Ukusuleleka kwe-fungal eqhubekayo kuba yimbangela ebalulekileyo yokugula nokufa kubantu abane-HIV, ngelixa iimeko ezingenangqondo okanye izifo ezingathandekiyo ziqhelekileyo. Phakathi kwezifo ezithintekayo zentsholongwane ezihlala zixhatshazwa yi- HIV :
- I- candidiasis yomlomo kunye ne-esophageal (thrush)
- I-Cryptococcosis (kuquka i-cryptococcal meningitis)
- Histoplasmosis
- ICoccidioidomycosis (i-Valley Fever)
Kuye kwaphawulwa ezinye izifo ezifayo (kuquka i-aspergillosis, i-penicillosis, kunye ne-blastomycosis), ngokuqhelekileyo kubantu abanama-CD4 amanqaku angaphantsi kwama-250 cells / mL.
Kukho inani lee-ejenti eziqhelekileyo ezisetyenziselwa ukunyanga izifo ezibangelwa yi-HIV. Ezi zi yobisi zihlulwe ngokweenkqubo ezithile zesenzo, kwaye zichithwe zibe ngamaqela amane aqhelekileyo:
I. Iipolene ze-Antifungals
I-Polyene antitifungals isebenza ngokuphula umgca we-cell fiber membrane, ekugqibeleni iholele ekufeni kweseli. Iindawo eziqhelekileyo ze-polyene ezinokusetyenziswa kwi-HIV zi:
- I-Amphotericin B : Ngokuqhelekileyo inxulumene nophatho lwe-systemic (umzimba wonke) izifo ezifana ne-cryptococcal meningitis. Xa ilawulwa nge-intravenously, i-amphotericin B iyaziwa ngokuba neempembelelo ezibi kakhulu, ngokuqhelekileyo ngokusabela ngokukhawuleza kuvela emva nje kokunyuka (umz., Ukukhupha, ukukhupha, ukukhwabanisa, intlungu, kunye nentlungu). Ngaloo ndlela, ukulawulwa kwe-amphotericin B kubonakala ngokugqithisileyo kuboniswa zizigulane ezigulisa umzimba okanye ezigulayo. Amalungiselelo omlomo ayatholakala ukuze asebenze ekuphatheni i-candidiasis, ekhuselekile ukusetyenziswa kunye nokutywala kweziyobisi eziphantsi.
- I-Nystatin : ilawulwa ngomlomo okanye kwi-topically ukuze i-candidiasis yomlomo, i-esophageal, kunye ne-vaginal. I-Nystatin ingasetyenziselwa nje ngeprophylactic (ukuthintela) unyango olunegciwane lesandulela ngculaza elinomngcipheko omkhulu wokusuleleka kwintsholongwane (i-CD4 count of 100 cells / mL okanye ngaphantsi). I-Nystatin ifumaneka njengeipilisi, i-mouthwash, i-pastilles, i-powders, i-creams, ne-ointments.
II. Azole Antifungals
I-Azole antitifungals iphazamisa ukuhlanganiswa kwee-enzyme ezifunekayo ukugcina ingqibelelo yefomal fungal, ngokunjalo ukuvimbela amandla okukhusela. Iziphumo eziqhelekileyo ziquka ukugqithisa, intloko, isisu, isisulu, ukuhlanza, uhudo, isisu, kunye neenzyme eziphezulu zesibindi.
- I-Diflucan (i-fluconazole) : Ngokuqinisekileyo enye yezinto ezinqunyiwe kakhulu emhlabeni wonke, iDiflucan isetyenziselwa unyango lwezilwanyana ezifayo, ezibandakanya i-candidiasis, cryptococcosis, i-histoplasmosis kunye ne-coccidioidomycosis. I-Diflucan ifumaneka kwifomu yeethebhulethi, njengepowder yokumiswa komlomo, okanye njengesisombululo esingasinyanzelo sokusetyenziswa kwe-intravenous.
