Kusintha kwa mahomoni kungapangitse amayi kukhala pangozi yaikulu ya HIV
Kuopsa kwa kachilombo ka HIV kumakhala kochuluka kwambiri kuchokera kwa amuna kupita kwa amayi kusiyana ndi amayi kupita kwa amuna chifukwa chachitetezo chachikulu cha amayi, chiberekero komanso (mwina) chiberekero. Sikuti kokha pali minofu yambiri ya ubele (FRT) poyerekeza ndi mbolo, kusintha kwa biology kungapangitse ma tishu a mucosal omwe amachititsa kuti FRT iwonongeke kwambiri.
Ngakhale kuti mazira a mukazi ndi ochepa kwambiri kusiyana ndi rectum, ndipo pafupi ndi khumi ndi awiri omwe amagawanika matenda a epithelial omwe amachititsa chitetezo ku matenda, kachilombo ka HIV kamatha kupeza thupi lokhala ndi maselo abwino. Kuwonjezera pamenepo, chiberekero, chomwe chimakhala chochepa kwambiri kuposa chiberekero, chimayikidwa ndi CD4 + T-maselo , maselo omwe amateteza mthupi mwathu omwe amatengera kachilombo ka HIV.
Zinthu zambiri zingalimbikitse chiopsezo cha amayi ku HIV, kuphatikizapo bacterial vaginosis (yomwe ingasinthe zamoyo za m'mimba) komanso chiberekero cha ectopy (chomwe chimatchedwanso "chiberekero").
Koma umboni wowonjezereka wasonyezeranso kuti kusintha kwa mahomoni, kaya kumachitika mwachibadwa kapena kukakamizidwa, kumathandiza kwambiri kuwonjezera mwayi wa amayi kuti atenge HIV.
Msambo ndi HIV
Phunziro la 2015 kuchokera kwa ofufuza a ku Yunivesite ya Dartmouth ya Geisel School of Medicine inanena kuti kusintha kwa mahomoni pa nthawi ya msambo kumapereka kachilombo ka HIV ndi matenda ena opatsirana pogonana omwe ali ndi "mwayi wodwala".
Chitetezo cha mthupi, zonse zachibadwa (zachilengedwe) ndi kusintha (zomwe zimatengedwa pambuyo pa matenda oyamba), zimadziwika kuti zimayang'aniridwa ndi mahomoni. Pakati pa msambo, mahomoni awiriwa amatanthawuza kuti zikhale zovuta kuti mimba ikhale ndi mimba komanso kuti mimba ikhale ndi mimba komanso progesterone. Imeneyi imakhudza maselo a epithelial, fibroblasts (maselo omwe amapezeka m'magulu ogwirizana), ndi maselo a chitetezo omwe amayendetsa FRT.
Pochita izi, chitetezo cha mthupi chimachepetsedwa, ndipo chiopsezo chotenga kachirombo ka HIV chikuwonjezeka kwambiri.
Ngati zitsimikiziridwa, phunziroli lingathandize njira zochiritsira zomwe zingawathandize kupititsa patsogolo zokhudzana ndi mavairasi kapena / kapena kuchita zogonana (mwachitsanzo, kuzindikira nthawi zabwino kuti agonane) pazinthu zomwe zimatchedwa "mawindo."
Kusamuka kwa mimba ndi HIV
Komanso, maphunziro ena a 2015 kuchokera ku yunivesite ya Pittsburgh Medical Center adanena kuti kusintha kwa FRT kungapangitse chiopsezo chachikulu cha kachirombo ka HIV kumbuyo kwa amayi amasiye.
Zikudziwika bwino kuti chitetezo cha m'mimba mwa njira ya m'mimba mwachangu imachepa msanga panthawi yomwe amatha kusamba, komanso kuperewera kwa mitsempha ya epithelial komanso kuchepetsa kuchepa kwa mucosal. (Mucosa, yomwe imadziwika kuti imakhala ndi maantimicrobial, imathandizidwa ndi zotchinga kuchokera kumtunda wapamwamba wa FTR zomwe zimapereka chitetezo chamtundu kumtunda wamtundu wapansi.)
