\u00fdch epidemiologick\u00fdch hrozeb, v n\u011bkter\u00fdch m\u00e9n\u011b rozvinut\u00fdch zem\u00edch pak hrozbou zcela fat\u00e1ln\u00ed.<\/p>\n

\u201eV polovin\u011b osmdes\u00e1t\u00fdch let jsem kon\u010dila studia na tehdej\u0161\u00ed L\u00e9ka\u0159sk\u00e9 fakult\u011b hygienick\u00e9 v Praze s prax\u00ed na infek\u010dn\u00edm odd\u011blen\u00ed nemocnice na Bulovce, kde jsme dost\u00e1vali informace o nov\u00e9m onemocn\u011bn\u00ed, devastuj\u00edc\u00edm imunitn\u00ed syst\u00e9m. Teprve se hledal p\u016fvodce, cesty p\u0159enosu a mo\u017enosti l\u00e9\u010dby. U n\u00e1s prakticky neexistovala literatura, nem\u011bli jsme p\u0159\u00edstup k zahrani\u010dn\u00edm odborn\u00fdm informac\u00edm a otev\u0159en\u00e1 odborn\u00e1 i spole\u010densk\u00e1 diskuse o tomto onemocn\u011bn\u00ed, kter\u00e9 se zpo\u010d\u00e1tku \u0161\u00ed\u0159ilo prim\u00e1rn\u011b v populaci homosexu\u00e1ln\u00edch, p\u0159\u00edpadn\u011b bisexu\u00e1ln\u00edch mu\u017e\u016f, byla v prvn\u00edch letech jej\u00ed existence tabu. Systematicky ji v na\u0161ich podm\u00ednk\u00e1ch sledujeme od roku 1985, kdy vznikla N\u00e1rodn\u00ed referen\u010dn\u00ed laborato\u0159 pro AIDS. Od \u0159\u00edjna osmdes\u00e1t p\u011bt vedeme epidemiologick\u00e9 p\u0159ehledy a data. V t\u00e9to dob\u011b jsme k probl\u00e9mu, kter\u00fd m\u011bl obrovsk\u00fd potenci\u00e1l r\u016fstu, za\u010dali p\u0159ij\u00edmat i syst\u00e9mov\u00e1 \u0159e\u0161en\u00ed, proto\u017ee jevy jako homosexualita a rizikov\u00e9 chov\u00e1n\u00ed do t\u00e9 doby ofici\u00e1ln\u011b neexistovaly. Kdy\u017e zem\u0159el v \u00fanoru 89 krasobrusla\u0159 Ondrej Nepela, o d\u016fvodu \u00famrt\u00ed se mezi lidmi jen spekulovalo. P\u0159ineslo to ale ur\u010dit\u00fd zlom v postoj\u00edch gay komunity k tomuto riziku. Zlep\u0161ila se diagnostika a otev\u0159en\u011bj\u0161\u00ed za\u010dalo b\u00fdt i informov\u00e1n\u00ed a edukace ve\u0159ejnosti. V regionech mimo Prahu k tomu doch\u00e1zelo se zpo\u017ed\u011bn\u00edm, prvn\u00ed anonymn\u00ed poradnu a linku HIV\/AIDS jsem p\u0159i tehdej\u0161\u00ed Okresn\u00ed hygienick\u00e9 stanici v \u010c. Bud\u011bjovic\u00edch spoluzakl\u00e1dala a\u017e na p\u0159elomu osmdes\u00e1t\u00fdch a devades\u00e1t\u00fdch let, \u201c<\/em> \u0159\u00edk\u00e1 \u0159editelka Krajsk\u00e9 hygienick\u00e9 stanice (KHS) Jiho\u010desk\u00e9ho kraje Kvetoslava Kotrbov\u00e1.<\/p>\n

Syndromem z\u00edskan\u00e9ho selh\u00e1n\u00ed imunity (Acquired Immune Deficiency Syndrome) se od roku 1981, kdy byl pops\u00e1n prvn\u00ed p\u0159\u00edpad, nakazily ve sv\u011bt\u011b des\u00edtky milion\u016f osob, aktu\u00e1ln\u011b se uv\u00e1d\u00ed kolem pades\u00e1ti milion\u016f pozitivn\u00edch. Zcela devastuj\u00edc\u00ed je v zem\u00edch t\u0159et\u00edho sv\u011bta, p\u0159edev\u0161\u00edm v subsaharsk\u00e9 Africe, v zem\u00edch jako je Nig\u00e9rie, kde zas\u00e1hl a\u017e \u010dtvrtinu populace, vysok\u00fd v\u00fdskyt je ale i v zem\u00edch jako je Jihoafrick\u00e1 republika, Indie a v Evrop\u011b n\u011bkter\u00e9 postsov\u011btsk\u00e9 zem\u011b, p\u0159edev\u0161\u00edm Ukrajina.<\/p>\n