- I-Nzoral (ketoconazole) : I-Nizoral yimihla yokuqala ye-azole antitifungal, kodwa sele ixhaswa ngamanye ama-azol anesifo esicinci kunye nokunyuka okukhulu. Itholakala kwifomu yeethebhulethi, kunye nezicelo ezahlukahlukeneyo zokusetyenziswa kwizifo ezithintekayo, kuquka ne-candidiasis.
- I-Sporanox (itraconazole) : Ngokuqhelekileyo isetyenziselwa ukusuleleka kwintsholongwane (njenge-candidiasis okanye cryptococcosis) xa ezinye iimpawu ezifake i-antifungals zingasebenzi okanye zingalunganga. I-Sporanox ifumaneka kwifom ye-capsule okanye njengesisombululo somlomo (esicatshulwe ngokugqithiseleyo ngokubanjelwa kunye nokuhlaziywa kwemvelo). Ukulungiswa kwe-intravenous ayisekho kwi-US Ngenxa yokungena kwayo ephantsi kwi-cerebrospinal fluid, i-Sporanox isetyenziswa kuphela kumgca wesibini xa unyanga i-cryptococcal meningitis.
Ezinye i-azol ezisetyenziselwa unyango lwe-fungal infections ziyi-VFend (voriconazole) kunye nePosanol (posaconazole).
III. Antimetabolite Antifungal
Kukho enye i-antimetabolite (i-Ancobon) eyaziwa ngokuba nepropatial impahla, eyenziwa ngokuphazamisa ukusetyenziswa kwe-RNA kunye ne-DNA.
- I-Ancobon (i-flucytosine) : Isetyenziselwa ukunyanga iimeko ezinzulu ze-candidiasis kunye ne-cryptococcosis, i-Ancobon isoloko ilawulwa yi-fluconazole kunye / okanye i-amphotericin B njengoko ukuphuhliswa koxhatshazo kuqhelekileyo xa kusetyenziswa yodwa. Ukuhlanganiswa kwe-amphotericin B kunye ne-Ancobon kuboniswe ukuba kulungele unyango lwe-cryptococcal meningitis. I-Ancobon ifumaneka kwifomsule ifomu. Imiphumo emibi ingabandakanya ukunyanzeliswa kwesisu kunye nokunciphisa umongo we-bone (kubandakanya i-anemia). I-Rash, intloko, ukudideka, i-hallucination, sedation, kunye nomsebenzi wokuphakamisa isibindi kuye kwabikwa kwakhona.
IV. Echinocandins
Iklasi elitsha le-antifungals elibizwa ngokuthi i-echinocandins iphinda iqashwe kwonyango le-candidiasis kunye ne-aspergillosis. I-okinocandins isebenza ngokuthintela ukuhlanganiswa kwee-polysaccharides ezithile kwindonga yeselwane yefungal. Ngokuqhelekileyo, i-echinocandins inikezela inetyhefu esezantsi kunye neendlela ezincinci zokusebenzisana kwezidakamizwa, nangona okwangoku zihlala zisetyenziswe kwizigulane ukunganyanzeliseki kwezinye iimveliso zendabuko. Zonke ezi zintathu zilawulwa nge-intravenously, kunye nokukhuselwa okufanayo, ukusebenza kakuhle kunye nokunyamezela.
- Eraxis (anidulafungin)
- Cancidas (caspofungin)
- Mycamine (micafungin)
Imithombo:
I-Marty, F. kunye ne-Mylonakis, E. "Ukusetyenziswa kobuqu kwi-HIV." Iingcamango zengcali Pharmacotherapy. Fe bruwari, 2002; 3 (2): 91-102.
Mei, H .; Kok, L; Shariff, M .; okqhubekayo. Usetyenziso olwenziweyo lwe-Infection Infection in patients Patients: Ukuthelekiswa koBuchule noKhuseleko. " AIDS. 2011; 2 (12): WMC002674.
Iziko zeSizwe zezeMpilo (NIH). "Izikhokelo Zokuthintela Nokunyangwa Kwezonyango Ezichaphazelekayo Kwi-HIV-Abathintekayo Abathintekayo ne-Adolescents." EBethesda, eMaryn; hlaziywa ngoSeptemba 27, 2013.