Phunziro limasonyeza kuti Kusuta ndi koopsa kuposa HIV
Kusuta fodya kumakhalabe pakati pa zovuta kwambiri ndi zovulaza zomwe zikukumana ndi anthu omwe ali ndi kachilombo ka HIV lero. Poyerekeza ndi chiwerengero cha anthu onse a ku United States, komwe kufuta kwafala kwazaka zaposachedwapa kwa pafupifupi 21 peresenti, pafupifupi 42 peresenti ya anthu omwe ali ndi kachilombo ka HIV amadziwika kuti ndi osuta. Ichi ndi chiwerengero chochititsa mantha ndipo chimodzimodzi chikugwirizana ndi kuwonjezeka kwa machitidwe okhudzana ndi kachirombo ka HIV komanso kufa msanga.
Anthu omwe ali ndi kachilombo ka HIV ali ofanana ndi utsi
Pali kafukufuku wochepa kuti athe kufotokozera momveka bwino kuchuluka kwa anthu osuta fodya. Kafukufuku wina wasonyeza kuti kupsyinjika kwakukulu ndi kupsinjika maganizo kumachita mbali yofunikira ndipo ambiri amapita ku chikonga monga njira yothetsera zovuta za tsiku ndi tsiku za HIV.
Koma sizikudziwikanso ngati nkhanizi zimayambitsa fodya, kapena zimangopangitsa kuti anthu omwe ali ndi kachilombo ka HIV asawonongeke.
Deta ikutsutsana. Malinga ndi kafukufuku wochokera ku US Centers for Disease Control and Infection (CDC), anthu omwe ali ndi kachilombo ka HIV omwe ali ndi kachilombo ka HIV ku US amayamba kukhala akuluakulu kusiyana ndi achinyamata, ndipo 58% ali ndi zaka 45 kapena kuposerapo, 40 peresenti ali ndi zaka 25 mpaka 44, ndipo awiri pa zana ali ndi zaka 18 mpaka 24.
Ziwerengero izi zikusonyeza kuti nkhawa za HIV sizinayambitse kugwiritsira ntchito fodya, makamaka ngati achinyamata omwe ali ndi kachilombo ka HIV omwe amakhala ndi kachilombo ka HIV, omwe amakhala ndi 26 peresenti, amakhala osuta kwambiri kusiyana ndi omwe alibe kachilombo ka HIV (awiri peresenti poyerekeza ndi 19 peresenti).
M'malo mwake, ziwerengerozi zikugwirizana ndi zomwe zimachitika ku US, komwe anthu osuta fodya sangakwanitse kufufuza kusuta fodya kusiyana ndi osuta fodya (84 peresenti poyerekeza ndi 66 peresenti).
Mosiyana, kugonana sikumaphatikizapo kusuta fodya. Ndipotu chiŵerengerocho chimakhala chosiyana ndi chiwerengero cha amuna ndi akazi omwe amatha kusuta (51 peresenti) monga amatsenga, achiwerewere, kapena akazi amodzi (49 peresenti), ngakhale kuti matenda atsopano pakati pa amuna omwe amagonana ndi amuna (MSM) katatu apamwamba kusiyana ndi amuna kapena akazi okhaokha.
Izi zikutanthauza kuti chiwerengero chachikulu cha osuta omwe ali ndi kachilombo ka HIV ndizochita zogonana. Chifukwa chake izi sizikudziwikiratu makamaka makamaka chifukwa chakuti kusuta pakati pa amuna kapena akazi, achiwerewere, ndi amuna kapena akazi omwe ali pachiwerewere, amakhala pafupifupi kawiri kawiri kwa amuna kapena akazi okhaokha, malinga ndi lipoti la 2010 la American Lung Association.
Mmene Kusuta Kumakhudzira Anthu Omwe Ali Ndi HIV
Kusuta kumachititsa kuti anthu omwe ali ndi kachilombo ka HIV athane ndi matenda omwe ali ndi kachirombo ka HIV. Izi zikugwirizana ndi kafukufuku wa 2013 kuchokera ku Copenhagen University Hospital, zomwe zinasonyeza kuti kusuta, komweko, kumachepetsa moyo wa anthu omwe ali ndi kachilombo ka HIV kwa zaka 12.3.