Posledn\u00ed aktu\u00e1ln\u00ed data N\u00e1rodn\u00ed referen\u010dn\u00ed laborato\u0159e pro AIDS jsou ze z\u00e1\u0159\u00ed a uv\u00e1d\u011bj\u00ed kumulativn\u011b za posledn\u00edch t\u0159icet p\u011bt let celkem 3787 potvrzen\u00fdch p\u0159\u00edpad\u016f HIV pozitivn\u00edch ob\u010dan\u016f \u010cR nebo zde trvale \u017eij\u00edc\u00edch cizinc\u016f. Z toho 709 osob je nebo bylo ve st\u00e1diu AIDS, 325 osob dosud u n\u00e1s tomuto onemocn\u011bn\u00ed podlehlo.<\/p>\n

V drtiv\u00e9 v\u011bt\u0161in\u011b se jedn\u00e1 o onemocn\u011bn\u00ed mu\u017e\u016f – je potvrzeno 3255 p\u0159\u00edpad\u016f u mu\u017e\u016f a 532 u \u017een. Mezi zem\u0159el\u00fdmi je 575 mu\u017e\u016f a 134 \u017een. HIV (Human Immunodeficiency Virus) je nej\u010dast\u011bji p\u0159en\u00e1\u0161en krv\u00ed, spermatem a sekretem infikovan\u00fdch osob a souvis\u00ed \u00fazce s rizikov\u00fdm chov\u00e1n\u00edm. Nej\u010dast\u011bj\u0161\u00ed cestou p\u0159enosu je jak\u00fdkoliv nechr\u00e1n\u011bn\u00fd sex, sd\u00edlen\u00ed st\u0159\u00edka\u010dek, jehel \u010di roztok\u016f u nitro\u017eiln\u00edch u\u017eivatel\u016f drog a v minulosti, ne\u017e se poda\u0159ilo stoprocentn\u011b identifikovat cesty p\u0159enosu, doch\u00e1zelo i k p\u0159enosu nap\u0159\u00edklad z krevn\u00edch deriv\u00e1t\u016f p\u0159i transf\u00faz\u00edch, v dev\u00edti p\u0159\u00edpadech je u n\u00e1s pops\u00e1n i p\u0159enos z t\u011bhotn\u00e9 matky na d\u00edt\u011b. V sou\u010dasn\u00e9 dob\u011b p\u0159evl\u00e1d\u00e1 p\u0159i depist\u00e1\u017ei nov\u00fdch p\u0159\u00edpad\u016f jako zp\u016fsob p\u0159enosu jednozna\u010dn\u011b nechr\u00e1n\u011bn\u00fd sex, v mnohem men\u0161\u00ed m\u00ed\u0159e ne\u017e d\u0159\u00edve d\u00edky v\u00fdm\u011bnn\u00fdm program\u016fm sd\u00edlen\u00ed infikovan\u00e9ho injek\u010dn\u00edho materi\u00e1lu.<\/p>\n

Podle statistik N\u00e1rodn\u00ed referen\u010dn\u00ed laborato\u0159e pro AIDS St\u00e1tn\u00edho zdravotn\u00edho \u00fastavu je u n\u00e1s v\u00fdrazn\u011b nej\u010dast\u011bj\u0161\u00ed cestou p\u0159enosu nechr\u00e1n\u011bn\u00fd homosexu\u00e1ln\u00ed nebo bisexu\u00e1ln\u00ed styk. Tento zp\u016fsob p\u0159enosu uv\u00e1d\u00ed 2491 HIV pozitivn\u00edch mu\u017e\u016f, 322 z nich je ve st\u00e1diu AIDS. Heterosexu\u00e1ln\u00ed styk uv\u00e1d\u00ed 465 mu\u017e\u016f a 472 \u017een, 270 pacient\u016f z t\u00e9to skupiny je ve stadiu AIDS. V po\u0159ad\u00ed t\u0159et\u00ed nej\u010dast\u011bj\u0161\u00ed je nitro\u017eiln\u00ed u\u017e\u00edv\u00e1n\u00ed drog. Takto onemocn\u011blo 137 mu\u017e\u016f a 31 \u017een, 48 pacient\u016f je ve st\u00e1diu AIDS. Velkou skupinu tvo\u0159\u00ed i kombinace nitro\u017eiln\u00edch u\u017eivatel\u016f a homo nebo bisexu\u00e1ln\u00edho styku, takto onemocn\u011blo 71 mu\u017e\u016f, 13 je ve st\u00e1diu AIDS.<\/p>\n

