Izidakamizwa ze-HIV Akunjalo kuphela Kwimeko yeziTshintsho zeMzimba
I-Lipodystrophy , ngokuphindaphindiweyo ukulungelelaniswa ngokuthe ngqo komzimba womzimba, bekude kuthathwa njengefuthe elichaphazelekayo kunye neenombolo zamachiza e-antiretroviral , ngokukodwa ezinjengezizukulwana ezizaliswayo njengeZerit (stavudine) kunye ne-Retrovir (AZT), eziseklasini yeziyobisi ezibizwa ngokuba yi- nucleoside reverse i-transcriptase inhibitors .
Kwiminyaka yakutshanje, ezinye iizithunywa ziye zongezwa kwoluhlu lwababhenkethi abanokwenzeka, kuquka uSustiva (efavirenz), i-Isentress (raltegravir), kunye neklasi yezilwanyana ze-HIV ezibizwa ngokuba yi- protease inhibitors .
Xa kuthethwa oko, isizathu esiyiyo sokuba lipodystrophy- mhlawumbi kwindlela yokuqokelela amafutha (lipohypertrophy) okanye ukulahleka kweoli (i-lipoatrophy) -iyona nto ingabonakali kakuhle. Ubungqina obandayo bucebise ukuba i-HIV ngokwawo, kunye nokuvuvukala okuqhubekayo okuchaphazelekayo , inokuba ngabagawuli abalulekileyo, nangona kutshanje bekukho idatha encinci yokuqinisekisa oku.
Uphononongo luka-2015 olwenziwe kwiNgqungquthela yeeRevrovirus kunye nezifo ezithintekayo kwi-Seattle zancedisa ukukhanya okucacileyo malunga nesifundo. Ngokutsho kophando, abantu abaneentlobo eziphezulu zentsholongwane ekuqaleni kweyeza (iikopi ezingaphezu kwe-100,000 / mL) kubonakala kunendawo ephezulu ye-lipodystrophy kunezo ezinomthwalo omncinci we-viral.
IsiCwangciso soFundo kunye neziphumo
Uphononongo lweeveki ezingama-96, oluqhutywa ngabaphandi kwi-Case Western Reserve University e-Ohio, wathatha izigulane ezingama-328 ze-HIV ezingenakho ukuvavanywa kwangaphambili kunyango. Iminyaka yobudala yayineminyaka engama-36; 90% babengamadoda.
Omnye wabathathi-nxaxheba wayemiselwe enye yeerimenimitha ezintathu zezidakamizwa ezahlukeneyo, ezibandakanya umqolo weTruvada (tenofovir + emtricitabine) kunye nokuba
- Reyataz (atazanavir) + Norvir (ritonavir),
- I-Prezista (darunavir) + i-Norvir (ritonavir), okanye
- Isentress (raltegravir).
Ngaphezulu kwesi sifundo, izigulane zanikezwa i-CAT rhoqo kunye ne- DEXA (i-absoralometry emibini-ene-X-ray absorptiometry) ihlola ukulinganisa utshintsho lomzimba.
Ngoxa bekukhankanywe ukuba izidakamizwa ezahlukileyo ze-antiretroviral ziza kuthintela iziphumo ezahlukileyo kwizigulane, izazinzulu zandimangalisile ukubona ukuba ukunyuka kwamafutha omzimba kwakubhaliswa ngokufanayo kuwo onke amaqela. Ngokubanzi, ubunzima bomzimba bunyuke ngo-3% ukuya kwi-3.5%, ngelixa i-fat fat likhula likhuphuke ngo-11% ukuya kwi-20% kwaye isiswini esiswini sisanda ngo-16% ukuya kwi-29%.
Ukwahlukana kuphela okulinganiselwe abayifumanayo kwimizi yesifo segciwane. Kulabo abanemithwalo ephezulu yentsholongwane ye-viral, i-fatcer visceral (okt, ngaphakathi kwesigxina esiswini) yenyuka ngama-35% ngokungakhathaliseki ukuba isicatshulwa okanye inkunkuma yeklasi. Ngokwahlukileyo, izigulane ezineentlobo zentsholongwane ezingaphantsi kwama-100,000 ikopi / mL zineenzuzo ezi-14% kuphela nge-Isentress kwaye zingaphantsi kwama-10% kunye ne-protease inhibitors.
Ukongeza, iphakama kwi-Interleukin-6 (i-IL-6), ummakishi wokusebenza kwamagciwane, ayenxulumene nokunyuka kwamafutha omnxeba (oko kukuthi, amanqatha ngokukhawuleza ngaphantsi kwesikhumba). Oku kuphakamisa ukuba ukuvutha okuhambisana ne-HIV kudlala indima ngqo kwiimpembelelo eziphantsi kwamanqatha, mhlawumbi kwi-consort kunye okanye ezizimeleyo ngoncedo lwonyango.
Kungakhathaliseki ukuba izizathu okanye izinto ezinobangela, inzuzo ye-fatceral ye-visceral ye-30% ngaphezu kweminyaka emibini ibaluleke kakhulu, ihamba nayo ingozi yentsholongwane ye- cardiovascular disease , isifo sikashukela kunye ne- dyslipidemia .
Iziphumo zingabonelela ngobungqina obongezelelweyo malunga neenzuzo zonyango ekuxilongweni , ngaphambi kokuba i-viral load iphakanyiswe okanye ii- CD4 zibalo ziphelile.
Imithombo:
McComsey, G .; Moser, C; Ribaudo, H .; okqhubekayo. "IQumrhu Eliyilungelelwano Utshintsho Emva kokuqaliswa kweRaltegravir okanye iProtease Inhibitors." INgqungquthela yeeRevrovirus kunye nezifo ezithintekayo (CROI); Seattle, Washington; NgoFebruwari 23-26, 2015; ezingabonakaliyo 140.
Virolet, C: Delhumeau-Cartier, C .; Sartori, M .; okqhubekayo. "I-Lipodystrophy phakathi kwezigulane ezinegciwane lesandulela ngculazi: isifundo esiphambanweni sempembelelo kwimpembelelo yobomi kunye neengxaki zempilo yengqondo." Uphando lwe-AIDS kunye noTyhulwa. 2015; 12-21: I-DOI 10.1186 / s12981-051-0061-z.