Kutumiza kumatheka ngakhale ndi kachilombo kosaoneka
Ngati muli ndi kachilombo ka HIV ndi kumwa mankhwala monga momwe mwafunira, mungaganize kuti chiopsezo chanu chowapatsira ena chidzakhala chochepa, chabwino?
Kawirikawiri, mungakhale wolondola, koma pali zizindikiro pamene anthu omwe ali ndi kachilombo kosawoneka m'magazi awo mwadzidzidzi ali ndi kachilombo koyambitsa matendawa m'mimba mwawo kapena mwachinsinsi. Ichi ndi chodabwitsa chomwe chimadziwika ngati kukhetsa mavairasi.
Ngakhale kuti nthawi zambiri timatchulidwa kukhetsa pamene zimapezeka mu chiwalo chachiberekero cha amuna kapena akazi (kutaya magazi), chikhoza kuchitika pakamwa (kukhetsa pamlomo).
Kuwonjezeka kwa ntchito zokhudzana ndi mavairasi-makamaka mu umuna kapena zobisika za m'mimba-kumatanthawuzira ku mwayi waukulu wopatsirana kachirombo ka HIV kwa wokondedwa.
Mmene Kutsegulira Matenda a Chigwirizano Kumayambira
Mu sayansi, mawu oti "kukhetsa" amatanthauza njira yomwe kachilombo kamatulutsidwa, kapena kukhetsa, kuchokera ku selo yolandiridwa yomwe yatenga. Njira ziwiri zomwe zingatheke ndizimene zimadziwika monga budding ndi apoptosis:
- Budding amatanthauza siteji ya moyo wa HIV pamene kachilombo kamatulutsa kachilombo kamene kamakhala ndi kachilombo kamene kamakhala ndi kachilombo kamene kamakhala ndi kachilombo kamene kamakhala nako. Zingathe kumera kuchokera kwa alendo ngati kachilombo koyambitsa.
- Apoptosis , yomwe imadziwikanso kuti kudzipha, ndiyo njira imene selo imadzipha yokha ikayikidwa pansi. Pa matenda ena, apoptosis idzawononga kachilombo koyambitsa matenda pamodzi ndi selo yolandiridwayo. Ndili ndi kachilombo ka HIV, komabe kachilombo kameneka kamakakamiza selo kuti likhale loyambitsa matendawa kuti limasulidwe.
Kodi palibe chifukwa chotani chomwe chikufotokozera kuti kachilombo ka HIV kamatha kuchitika m'magawo achiberekero koma osati m'magazi kumene sichidzaonekeratu.
Umboni tsopano ukusonyeza kuti zifukwa ziwiri zingapangitse izi: kusiyana kwa kachilombo ka HIV m'maselo a thupi lathu komanso kusiyana kwa kachilombo ka HIV mkati mwa ziwalo za thupi lathu.
Kutulutsidwa kwa Mthendayi Yamagulu ndi Kusintha kwa HIV
Chimodzi mwa mavumbulutso oyambirira achitika mu 2000 pamene anapeza kuti vuto la HIV lingasinthe kuchokera kumbali imodzi ya thupi kupita ku yotsatira. Malinga ndi kafukufuku wochokera ku Multicenter AIDS Cohort Study (MACS), anthu ena omwe ali ndi kachilombo ka HIV adasonyezedwa kuti ali ndi mitundu yosiyanasiyana ya kachirombo ka HIV m'magazi awo ndi ena m'mimba mwawo.
Phunziroli linapitirizabe kuyang'ana njira zomwe zakhazikitsidwa pakati pa ophunzira. Nthawi zina, kukhetsa ndi njira yowonjezera yomwe imachitika muzigawo zonse za magazi ndi nyemba. Kwa ena, iwo anali pakati pokha ndipo ankachitika makamaka mu chiwalo chogonana. Kwa ena komabe, panalibe kukhetsa konse.
Zomwe zotsatirazi zinatsimikiziridwa zinali:
- Kusiyana kwa kachilombo ka HIV kungatanthauze kusintha kwa mankhwala.
- Kusakaza kachilombo ka HIV kungakhale chikhalidwe chomwe munthu amapangidwira.
Mwa anthu omwe anali ndi pakati pa kukhetsa, zofukufukuzo zinali zozama kwambiri. Pa amunawa, ofufuza a MACS adanena kuti matenda a bakiteriya a prostate gland anali ogwirizana kwambiri ndi spikes mumagulu opatsirana pogonana . Ankaganiza kuti kutupa kwa prostate kumalo komweko kumapangitsa kuti tizilombo toyambitsa matenda tizilombo toyambitsa matenda tizilombo toyambitsa matenda tizilombo toyambitsa matenda.
Kafukufuku wotsatira akugwirizanitsa zowonjezera izi ndipo asonyeza kuti kukhetsa kungachitike chifukwa cha matenda opatsirana pogonana (matenda opatsirana pogonana) , matenda omwe amakhalapo, komanso ngakhale kusamba .