Kdy\u017e se pod\u00edv\u00e1me na jednotliv\u00e9 regiony republiky, Jiho\u010desk\u00fd kraj je se 124 p\u0159\u00edpady HIV pozitivity a relativn\u00edm v\u00fdskytem 19,4 p\u0159\u00edpadu na sto tis\u00edc obyvatel regionu na dev\u00e1t\u00e9m m\u00edst\u011b mezi \u010dtrn\u00e1cti kraji \u010cR. Nejv\u011bt\u0161\u00ed v\u00fdskyt je koncentrov\u00e1n v Praze, kter\u00e1 eviduje 1817 p\u0159\u00edpad\u016f (tj. 141,8 na sto tis\u00edc), vysok\u00fd relativn\u00ed v\u00fdskyt je na Karlovarsku (103 p\u0159\u00edpady, tj. 34,7 na sto tis\u00edc) a ve St\u0159edo\u010desk\u00e9m kraji (370 p\u0159\u00edpad\u016f, tj. 27,6 na sto tis\u00edc). Nejmen\u0161\u00ed v\u00fdskyt je evidov\u00e1n na Vyso\u010din\u011b (47 p\u0159\u00edpad\u016f, tj. 9,2 na sto tis\u00edc). V Jiho\u010desk\u00e9m kraji se v pr\u016fb\u011bhu sledov\u00e1n\u00ed dostalo 33 pacient\u016f do st\u00e1dia AIDS.<\/p>\n

\u201eZa leto\u0161ek evidujeme ke konci z\u00e1\u0159\u00ed, do kdy jsou dosud v\u011brohodn\u011b validov\u00e1ny podklady N\u00e1rodn\u00ed referen\u010dn\u00ed laborato\u0159\u00ed, v kraji deset nov\u00fdch p\u0159\u00edpad\u016f HIV pozitivn\u00edch pacient\u016f. Za z\u00e1\u0159\u00ed p\u0159ibyly v kraji dva p\u0159\u00edpady, v cel\u00e9 republice to bylo 29 nov\u00fdch pacient\u016f, t\u0159iadvacet mu\u017e\u016f a \u0161est \u017een. Kdy\u017e se pod\u00edv\u00e1me na cesty p\u0159enosu z\u00e1\u0159ijov\u00fdch p\u0159\u00edpad\u016f, tak u osmn\u00e1cti mu\u017e\u016f se jednalo o homosexu\u00e1ln\u00ed styk, u dvou o heterosexu\u00e1ln\u00ed a u t\u0159\u00ed p\u0159\u00edpad\u016f nebylo mo\u017en\u00e9 cestu p\u0159enosu p\u0159esn\u011b zjistit. U \u017een \u0161lo v p\u011bti p\u0159\u00edpadech o heterosexu\u00e1ln\u00ed styk a v jednom p\u0159\u00edpad\u011b nebylo mo\u017en\u00e9 zp\u016fsob p\u0159enosu ur\u010dit. To jasn\u011b dokumentuje, \u017ee nejrizikov\u011bj\u0161\u00ed je v sou\u010dasn\u00e9 dob\u011b u mu\u017e\u016f nechr\u00e1n\u011bn\u00fd homo nebo bisexu\u00e1ln\u00ed styk a u \u017een nechr\u00e1n\u011bn\u00fd heterosexu\u00e1ln\u00ed styk. V\u0161echny ostatn\u00ed typy p\u0159enosu s v\u00fdjimkou nitro\u017eiln\u00edho u\u017e\u00edv\u00e1n\u00ed drog, respektive sd\u00edlen\u00ed injek\u010dn\u00edho materi\u00e1lu, jsou v\u011bt\u0161inou ji\u017e eliminov\u00e1ny a ve statistik\u00e1ch posledn\u00edch let se nevyskytuj\u00ed,\u201c<\/em> uv\u00e1d\u00ed \u0159editelka protiepidemick\u00e9ho odboru KHS Jitka Lu\u0148\u00e1\u010dkov\u00e1.<\/p>\n