Kuwonjezera pamenepo, chiopsezo cha kufa (kaya ndi chokhudzana ndi kachilombo ka HIV komanso chosakhala ndi kachilombo ka HIV) chinkawoneka kuti chikuwonjezeka kasanu ndi kawiri kwa osuta kachilombo ka HIV kuposa anthu omwe ali ndi kachirombo ka HIV omwe sanasute konse.
Zina mwazoopsa za kusuta fodya:
- Kusuta ndi chinthu chimodzi chomwe chimayambitsa matenda a mtima kwambiri (ACS) mwa anthu omwe ali ndi HIV. Malinga ndi kafukufuku wochokera ku yunivesite ya Barcelona, zopereka za kusuta kwa ACS omwe ali ndi kachilombo ka HIV zinali zazikulu kuposa zopereka za shuga kapena matenda oopsa kwambiri ndipo anali oposa kachiwiri kuposa omwe akuluakulu omwe alibe kachilombo ka HIV (54 peresenti ndi 31 peresenti) . Kugwiritsa ntchito ma antiretroviral kapena CD4 kuchuluka kwa chiwerengero cha munthu / kachilombo ka HIV kunkawoneka kuti alibe zotsatira zowonjezera ngati osuta omwe ali ndi kachilombo ka HIV akupanga ACS kapena ayi.
- Kusuta kumaonedwa ngati chinthu choopsa kwambiri pakukula kwa khansa ya m'mapapo . Ndipotu, pamakhala chiopsezo cha khansa ya m'mapapo pakati pa anthu omwe ali ndi kachilombo ka HIV, osaphatikizapo kuchuluka kwa CD4 kapena mbiri ya matenda opatsirana ndi HIV. Kafukufuku wochokera ku sukulu ya Swiss HIV Cohort akusonyeza kuti anthu omwe ali ndi kachilombo ka HIV omwe ali ndi kachilombo koyambitsa matenda a HIV omwe ali ndi kachilombo ka HIV, amakhala ndi zaka 14 okha omwe ali ndi moyo zaka ziwiri. Izi zidati, anthu omwe kale ankasuta fodya adasonyezedwa kuti ali ndi chiopsezo chotere kusiyana ndi omwe akusuta, akutsindika kufunika kwa kusuta fodya kwa omwe ali ndi HIV.
- Kusuta kumapangitsanso chiopsezo cha matenda osokoneza bongo (COPD) komanso chibayo chopezeka m'magulu. Omwe akusuta omwe ali ndi kachilombo ka HIV samangokhala ndi zizindikiro zambiri zozizira kusiyana ndi osasuta, ali ndi kuchulukitsa kawiri pangozi ya imfa. Kafukufuku wina wasonyeza mgwirizano pakati pa kusuta fodya ndi cangudiasis .
- Pali mgwirizano wamphamvu pakati pa kusuta ndi matenda a papillomavirus (HPV) mwa amayi ndi abambo omwe ali ndi HIV. Azimayi omwe ali ndi kachilombo ka HIV omwe akusuta amakhala ndi chiopsezo chotenga kachilombo ka HIVV kusiyana ndi amayi omwe ali ndi kachilombo ka HIV omwe samasuta. Mofananamo, kusuta kwa amuna omwe ali ndi kachilombo ka HIV kunayanjanitsidwa ndi chiopsezo chowonjezeka cha chitukuko cha HPV. Matenda omwe amagwiritsidwa ntchito a HPV ndi ogwirizana kwambiri ndi chiopsezo chachikulu cha khansara ya chiberekero kwa amayi ndi khansa ya abambo mwa amuna. Kafukufuku wambiri akusonyeza kuti kusuta kuli ndi zotsatirapo zowononga chitetezo cha munthu, zonse zowonongeka ndi mucosal (zomwe zimaphatikizapo zomwe zimaphatikizapo maselo a Langerhans omwe amatetezera chiberekero ndi anus). Chiwerengero cha CD4 pansi pa maselo 350 / mL amanenedwa kuti ndi othandizira.