Kugwiritsa ntchito mankhwala osokoneza bongo angayambitse mwazi, matiski
Timayesa magazi kuti tipeze kachilombo koyambitsa matenda a Edzi osati chifukwa ndi njira yabwino kwambiri yotengera kachilombo ka HIV koma chifukwa chimapereka mwayi wofikira poyerekeza ndi, kunena, fupa kapena mafupa. Izi sizikutanthauza kuti sizomwe zimakhala zolimba kwambiri-koma sizikutitsimikizira zonse momwe mankhwala ogwiritsira ntchito ma ARV amathamangira m'maselo osiyanasiyana ndi matupi a thupi lathu.
Mwachitsanzo, takhala tikudziwa kuti mankhwala monga zidovudine (AZT) amatha kulowa mkati mwa ubongo komanso maselo a m'mimba mwachangu komanso mozama kwambiri kuposa pafupifupi mankhwala ena onse a HIV. Ichi ndi chifukwa chake adagwiritsidwa ntchito kwa nthawi yaitali kwa anthu omwe ali ndi matenda a Edzi aumphawi ngati njira yothetsera vutoli.
Mofananamo, pali umboni wochulukirapo wakuti mankhwala a Truvada, pamene amagwiritsidwa ntchito monga mankhwala oletsa kuteteza ( odziwika ngati PrEP ), saloŵa m'mimba mwa vaginja mofanana ndi momwe amachitira kachilomboka.
Kafukufuku wochokera ku yunivesite ya North Carolina ku Chapel Hill inasonyeza kuti kuyerekezera kwa Truvada mu minofu kumapereka 90% pokhapokha chitetezo ndi mankhwala awiri okha kapena atatu pa PrEP mlungu uliwonse . Mosiyana ndi zimenezi, Truvada mumatenda amtunduwu anali otsika kwambiri, ndipo amapereka chitetezo chokha cha 70 peresenti ngakhale kuti nthawi zonse zimakhala zotetezeka.
Zomwezo zingakhale zogwiritsidwa ntchito kwambiri pamagawo amtundu wamwamuna. Ngati ndi choncho, ndizotheka kuti kachilombo ka HIV kangathe kupewera kachilomboka kwina kulikonse m'thupi koma sichikupezeka m'kati mwa chiberekero ngati pali matenda.
Pachifukwa ichi, akukhulupirira kuti chitetezo cha mthupi chikhoza kukhala chowopsa chomwe chimachititsa kuti amuna ndi akazi adye.
Momwe Mmene Matenda a Mumthupi Amayendera Amachititsa Kuti Shedding
Kukhalapo kwa matenda alionse kudzachititsa chitetezo cha mthupi. Izi zikachitika, thupi lidzayankha potulutsa zinthu m'thupi lomwe limatchedwa cytokines lomwe limatulutsa ndi kuteteza maselo a chitetezo ku magwero a matenda. Ngakhale zina za cytokines zimathandizira kulimbana ndi matenda, zina zimakhala ndi zotsatira zotsutsana ndi "kudzutsa" kukhala ndi kachilombo koyambitsa matenda a HIV mumaselo osiyanasiyana ndi matupi a thupi.
Amadziwika ngati malo osungiramo zinthu , malowa amatha kuteteza HIV ku chitetezo cha mthupi. Nthawi zambiri pakakhala matenda aakulu, pamene chitetezo cha mthupi chitsegulidwa, kachilombo kamene kamatuluka mwadzidzidzi. Ichi ndichifukwa chake anthu ena amatha kupita zaka popanda mankhwala ndipo mwadzidzidzi ali ndi matenda aakulu omwe amatsagana ndi nthendayi yambiri pamagwira ntchito.
Njira yomweyi ikuwoneka kuti ikugwiritsidwa ntchito pa njira yowononga kachilombo ka HIV. Pamaso pa matendawa, nenani matenda opatsirana pogonana kapena prostatitis , chitetezo cha mthupi chimasula mtundu wa proinflammatory cytokines (mtundu womwe umagwirizana ndi kutukusira). Kuphulika kumeneku kwadzidzidzi kumagwirizanitsa ndi kuwonjezeka kwa kukhetsa kwadzidzidzi.
Izi zikachitika, maselo oyera a chitetezo (leukocytes) amateteza mwadzidzidzi malo a matenda. Mmodzi wotchedwa leukocyte, wotchedwa CD4 T-cell , ndiwopambana kwambiri wa HIV. Pamene ma T-maselowa ali ndi kachilombo koyambirira, chiwerengero cha mavairasi chikumka mpaka nthawi yomwe matenda opatsirana amapezeka.
Pa nthawi imeneyi, munthu amene ali ndi kachilombo ka HIV angathe kutenga kachilombo kwa ena. Ngakhale kuti chiwerengero cha tizilombo chikhoza kuwonjezeka ndi chipika chimodzi chokha kapena chomwecho (kulumpha kuchokera, nkuti, 100 mpaka 1,000), zikhoza kukhala zokwanira kuti zithetse.
HIV Kutaya Pakati pa Mimba
Kutaya kachilombo ka HIV kungatheke chifukwa cha kusamba. Pamene kukhetsa sikungapangitse kwambiri chiopsezo chotenga kachilombo ka HIV kuchokera kwa amayi pa chithandizo cha kachilombo ka HIV, chingatheke kwa iwo omwe sadziŵa kuti ali ndi chikhalidwe kapena ayi.
