HIV - komanso malingaliro osagwirizana ndi kachirombo ka HIV akuwonjezeka
Zotsatira za khansara mwa anthu omwe ali ndi kachilombo ka HIV akhala akudandaula kwambiri ndipo cholinga cha kafukufuku wowonjezera ndi ofufuza zachipatala. Ngakhale kuti pangozi yothetsera AIDS monga Kaposi sarcoma ndi non-Hodgkin lymphoma (NHL) yayamba kwambiri chifukwa cha kupita patsogolo kwa mankhwala opatsirana pogonana , zotsatira za khansa zina zakula mofulumira.
Zomwe sizingatheke kupha khansa lero ndizo zimayambitsa imfa ya anthu omwe ali ndi kachirombo ka HIV m'mayiko otukuka, malinga ndi kafukufuku wochokera ku Swiss HIV Cohort Study. Zotsatira za ziwawa monga khansara yamapapo ndi khansara ya khansa tsopano ikuyenda paliponse kuyambira katatu mpaka 50 kuposa wamkuluwo.
Edzi-Kufotokozera Khansa
Kumayambiriro kwa zaka za m'ma 1980, kansa ya khungu yosawerengeka yotchedwa Kaposi sarcoma (yomwe, mpaka nthawi imeneyo, inakhudzidwa kwambiri ndi amuna okalamba ku Eastern Europe) inali pakati pa magulu omwe anapezeka ndi HIV. mu 1981. Posakhalitsa, osakhala Hodgkin lymphoma ndi invervous cervical carcinoma (ICC) anawonjezeredwa pa mndandanda ngati khansa yotchedwa AIDS-kufotokoza.
Poyambitsa mankhwala opatsirana pogonana (ART) mu 1996, malo adasintha kwambiri. Ali ndi mankhwala omwe amatha kuthetsa kachilombo ka HIV ndi kubwezeretsa chitetezo cha thupi, zomwe zimachitika ndi Kaposi ndi NHL zagwetsedwa pafupi ndi 50 peresenti, pomwe ICC yakhala yosasintha kwambiri mpaka lero.
(Chifukwa cha ichi sichimvetsetsedwa bwino ngakhale ena amakhulupirira kuti mapiromavirus ena (omwe amadziwika kuti amachititsa khansa ya chiberekero), yomwe imakhala ndi kachilombo koyambitsa matenda a chiberekero, amatha kukhala makamaka mwa amayi omwe ali ndi HIV.)
Ngakhale zambiri zapita patsogolo, anthu omwe ali ndi kachilombo ka HIV ali ndi mwayi wokwanira kukhala ndi ICC, kasanu ndi kawiri kuti akhale ndi NHL, ndipo nthawi zambiri amatha kukhala ndi kachirombo ka Kaposi kusiyana ndi anzawo omwe alibe kachilomboka.
Osati AIDS-Kufotokozera Khansa
Chifukwa cha ART komanso kukula kwa anthu omwe ali ndi kachilombo ka HIV, ochita kafukufuku anayamba kuona mitundu yambiri ya khansa ikuwoneka mobwerezabwereza kwa anthu omwe ali ndi HIV. Nthawi zambiri izi zimachitika kuti anthu ambiri akhulupirire kuti pali chiyanjano pakati pa HIV ndi mitundu ina ya khansa.
Zina mwa izi, monga khansa ya ana , chiwonetserocho chinkawonekera bwino. Nthaŵi zambiri ku US, omwe ali ndi zaka zoposa 20,000 zomwe zalembedwa pakati pa 1980 ndi 2005, khansa ya khansa lero ndi khansa yachinayi yomwe imapezeka anthu omwe ali ndi HIV. Komanso, amuna ogonana kapena amuna kapena akazi okhaokha omwe ali ndi kachilombo ka HIV angakhale ndi mwayi wochuluka kwambiri wokhala ndi khansa ya ana kuposa 60 omwe sali ndi HIV.
Mofananamo, matenda a Hodgkin (mtundu wa khansara yamagazi yofanana ndi wosakhala Hodgkin lymphoma) ndi pakati pa zisanu kapena 10 nthawi yomwe amatha kukhudza anthu omwe ali ndi kachilombo ka HIV, pamene khansa ya mutu / khosi ndi khansa ya chiwindi, zimachitika.
Zonse zanenedwa, khansa ya ubongo, pakamwa, mmero, mapapo, chiwindi, impso, chiberekero, nthendayi ndi minofu zimawonetsedwa kuti zimakhudza kwambiri anthu omwe ali ndi kachilombo ka HIV, ndipo ambiri amapezeka zaka 10 mpaka m'mbuyomo kusiyana ndi anzawo omwe alibe kachilomboka.
(Pambaliyi, anthu omwe ali ndi kachilombo ka HIV sawoneka kuti ali pachiopsezo chachikulu cha kukula kwa khansa, mazira, chikhodzodzo, prostate, colon kapena rectum.)