- Kusuta fodya kungapangitse amayi kutenga chiopsezo chotumiza kachilombo ka HIV kwa mwana wake pakubereka, ndipo kupweteka kwa mimba kusanakwane kumachitika kawirikawiri kwa amayi omwe ankasuta panthawi yoyamba ya mimba. Zonse zanenedwa, chiopsezo chowonekera chowonekera chikuwonetsedwa kukhala chapamwamba kuposa katatu mwa amayi osasuta omwe ali ndi HIV.
- Kusuta kumakhudzanso chiopsezo chowonjezeka cha kuperewera kwa mafupa (mwachitsanzo, osteopenia, osteoporosis), ndipo amaonedwa kuti ndi omwe amadzipangira okha omwe ali ndi HIV. M'badwo wokalamba ndi mtundu woyera umatanthauzanso za ziphuphu zochitika.
Ubwino Wosiya
Zopindulitsa ndi zazing'ono za kulekerera zonse ndi zosatsutsika komanso zomveka bwino. Kusiya kusuta pang'onopang'ono kumachepetsa chiopsezo cha matenda a mtima kwa anthu omwe ali ndi kachilombo koyambitsa matenda a Edzi, ndi kufufuza kwina komwe kumachepetsa chiopsezo cha pafupifupi 65 peresenti patatha zaka zitatu. (Kafukufuku wochokera ku Aquitaine Cohort Phunziro ku France akusonyeza kuti kutha basi kungakhale chinthu chokha chogwirizana ndi kusintha kwa mtima kwa anthu omwe ali ndi kachilombo ka HIV kuposa mankhwala ochepetsa mankhwala ochepetsa kachilombo ka HIV.
Mofananamo, ngozi ya khansa ya m'mapapo ikhoza kuchepetsedwa ndi pafupifupi 50 peresenti mwa osuta kachilombo ka HIV amene asiya chaka chimodzi kapena kuposa. Zotsatira zofanana zikuwonedwa kwa odwala omwe ali ndi COPD, chibayo chababaya, ndi zina zomwe zimapatsirana komanso zopanda kupatsirana.
Ndikofunikira kuti tiwonetsetse kuti posachedwa ndi bwino kusiyana ndi mtsogolo pokhudzana ndi kusiya, makamaka kwa iwo omwe ali ndi machitidwe a chitetezo cha mthupi. Kafukufuku wochokera ku Anderson Cancer Center ku yunivesite ya Texas anasonyeza kuti kusuta fodya kumachepetsa kulemera kwa zizindikiro zokhudzana ndi kachirombo ka HIV m'miyezi itatu yokha komanso kuti zizindikiro zikhoza kupitirirabe ngati nthawi yopanda fodya ikukula.
Kuwonjezera apo, kusuta kudziletsa kumagwirizanitsa ndi kukhazikika kwa anthu omwe ali ndi matenda opatsirana pogonana.
Zotsatira:
Mdodo, R .; Frazier, E .; Mattson, C .; et al. "Kusuta fodya pakati pa anthu akuluakulu a HIV / akuluakulu akusamalira: Ntchito Yowunika Zamankhwala, US, 2009." Msonkhano wa 20 pa za Retroviruses ndi Matenda Opondereza (CROI 2013). Atlanta, Georgia; March 3-6, 2013: Zosintha 775.
Helleberg M .; Afzal, S .; Kronborg, G ;; et al. "Kufa kumayambira chifukwa chosuta fodya pakati pa anthu omwe ali ndi kachilombo ka HIV. Matenda opatsirana pogonana. March 2013; 56 (5): 723-734.
Clifford G ;; Lise, M .; Franceschi, S .; et al. "Khansara ya m'magazi m'maphunziro a gulu la HIV / Swiss: gawo la kusuta fodya, matenda a immunodeficiency ndi matenda a pulmonary." British Journal ya Cancer. January 12, 2012; 106 (3): 447-452.
Amuna, K .; Griffith, T .; McGinnis, K .; et al. "Zotsatira za kusuta fodya pa imfa, umoyo wa moyo, ndi matenda oopsa omwe ali ndi kachilombo ka HIV." Journal of General Internal Medicine. December 2005; 20 (12): 1142-1145.