Za posledn\u00edch dvan\u00e1ct sledovan\u00fdch m\u011bs\u00edc\u016f, tedy od z\u00e1\u0159\u00ed lo\u0148sk\u00e9ho roku do konce z\u00e1\u0159\u00ed 2020, p\u0159ibylo v Jiho\u010desk\u00e9m kraji dvan\u00e1ct p\u0159\u00edpad\u016f. V cel\u00e9 \u010cesk\u00e9 republice bylo letos reportov\u00e1no sto devades\u00e1t sedm p\u0159\u00edpad\u016f, nejv\u00edce, sedmdes\u00e1t dva, v Praze. Ro\u010dn\u00ed p\u0159\u00edr\u016fstek za posledn\u00ed sledovan\u00fd rok od z\u00e1\u0159\u00ed do z\u00e1\u0159\u00ed byl v \u010cR 239 p\u0159\u00edpad\u016f.<\/p>\n

AIDS byl poprv\u00e9 zaznamen\u00e1n p\u0159ed t\u00e9m\u011b\u0159 \u010dty\u0159iceti lety. \u201eOd t\u00e9 doby jsme z\u00edskali \u0159adu poznatk\u016f. Poda\u0159ilo se eliminovat n\u011bkter\u00e9 cesty p\u0159enosu, da\u0159\u00ed se l\u00e9\u010dbou prodlu\u017eovat d\u00e9lku do\u017eit\u00ed pacient\u016f, ale neum\u00edme ho zcela vyl\u00e9\u010dit a neum\u00edme edukac\u00ed zjevn\u011b st\u00e1le odstranit n\u011bkter\u00e9 typy rizikov\u00e9ho chov\u00e1n\u00ed. Velk\u00fdm probl\u00e9mem tohoto onemocn\u011bn\u00ed je, \u017ee m\u00e1 n\u011bkolik st\u00e1di\u00ed, z nich\u017e to prvn\u00ed \u2013 akutn\u00ed HIV infekce – se u pacient\u016f projev\u00ed t\u0159eba hore\u010dkami, zdu\u0159en\u00edm kr\u010dn\u00edch uzlin, bolest\u00ed sval\u016f nebo vyr\u00e1\u017ekou. Ale u \u010d\u00e1sti pacient\u016f prob\u011bhne zcela bezp\u0159\u00edznakov\u011b. Pak nastupuje druh\u00e1 f\u00e1ze, kdy imunitn\u00ed syst\u00e9m zat\u00edm funguje norm\u00e1ln\u011b, pacient nem\u00e1 \u017e\u00e1dn\u00e9 p\u0159\u00edznaky, ale je ji\u017e nosi\u010dem a m\u016f\u017ee nakazit druh\u00e9, ani\u017e by o sv\u00e9 pozitivit\u011b v\u011bd\u011bl. V tom je jeho velik\u00e9 nebezpe\u010d\u00ed, proto\u017ee tato asymptomatick\u00e1 f\u00e1ze m\u016f\u017ee trvat relativn\u011b dlouho. Pak ale u nel\u00e9\u010den\u00fdch p\u0159\u00edpad\u016f doch\u00e1z\u00ed d\u0159\u00edve nebo pozd\u011bji k poruch\u00e1m imunity a pacient se postupn\u011b dost\u00e1v\u00e1 do stadia AIDS, kter\u00e9 m\u00e1 ji\u017e symptomy jako v\u00fdraznou ztr\u00e1tu hmotnosti, hore\u010dky, pr\u016fjmy, naru\u0161en\u00ed centr\u00e1ln\u00ed nervov\u00e9 soustavy a funkc\u00ed mozku a m\u016f\u017ee um\u00edrat i na jin\u00e1, pro zdrav\u00e9ho \u010dlov\u011bka ban\u00e1ln\u00ed onemocn\u011bn\u00ed,\u201c<\/em> \u0159\u00edk\u00e1 Kvetoslava Kotrbov\u00e1.<\/p>\n

\u201eUv\u011bdomuji si jist\u00e9 paralely mezi epidemiologickou situac\u00ed p\u0159ed p\u011btat\u0159iceti lety a dnes. Ve sv\u00e9 dob\u011b byl pro n\u00e1s HIV zcela nov\u00fdm p\u016fvodcem a p\u0159edstavoval celosv\u011btovou hrozbu podobn\u011b jako nyn\u00ed COVID-19. A p\u0159es ve\u0161ker\u00fd v\u00fdvoj \u00fa\u010dinn\u00e9 l\u00e9\u010dby byla a je v obou p\u0159\u00edpadech kl\u00ed\u010dem k \u00fasp\u011bchu d\u016fsledn\u00e1 prevence,\u201c<\/em> dopl\u0148uje \u0159editelka KHS.<\/p>\n

(tzkhs)<\/strong><\/p>\n

 <\/p>\n

 <\/p>\n","protected":false},"excerpt":{"rendered":"

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