Zifukwa Zowopsa Kwambiri
Matenda ena omwe amachititsa kuti matendawa asokonezeke, monga kuti pakati pa chiwindi cha chiwindi ndi khansa ya chiwindi; HPV ndi khansara ya ana / chiberekero; ndi Epstein Barr ndi matenda a Hodgkin.
Pakalipano, zikhalidwe za chikhalidwe, monga kusuta ndi mowa, zimapangitsanso mavuto, makamaka ndi khansa ya m'mapapo kapena chiwindi.
Chofunika kwambiri, mwinamwake, ndicho gawo la HIV palokha. Ngakhale tikudziwa kuti HIV siimayambitsa khansa, kutupa kosalekeza komwe kumakhudzana ndi matenda kumawoneka kuti akugwirizana kwambiri ndi chiŵerengero chokwanira.
Izi zimawoneka zoona ngakhale pamene odwala ali pa ART omwe ali ndi mavairasi osadziwika .
Kafukufuku lero akusonyeza kuti kutupa kosalekeza, ngakhale pamatsika otsika, kungakhale ndi msinkhu wa msinkhu wa chitetezo cha mthupi. Kuwonongeka uku (kumatchedwa senescence msanga) kumatengedwa mwachibadwa kwa anthu achikulire. Komabe, chifukwa cha kutupa kwa kachilombo ka HIV, kupweteka msanga kumeneku sikungowonjezera nthawi yokhala ndi khansara, imatero ndi matenda ena okalamba, kuchoka ku matenda osokonekera maganizo mpaka kufooka kwa matenda a mtima .
Mmene Mungachepetsere Vuto Lanu la Khansa
Chofunika kwambiri kuti kuchepetsa chiopsezo cha khansa ndiko kuyambitsa matenda ndi kachilombo ka HIV. Kuyamba kwa ART panthawi ya kugonana kumatha kusamalira kapena kubwezeretsa chitetezo champhamvu choteteza thupi kuthupi pamene kuchepetsa chiopsezo cha khansa pafupifupi 50 peresenti.
Zizindikiro zina za anthu omwe ali ndi kachilombo ka HIV ndizo:
- Pulogalamu ya pap yowonetsera kansa ya pachibelekero
- Kuchepa kwa hepatitis B ndi kuyesedwa kwa hepatitis C
- Zomwe zimachitika papepala zowonongeka kwa amuna ogonana kapena amuna kapena akazi okhaokha kapena munthu aliyense ali ndi zida za ana
- Katemera wa HPV kwa akazi a zaka zapakati pa 11 ndi 26, amuna a zaka zapakati pa 11 ndi 21, amuna ogonana omwe amagonana ndi amuna (MSM) a zaka zapakati pa 22 ndi 26, kapena amuna osamalidwa bwino omwe ali ndi zaka zapakati pa 22 ndi 26
- Kusuta fodya
- Kuchepetsa mowa, makamaka kwa anthu omwe ali ndi hepatitis B kapena C
- Njira zogonana zogonana pofuna kupewa matenda a hepatitis C ndi matenda a HPV
- Zoyezetsa zina za kansalu zomwe zimayesedwa ndi dokotala wanu
Zotsatira:
Hleyhel, M .; Belot, A .; Bouvier, A., et al. "Kuopsa kwa matenda a Edzi a AIDS omwe ali ndi HIV-1 odwala (1992-2009): zotsatira za FHDH-ANRS CO4." Journal of International AIDS Society. November 11, 2012; 15 (4)
Crum-Cianflone, N., MD; Huppler Hullsiek, K., PhD; Vincent Marconi, Vm MD, et al. "Zotsatira za Chiwerengero cha Khansa Pakati pa Anthu omwe ali ndi kachilombo ka HIV ndi zotsatira za Antiretroviral Therapy: Phunziro la Ophunzira a Zaka 20." Edzi , 2009; 23 (1): 41-50.
Zida, M .; Pfeiffer, R .; Gail, M., et al. "Ngozi ya khansa kwa anthu omwe ali ndi kachirombo ka HIV ku United States." XVIII Conference International AIDS, Vienna. Mfundo Yeniyeni WEAB0101, 2010.
Nguyen, M .; Farrell, K .; ndi Gunthel C. "Osati Edzi-Kutanthauzira Malingaliro Odwala Odwala ndi HIV mu HAART Era: Report Now Infection Disease Report." Ripoti Yamakono Yopatsirana. January 2010; 12 (1): 46-55.
Chao, C .; Leyden, W .; Xu, L., et al. "Kuwonetsa mankhwala ochepetsa kachilombo ka HIV ndi chiopsezo cha khansa omwe ali ndi kachirombo ka HIV." AIDS. November 13, 2012; 26 (17): 2223-31.