Ngaba unyango lweNtsholongwane kaGawulayo okanye leNtsholongwane kaGawulayo?
Umzimba okhoyo wangoku uphando ubonise ukuba abantu abane- HIV bangama-50 ekhulwini amathuba okuba bahlaselwe intliziyo kunabantu bonke. Ucwaningo lweminyaka emithandathu oluqhutywe njengenxalenye yeSifundo se-Aging Cohort Study (VACS) sibonise ukuba iipesenti ezingama-41 ze- myocardial infractions (MIs) zenzeka kubantu abane-HIV.
Xa kuqhathaniswa namazinga kaMasipala kwiqela elidala ( jonga ngezantsi ), abaphandi banokugqiba ukuba umngcipheko we-MI "wawubaluleke kakhulu kwaye uhlala uphezulu" phakathi kwabathathi-HIV abathathi-nxaxheba kwaye ngokunyuka kwanda kwithuba, kungakhathaliseki ukusetyenziswa kakubi kweziyobisi, ukugula komzimba okanye enye ingozi yomzimba. izinto.
Inani lama-Myocardial Amapheferensi (I-MIs) Ngamawaka aneminyaka eyi-1 000
| Umda wobudala | Bezilwanyana abane-HIV | Veteran abangenayo i-HIV |
| 40-49 | 2.0 iimeko | 1.5 iimeko |
| 50-59 | 3.9 amatyala | 2.2 amacala |
| 60-69 | 5.0 amacala | 3.3 amatyala |
Amanani ahambelana nophando lwangaphambili olubonisa ukunyuka kwama-MI ngokuphindwe kabini phakathi kwabantu abane-HIV, kunye nokunyuka okongezelelweyo kabini kwizigulane ezine- HIV kunye ne-hepatitis C coinfection .
INTSHOLONGWANE YENTSHINTSHOLONGWANE YENTSHINTSHOLONGWANE KAGAWULAYO?
Nangona iimbangela zezi zinyusa azicaci ngokupheleleyo, ubungqina obuphakamileyo bubonisa ukuba i-HIV ngokwayo ingabangela uxanduva, mhlawumbi ngenxa yokuphendula okuvuthayo okubangelwa ukusuleleka kwe-HIV.
Uphando lwe-2012 kwiDatala yeSibhedlele saseFransi kwi-HIV (FHDH) yagqiba ekubeni i-HIV, kunye nesimo somzimba somzimba wesigulane, ziimeko ezizimeleyo zokunyuka kwengozi. Ukongezelela, umngcipheko wesigulane sokuhlaselwa kwentliziyo kubonakala ukwandiswa ngokubambisana ngokuthe ngqo ukuhla kwinqanaba le- CD4 kunye nokwandiswa komthwalo wentsholongwane .
I-CD4 nedir yesigulane (ixabiso eliphantsi kunazo zonke i-CD4 count liwile) likwaqwalaselwa njengegalelo eliphambili.
Oko kubonakala kukho konke oku kubonisa ukuba ukusuleleka kwexesha elide le-HIV kumbeka umntu phantsi komthwalo wokuvuvukala okuqhubekayo, oku kungayichaphazela kakhulu inkqubo ye-cardiovascular in both cellular and genetic level.
Uphando oluqhutywe kwiYunivesithi yaseCalifornia, eSan Francisco luchaza umbutho phakathi kwe-CD4 count kunye nempilo engummiselo, apho izigulane ezine-CD4 count (okanye ngaphandle kwonyango lwe-HIV ) zinobuqili obunzima obunzima nokuqhathaniswa xa kuthelekiswa nezigulane ezinamaxabiso aphezulu e-CD4, unyango lokuqala, kunye nokulawulwa kwintsholongwane eqhubekayo.
Ngaba i-HIV Izidakamizwa Zenza Iingxaki Zentliziyo?
Nangona ezinye izidakamizwa ze-antiretroviral, ngokukodwa iZiagen (abacavir), ziye zabikwa ukuba zandise ingozi yokuhlaselwa kweentliziyo, uphando lwangoku luhlelwe ngokwahlukileyo kule ndaba. Ngokubanzi, umngcipheko ubonakala ngokuphakamileyo phakathi kwabo abaneemeko zentliziyo esele zikhona okanye abo banezinto ezinobungozi ezinhlanu okanye ngaphezulu ezinokwakheka kwengqondo (njengokubhema, isifo sikashukela okanye i-cholesterol ephezulu).
Nangona uphando oluthe lwaphinda lucetyiswe ukuba i-HIV i-prohibase i-inhibitor yeklasi (i-PI) izidakamizwa ngokunyusa ukwanda komngcipheko, abaninzi banokuvuma ukuba nayiphi na ingozi inokuthi idibaniswe ne-arhente ngayinye kunokuba yonke iklasi yeziyobisi. Izifundo ezimbini zakutshanje zigqityile ukuba ezintathu eziphambili ze-PI ziyaxolisa-iReyataz (atazanavir), iViracept (nelfinavir), kunye ne-Invirase (saquinavir) -ngekho nxaxheba kunye nomngcipheko we-MI.
