Iinguqu zeHormonal ziyakwazi ukubeka abafazi kwiNgcipheko ephezulu ye-HIV
Umngcipheko we- HIV uphezulu kakhulu ukusuka kumadoda ukuya kwabasetyhini kunokuba besuka kubafazi ukuya kumadoda ngenxa enkulu kwinxalenye yobunzima besisu, isibeleko kunye (mhlawumbi) nesisu. Akukhona nje kuphela ukuba kukho indawo enkulu yesikhumba kwindawo yokuzala inzala (FRT) xa kuthelekiswa ne-penis, utshintsho kwi-biology luyakwazi ukwenza ama-tissu e-mucosal anxulumene ne-FRT nangakumbi ekukhuselekeni.
Nangona iimbumba ze-mucosal zezilwanyana zincinci ngaphezu kobuhlanga, kunye neendwangu ezilishumi ze-tisti ze-epithelial ezinika umqobo okhuselekileyo ekusulelekeni, iNTSholongwane kaGawulayo isakwazi ukufikelela kumzimba ngamaseli enempilo. Ukongezelela, umlomo wesibeleko, onobumba obunomzimba obuncinci ngaphezu kwesondo, uhlanganiswe neCD4 + T-cell , amangqamuzana omzimba omzimba anesifo se-HIV ngokukhethekileyo.
Izinto ezininzi zinokuphucula ubungozi besifazane kwi-HIV, kubandakanywa ne- bacterial vaginosis (enokutshintsha izityalo zangasese) kunye ne- ectopy yesibeleko (eyaziwa ngokuba yi-"cervix" engumntwana).
Kodwa ubungqina obandayo buye bakhombisa ukuba utshintsho lwe-hormone, oluvela ngokwemvelo okanye olwenziwe, ludlala indima ephambili ekwandiseni amathuba okufumana i-HIV.
Isisu kunye neHIV
Ucwaningo luka-2015 kubaphandi kwi-University of Geisel School of Medicine lucetyiswe ukuba utshintsho lwama-hormone ngexesha lomjikelezo oluqhelekileyo lokuya esikhathini lunikeza i-HIV kunye nezinye izifo ezithathelwana ngocansi (STIs) "iifestile ithuba" lokusulela.
Umsebenzi wokuzivikela omzimba, kokubili ungeyena (inendalo) kunye nokuguquguqukayo (okufunyenwe emva kokusuleleka kwintsholongwane yangaphambili), iyaziwa ukuba ilawulwa yi-hormone. Ngexesha lokuya esikhathini, iihomoni ezimbini zenzelwe ukwandisa iimeko zokuchumisa kunye nokukhulelwa-estradiol kunye neprogesterone- ifuthe ngqo kwiiseli ze-epithelial, i-fibroblasts (iiseli ezitholakala kwizicubu ezinxulumene), kunye namaseli omzimba afana ne-FRT.
Ngokwenza njalo, iimpendulo zomzimba ziyancipha, kwaye ingozi yokufumana i-HIV yanda kakhulu.
Ukuba kuqinisekisiweyo, isifundo sinokukunceda indlela yokuphucula imiphumo engakwazi ukuphucula ngcono imisebenzi yokulwa neentsholongwane kunye / okanye impembelelo yezocansi (oko kukuthi, ukuchonga amaxesha aphephile ukuba ulalane) ngeli xesha kuthiwa "window window".
Ukuxhoma kwexesha kunye neengozi zeHIV
Ngakolunye uhlangothi, olunye uphando luka-2015 oluvela kwiYunivesithi yaseYunivesithi yasePittsburgh lucetyise ukuba utshintsho kwi-FRT lunokufaka isandla engozini yokunyuka kwe-HIV kwintombi yabasetyhini.
Kuyaziwa ukuba umsebenzi we-immune we-inferior tract uhlawule ngokukhawuleza ngexesha kunye nangemva kokuphuma komyeni, kunye nokunciphisa amathambo e-epithelial kunye nokuncipha okuphawulekayo kumqobo we-mucosal. (I-mucosa, eyaziwayo ukuba iqulethe iindidi ze-antimicrobials, ixhaswa yimfihlo evela kwi-FTR ephezulu enika ukukhuselwa komgca kwinqanaba lomzimba ophantsi.)
