Kodi kachilombo ka HIV kapena kachilombo ka HIV ndi kofunika?
Kafukufuku watsopano wawonetsa kuti anthu omwe ali ndi kachilombo ka HIV ali oposa 50 peresenti yokhala ndi vuto la mtima kuposa anthu ambiri. Phunziro lazaka zisanu ndi chimodzi lomwe linapangidwa ngati gawo la Veterans Aging Cohort Study (VACS) linasonyeza kuti 41 peresenti ya zofooka za myocardial (MIs) zimachitika mwa anthu omwe ali ndi HIV.
Poyerekeza miyeso ya mibadwo ya zaka zakubadwa ( onani m'munsimu ), ofufuzawo anaganiza kuti chiopsezo cha MI chinali "chokwanira komanso chosasunthika" pakati pa omwe ali ndi kachilombo ka HIV ndipo nthawi zambiri yakula, mosasamala kanthu za mankhwala osokoneza bongo, matenda osokoneza bongo, kapena matenda ena a mtima zinthu.
Number of Myocardial Infarctions (MIs) Kwa zaka 1,000-Zaka
| Mtundu wa Zaka | Omwe ali ndi kachilombo ka HIV | Veteran anti-HIV |
| 40-49 | 2.0 milandu | 1.5 milandu |
| 50-59 | 3.9 milandu | 2.2 milandu |
| 60-69 | 5.0 milandu | 3.3 milandu |
Chiwerengerocho chikugwirizana ndi kafukufuku wakale omwe amasonyeza kuwonjezereka kwa magawo awiri pakati pa anthu omwe ali ndi kachilombo ka HIV, komanso kuonjezera kawiri kwa odwala omwe ali ndi kachilombo ka HIV ndi kugonana kwa chiwindi .
Kodi kachilombo ka HIV kamayambitsa bwanji vuto la mtima?
Ngakhale zifukwa zowonjezerazi sizowonekera bwino, umboni wokhutiritsa umasonyeza kuti kachilombo ka HIV kokha kamakhala ndi udindo, mwinamwake chifukwa cha kuyankhidwa kotupa kumeneku kumayambitsa matenda opatsirana pogonana.
Kuphunzira kwa 2012 kuchokera ku French Hospital Database yokhudza HIV (FHDH) inatsimikizira kuti kachilombo ka HIV, komanso chitetezo cha mthupi la wodwala, ndizozimene zimayambitsa ngozi. Kuonjezera apo, chiwopsezo cha wodwalayo chikhoza kuwonjezeka ndi kugwirizana kwachindunji kuti chichepetse kuwerengera kwa CD4 ndikuwonjezeka mu chiwerengero cha tizilombo .
CD4 ndidir ya wodwala (mtengo wotsika kwambiri CD4 yagwa) imatengedwa kuti ndiwothandiza kwambiri.
Zonsezi zikuwoneka kuti kudwala kwa kachilombo ka nthawi yaitali kumapangitsa munthu kuvutika ndi kutupa kosalekeza, komwe kumakhudza kwambiri mtima wamagulu ndi ma genetic.
Kafukufuku wopangidwa ku yunivesite ya California, ku San Francisco, anafotokoza za mgwirizano pakati pa CD4 count ndi thanzi labwino, pomwe odwala omwe ali ndi kachilombo ka HIV (kapena kuti palibe mankhwala omwe ali ndi kachilombo koyambitsa matenda a Edzi ) anali ndi kuuma kwakukulu komanso kolemetsa poyerekeza ndi odwala omwe anali ndi ma CD4 amphamvu, kuchiza msanga, ndi kulamulira kosasinthasintha kwa tizilombo.
Kodi mankhwala osokoneza bongo amachititsa mavuto a mtima?
Ngakhale kuti mankhwala ena opatsirana pogonana, makamaka Ziagen (abacavir), awonedwa kuti amachulukitsa chiopsezo cha mtima, kafukufuku wamakono wagawanika pa mutuwo. Zowonjezera, chiopsezochi chikuwoneka kuti chikukwera kwambiri pakati pa anthu omwe ali ndi mtima wam'mbuyomu kapena omwe ali ndi zifukwa zisanu kapena zowonjezera zowopsa za mtima (monga kusuta, shuga kapena cholesterol).
Ngakhale kufufuza kwina kwatchulidwanso kuti mankhwala a HIV protease inhibitor (PI) amachititsa kuti EDZI iwonongeke, ambiri amavomereza kuti pangozi iliyonse yomwe ingawonongeke ingagwirizane ndi wothandizira aliyense osati gulu lonse la mankhwala osokoneza bongo. Kafukufuku wina waposachedwapa waganiza kuti atatu mwa anthu akuluakulu omwe ali ndi PI-Reyataz (atazanavir), Viracept (nelfinavir), ndi Invirase (saquinavir) - alibe mgwirizano uliwonse ndi MI.