Kukho ukungathandabuzeki malunga nokuba ngaba ezinye ii-PI, ezifana ne-Kaletra (lopinavir) kunye ne-Crixivan (i-Invirase), igalelo ukususela ekusebenziseni i-PI ayithathwa njengeyona nto yodwa kwimigangatho ye-lipid ephezulu engabonakaliyo kwizigulane ze-HIV ezihlaselwa yintliziyo.
Nangona kunjalo, uhlobo oluphikisanayo lophando-kunye nokuxhaswa kunye nokunye ukugxothwa kwamabango-ukushiya igumbi lokulumka xa ukhetha ukudibanisa izidakamizwa ezifanelekileyo kwizigulane ezinobungozi obusifo senhliziyo. Kwakhona kugxininisa imfuno yokuhlola i-cardiovascular circulars kuzo zonke izigulane ezine-HIV, ngoncedo lokusasaza kwangaphambili ukwenzela ukunciphisa izinto ezinobungozi ezifana nokutshaya , ukutya kunye negazi.
Ukunyanga iSifo se-Cardiovascular Disease kubantu abane-HIV
Kwizigulane ze-HIV ezinezifo zonyango ze-coronary okanye iimvavanyo ezisisiseko ezibonisa izifo, ukuthunyelwa kwi-cardiologist kukhuthazwa kakhulu. Kufuneka kuthathelwe ingqalelo ukuba kuqale okanye kuguqulwe unyango ukubandakanya ama-antiretroviral agents anempembelelo encinci kumanqanaba e-serum lipid.
Ukongezelela, ukuhlolwa kufuneka kuthathelwe ingqalelo kuzo zonke izigulane ze-HIV eziza kunonyamekela ukuze zihlolisise ngokupheleleyo ingozi yomntu, kuquka uvavanyo olufana nalokhu:
- ifayile yokuzila ukutya (kuquka i-LDL cholesterol, i-cholesterol ye-HDL kunye ne-triglycerides)
- ukuhlolwa kwesifo sikashukela (phambi kokuqaliswa kwonyango, kunye nokujonga rhoqo emva koko)
- isiseko se-electrocardiogram (ECG) kwizigulane ezinezinto ezinobungozi begazi
- ukuhlolwa kwengcinezelo yegazi rhoqo
- ukungenelela ngogonyamelo kwizigulane ezinobungozi benhliziyo ukuze kuncitshiswe ukutshaya, ukukhuluphala, kunye nezinye izingozi eziguqukayo
Nangona kungekho zicwangciso zokhuseleko lwe-cardiovascular e-HIV ezikhoyo, ukucetyiswa kwendlela yokunciphisa umngcipheko wendabuko kunconywa-kungekhona kuphela kwizigulane ezinobungozi obunomdla owaziwayo kodwa njengendlela epheleleyo yokunyamekela kwexesha elide kuzo zonke izigulane ze-HIV. Ugxininiso kufuneka lwenziwe ukuqinisekisa:
- uqeqesho oluqhelekileyo, oluquka ukufaneleka kwempilo
- Ukunciphisa ukusetyenziswa kwamanzi azalisiweyo
- Ukuyeka ukutshaya kwe-HIV
- ukunciphisa ukusetyenziswa kotywala kwiinqununu ezintathu ngosuku okanye ngaphantsi
- ukunamathela ngokuthe ngqo kwi-antiretroviral therapy
Imithombo:
Freiberg, M .; Tshintsha, C. Kuller, L .; okqhubekayo. "Usulelo lwe-HIV kunye nomngcipheko we-myocardial infarction." Umbhalo we-American Medical Association (JAMA). Aprili 22, 2013; 173 (8): 614-622.
Freiberg, M .; Tshintsha, C. Skanderton, M .; okqhubekayo. "Umngcipheko wesiganeko senhliziyo yesifo phakathi kwezilwanyana kunye ne-HIV kunye ne-hepatitis C." Ukuhamba: Ubunjani beCrodiovascular Quality and Outcomes. Julayi 2011; 4 (4): 425-432.
Lang, S; UMary-Krause, M., Simon, A., et al. "Ukuphindaphinda kwe-HIV kunye ne-immune status ngabazimeleyo abazimele beengcipheko ze-myocardial infarction kubantu abane-HIV." Izifo ezithathelwanayo zonyango. Agasti 2013; 5 (4): 600-607.
Hsue, P .; Yabona, J .; Franklin, A .; okqhubekayo. "Ukwandiswa kwe-atherosclerotic kwizigulane ezineHIV: Inxaxheba yemeko yengozi yemveli kunye ne-immunological." INgqungquthela yeshumi kwi-Retroviruses kunye neZifo eziHlanganisiweyo (CROI 2003); EBoston, eMassachusetts; NgoFebruwari 10-14, 2003; ezingabonakaliyo 139.
Monforte, A .; Reiss, P .; Ryom. L; okqhubekayo. "I-Atazanavir ayihambelani nengozi yokwanda kweemoto ze-cardio- or cerebrovascular events." AIDS. NgoJanuwari 28, 2013; 27 (3): 407-415.