Kafukufuku wochokera ku Oregon Health and Science University (OSHU) adafufuzira gulu la amayi omwe adakonzedweratu kuti azitsuka chifukwa cha kugonana kwa herpes simplex (HSV-2) . (HSV-2, kachilombo koyambitsa 67 peresenti ya chiwerengero cha anthu padziko lapansi, amadziwikanso kuti amachititsa kuti amayi azikhala ndi zizindikiro zozizwitsa komanso zosadziwika .)
Pakati pa amaiwa, kachilombo ka HIV kanali kofala pa nthawi ya msambo ndi kuchulukitsa kawiri kawiri mu nthenda ya tizilombo poyerekeza ndi nthawi yoyamba. Izi zinachitika ngati mkazi ali ndi zizindikiro za HSV-2 kapena ayi. Ngakhale kuwonjezeka kumeneku sikungayimire kwambiri mwa amayi omwe ali ndi mavairasi oponderezedwa, iwo ankawoneka kuti ndi ofunika kwambiri kwa iwo omwe ali ndi mavairasi apamwamba.
Malinga ndi ochita kafukufuku, kutaya kwa ma ARV kumatanthawuza kuchuluka kwa 65 peresenti ya chiopsezo cha HIV ngati mkazi sakuchitidwa. Mosiyana ndi zimenezi, kachilombo ka HIV kangachepetsedwe, ngakhale kuti sichichotseratu, chiopsezo kwa munthu yemwe ali ndi kachirombo ka HIV.
Mawu Ochokera
Kuchokera poyambira PrEP, tawona dontho loyezera pogwiritsa ntchito makondomu. Kafukufuku wina wa ku France, anasonyeza kuti nthawi zambiri munthu amatenga PrEP, mwina sangagwiritse ntchito makondomu (54 peresenti yochepetsera kukhala yeniyeni).
Ngakhale kuti PrEP ikugwira ntchito mosakayika, makamaka pazifukwa zosiyana-siyana ndi anthu omwe ali pachiopsezo chotenga kachilombo ka HIV, siziyenera kusonyeza kuti makondomu ndi ofunikira kwambiri kuposa kale lonse.
Pamapeto pake, kachilombo ka HIV kamakhala chifukwa cha zinthu zambiri kuphatikizapo, pakati pazinthu zina, mtundu wa kugonana komwe umakhudzidwa ndi thanzi la munthu wosatetezeka. Ngakhale kuti chiwerengero cha tizilombo cha munthu wodwalayo ndi chochepa, zifukwa zina zingathe kukwera pamwamba pazomwe zikulitsa chiopsezocho, nthawi zina kwambiri.
Kachilombo ka HIV kamene sichidziwika kameneka kanakanizidwa ndi bacterial vaginosis yomwe imapangidwira ndi mankhwala omwe amachititsa kuti tizilombo toyambitsa matenda tizilombo toyambitsa matenda tizilombo toyambitsa matenda nthawi zina zimakhala zovuta kuti tipeze kachilombo ka HIV.
Ngati simukukayikira za mwamuna kapena mkazi wanu, ndipo ngati muli ndi zibwenzi zambiri zogonana, musati mutenge mwayi. Gwiritsani ntchito makondomu ndi zida zina zothandizira kuti muteteze nokondedwa wanu.
> Zotsatira:
> Gupta, P .; Leroux, C .; Patterson, B .; et al. "Kachilombo ka HIV kamene kamakhala ndi kachilombo ka HIV kamene kamakhala kofanana ndi Kumbali ya Viral Quasi-Species pakati pa Magazi ndi Masamba." Journal of Infectious Diseases. 2000: 182; 79-87.
> Patel, E .; Kirkpatrick, A .; Grabowski, M .; et al. "Penile Immune Activation and Risk of HIV Kedding: A Prospective Cohort Study." Clin Infect Dis. 2017; 64 (6): 776-784.
> Spencer, L .; Christiansen, S .; Wang, C. "Ntchito Yowonongeka kwa Mphamvu ndi Kutulutsa kachilombo ka HIV mu Tsamba lachikazi lachikazi." Journal of Deficiency Immune Deficiency Syndromes. 2016; 71 (2): 155-162.
> Cottrell, M .; Yang, K.; Prince, H .; et al. "Kulosera njira zogwirira ntchito za Truvada PrEP zoyenera ndi njira yopangira PK-PD yomwe imaphatikizapo minofu yogwira ntchito yotchedwa metabolites ndi nucleotide yodalirika (EN)." Mndandanda wa Kafukufuku Wopewera HIV; Cape Town, South Africa; October 28-31 2014; zolemba zamlomo 22.06 LB.
> Teyssier, L .; Suzan-Monti, M ;; Castro, D. "Kugwiritsa ntchito Koperani ndi Kondomu mu MSM High-Risk mu Mayankho a ANRS IPERGAY." Msonkhano wa Retroviruses ndi Matenda Opondereza (CROI); Boston, Massachusetts; February 22-25, 2016; zomveka 887.