Palinso kukayikira ngati ma PI ena, monga Kaletra (lopinavir) ndi Crixivan (Invirase), amapereka kuchokera panthawi yogwiritsira ntchito ma PIs sikuti ndi okhawo amene amachititsa kuti anthu omwe ali ndi kachilombo ka HIV athane ndi mtima.
Komabe, chikhalidwe chosagwirizana cha kafukufuku-ndi zothandizira ndi zina zotsutsa zifukwazo-zimachoka m'chipinda chochenjeza posankha mankhwala oyenera odwala omwe ali ndi chidziwitso cha mtima. Izi zikuwonetseranso kufunika kosintha machitidwe a mtima kwa odwala onse omwe ali ndi kachilombo koyambitsa matenda a Edzi, pothandizira kuti athetse kusokoneza, kudya, ndi kuthamanga kwa magazi.
Kuchiza Matenda a Mtima kwa Anthu Amene Ali ndi HIV
Odwala kachilombo ka HIV omwe ali ndi matenda ovomerezeka omwe ali ndi matendawa, kutumizidwa kwa katswiri wa zamoyo kumalimbikitsa kwambiri. Kuyenera kugwiritsidwa ntchito poyambitsa kapena kusintha mankhwalawa kuphatikizapo antiretroviral omwe alibe mphamvu pamagulu a serum lipid.
Kuwonjezera apo, kuwonetsetsa kuyenera kuganiziridwa kuti onse omwe ali ndi kachilombo ka HIV akuyang'aniridwa kuti awonetsetse kuti ali ndi vuto la mtima, kuphatikizapo:
- kusala kudya (kuphatikizapo LDL cholesterol, cholesterol cha HDL, ndi triglycerides)
- Kuyezetsa matenda a shuga (asanayambe kulandira mankhwala, ndi kuyang'anitsitsa nthawi zonse)
- electrocardiogram (ECG) ya odwala omwe ali ndi zidziwitso zoopsa za mtima
- kawirikawiri kuthamanga kwa magazi
- Kuchita nkhanza kwa odwala omwe ali ndi vuto la mtima kuti athetse kusuta, kunenepa kwambiri, ndi mavuto ena omwe angasinthe
Ngakhale kuti palibe njira zothetsera matenda a HIV zomwe zilipo, njira zowonongeka za chikhalidwe zimalimbikitsidwa-osati odwala omwe ali ndi chiopsezo cha mtima koma ngati njira yokwanira yosamalira anthu onse omwe ali ndi kachirombo ka HIV. Tiyenera kuonetsetsa kuti:
- kuchita masewera olimbitsa thupi, kuphatikizapo kuthamanga thupi
- mafuta odzaza ndi ochepa
- Kusuta kwapadera kwa HIV kumatha
- kuchepetsa kumwa mowa ku magawo atatu pa tsiku kapena osachepera
- kulumikizana bwino kwa mankhwala opatsirana pogonana
Zotsatira:
Freiberg, M ;; Chang, C .; Kuller, L .; et al. "Kutenga kachilombo ka HIV ndi chiopsezo chachikulu cha matenda a myocardial infarction." Journal of the American Medical Association (JAMA) Mankhwala Opatsirana. April 22, 2013; 173 (8): 614-622.
Freiberg, M ;; Chang, C .; Skanderton, M .; et al. "Kuopsa kwa matenda odwala matenda a mtima pakati pa anthu omwe ali ndi HIV komanso kachilombo ka HIV." Kuthamangitsidwa: Makhalidwe a Mtima ndi Zotsatira. July 2011; 4 (4): 425-432.
Lang, S .; Mary-Krause, M., Simon, A., et al. "Kubwereza kachilombo ka HIV ndi chidziwitso cha chitetezo cha mthupi ndizozidziyimira zowopsa za matenda a myocardial infarction omwe ali ndi kachirombo ka HIV." Matenda opatsirana pogonana. August 2013; 5 (4): 600-607.
Hsue, P .; Tawonani, J .; Franklin, A .; et al. "Kuwonjezereka kwa atherosclerotic kwa odwala omwe ali ndi kachilombo ka HIV: Udindo wa chikhalidwe ndi maumuniti." Msonkhano wa khumi pa Retroviruses ndi Matenda Osakanikirana (CROI 2003); Boston, Massachusetts; February 10-14, 2003; chosamveka 139.
Monforte, A .; Bwerani, P .; Chisokonezo. L ;; et al. "Atazanavir sichikukhudzidwa ndi chiopsezo chowonjezereka cha zochitika za matenda a mtima kapena cerebrovascular disease." AIDS. January 28, 2013; 27 (3): 407-415.