Ofufuzawa anapeza akazi okwana 165, kuphatikizapo amayi omwe amatha kupha anthu; Azimayi oyambirira osati amayi oletsa kulera; ndi amayi pa njira zothandizira kulera komanso kuchepetsa chiopsezo cha HIV poyerekeza ndi mankhwala omwe amapezeka ndi ulimi wothirira. Pogwiritsa ntchito mayeso oyezetsa kachirombo ka HIV, adapeza kuti amayi omwe amatha kukhala ndi kachilombo ka HIV amatha kuchita zinthu zolimbana ndi kachirombo ka HIV (11% vs 34%) kuposa magulu awiriwa.
Ngakhale kuti zogwirizana ndi zochepa ndi kafukufuku ndi kukula kwake, zimasonyeza kuti kusintha kwa mahomoni kumasana ndi kutha kwa amayi kungapangitse akazi achikulire kuwonjezeka kwa chiopsezo cha HIV. Choncho, kulimbikitsidwa kwakukulu kuyenera kukhazikitsidwa pa maphunziro okhudzana ndi kugonana kwa amayi achikulire, komanso kuonetsetsa kuti kachirombo ka HIV ndi matenda ena opatsirana pogonana sichipewa kapena kuchedwa.
Mankhwala opatsirana pogonana komanso kachilombo ka HIV
Umboni wakuti mankhwala opatsirana pogonana angapangitse chiopsezo cha amayi kuti akhale ndi kachilombo koyambitsa matenda a Edzi. Kusanthula kwakukulu kafukufuku wa maphunziro khumi ndi awiri-asanu ndi atatu omwe anachitidwa pakati pa anthu ambiri komanso anayi pakati pa amayi omwe ali pangozi yaikulu -amasonyeza kuwonjezereka kwakukulu kwa chiopsezo cha HIV kwa amayi omwe amagwiritsa ntchito mankhwala osokoneza bongo, a depot medroxyprogesterone acetate (DPMA, aka Depo -Provera ).
Kwa amayi ambiri, chiwopsezochi chinkawoneka kukhala chaching'ono.
Kuwunika komweku, kuphatikizapo amayi oposa 25,000, sanawonetsetse mgwirizano wogwirizana pakati pa njira zothandizira pakamwa ndi kachilombo ka HIV.
Ngakhale kuti chiwerengerochi chimawerengedwa kuti sichikwanira kuti chiwonongeko cha DPMA chigwiritsidwe ntchito, ochita kafukufuku akulangiza kuti amayi omwe amagwiritsa ntchito mankhwala oopsa a progestin amadziwitsidwa za kusadziŵa za DPMA ndi kachilombo ka HIV, komanso kuti akulimbikitseni kugwiritsa ntchito kondomu ndikufufuza njira zina zothandizira. HIV pre-exposure prophylaxis (PrEP ).
Zotsatira:
> Chappell, C .; Isaacs, C .; Xu, W .; et al. "Zotsatira za Kusamba Kwambiri Kwambiri pa Mankhwala Osokoneza Bongo Achipatala Amene Akugwira Ntchito Yachilombo cha Cervicovaginal." Journal American Obstetrics ndi Gynecology. March 20, 2015; DOI: http://dx.doi.org/10.1016/j.ajog.2015.03.045.
Ralph, L .; McCoy, S .; Shiu, K .; et al. "Kugwiritsa Ntchito Kachilombo ka Hormonal ndi Kuopsa kwa Akazi ku HIV Kupeza: Meta-Analingalira Zophunzira Zophunzira." Matenda Opatsirana a Lancet. January 8, 2015; 15 (2): 181-189.
Wira, C .; Rodriguez-Garcia, M .; ndi Patel, M. "Udindo wa mahomoni ogonana okhudzana ndi chitetezo chautetezo cha Tsamba la Kubereka kwa Mkazi." Chilengedwe Kuwonetsa Immunology . March 6, 2015; 15: 217-230.