Abaphandi bafumana abafazi abangama-165 abangabonakaliyo-kuquka nabasetyhini abasetyhini; Abasetyhini abasengaphambili bendoda hhayi kwi-contraceptive; kunye nabasetyhini kwi-contraceptive-kunye nokulinganiswa kwe-HIV ngokuqhathanisa ukusetyenziswa kwamanzi kunye nokunkcenkceshela. Ukusebenzisa iilingo zokuhlola uvavanyo lwe-HIV, bafumanisa ukuba abafazi besithuba se-menopausal babenomsebenzi omninzi we-HIV "wezemveli" (11% vs 34%) kunamanye amaqela amabini.
Ngelixa izigqibo ziphelelwe nguyilo loyilo kunye nobukhulu, lucacisa ukuba utshintsho lwama-hormone ngexesha nangemva kokumisa umva lungabafaka abantu besetyha badala ekwandiseni ingozi ye-HIV. Ngaloo ndlela, kugxininiswa ngakumbi kugxininiswe kwimfundo yesondo ngokukhuselekileyo kwabasetyhini abadala, kunye nokuqinisekisa ukuba i- HIV kunye nezinye izilingo ze-STI azikhunjulwa okanye zilibale.
Ulwaphulo lweHormonal kunye neengozi zeHIV
Ubungqina bokuba i-contraceptive ye-hormonal inokunyusa umngcipheko wesifazane we-HIV ayihambisani, mhlawumbi ngendlela yomlomo okanye izilwanyana zokulawula ukuzalwa. Ucwaningo lwe-meta olunzulu lwezifundo ezili-12-ezisibhozo ezenziwe ngokubanzi kunye nabane phakathi kwabasetyhini abasengozini -babonisa ukwanda okwemodareyithwa kwintsholongwane kaGawulayo kubasetyhini abasebenzisa i-acetate (i-DPMA, aka Depo -Provera ).
Kubasetyhini kuluntu jikelele, umngcipheko wawubonakala uncinci.
Uhlalutyo, olubandakanya abathathi-nxaxheba abangaphezu kwama-25,000, ababonanga nhlobo ubudlelwane obubonakalayo phakathi kokukhulelwa komlomo kunye nomngcipheko we-HIV.
Nangona idatha ingathatyathwa ukuba ayinayo ukubonisa ukupheliswa kokusetyenziswa kwe-DPMA, abaphandi bacebisa ukuba abesetyhini basebenzisa ii - injection kuphela ze-progestin malunga nokungaqiniseki malunga ne-DPMA kunye ne-HIV, kwaye ukuba bakhuthazwe ukusebenzisa iikhondom kwaye bahlole ezinye iindlela zokukhusela ezifana Intsholongwane ye-HIV ngaphambi kokuba i-prophylaxis (PrEP ).
Imithombo:
> Chappell, C; Isaacs, C; Xu, W; okqhubekayo. "Impembelelo Yokunquma Kwesisu Ngomsebenzi Wongama-Antitiviral Work of Cervicovaginal Lavage." I-American Journal ye-Obstetrics ne-Gynecology. Matshi 20, 2015; INDLELA: http://dx.doi.org/10.1016/j.ajog.2015.03.045.
Ralph, L .; McCoy, S; Shiu, K .; okqhubekayo. Usetyenziso lweNkqubo yokuLawula iHormon kunye neengozi zabasetyhini ekufumaneni i-HIV: I-Meta-Analysis of Studies Observational Studies. " Izifo ezithathelwanayo zeLancet. NgoJanuwari 8, 2015; 15 (2): 181-189.
Wira, C; Rodriguez-Garcia, M .; kunye nePatel, M. "Indima yeHormones yoLwesini kwiKhuselo lokuVimbela kweNqanaba yokuLawula abesifazana." Uhlolo lweNdalo Immunology . Matshi 6, 2015; 15: 217-230.