Iingcebiso eziguga ezempilo kubantu abaphila ne-HIV
Njengoko ukuvavanywa kwangaphambili kunye nonyango lwe-HIV kuye kwandisa izinga lokulindela ubomi kubantu bonke, ukugxininiswa ngakumbi ngoku kubeka kwimpilo enhle yabantu abaneminyaka engama-50 nangaphezulu, abahlala befumana ubuthathaka bokuqala kunye nokugula ngenxa yexesha elide - ntsholongwane.
Ngokweenkcukacha ezivela kumaziko e-US for Control and Prevention (CDC), ama-25 engama-1.2 yezigidi zabantu baseMerika abaphila ne-HIV-okanye malunga nabantu abangama-313,000-bawela kule ntsho longwane ye-HIV.
Iingqinisiso zibonisa ukuba, phakathi neminyaka embalwa, eso sibalo singakhulela kuma-50 ekhulwini.
Ukugula kwangaphambili
Ukutshabalala okungapheliyo okuchaphazelekayo ne-HIV kuye kwabandakanywa kwizinga eliphezulu ezizifo ezinxulumene ne-HIV-ezifana nesifo se-cardiovascular , i- cancer , i- neuro-cognitive disorders , kunye nohlobo lwe-2 lwesifo sikashukela- esivame ukubonakala kwiminyaka elishumi ukuya kwe-15 ngaphambili ngaphambili kulindeleke kwiindawo eziqhelekileyo, ezingenasifo. Kwaye kubantu ngabanye abaphumelele unyango lwe-HIV, abanako ukugcina imithwalo engabonakaliyo yentsholongwane ngeminyaka ngelo xesha, kusekho umngcipheko ophezulu kule miphumo ehambelana nokuguga.
Nangona iimeko zolu meko-ezaziwa ngokuba yi- senescence ngaphambi kwesikhathi- engaqondanga ngokupheleleyo, iyakwamkelwa ngokubanzi ukuba ukuvutha okungapheliyo kunokunciphisa umzimba womntu ngendlela engafani naleyo kubantu abadala, apho umzimba " lixesha."
Kwaye kubonakala kukuchaphazela abaninzi, ukuba akusiyo yonke i-system systems kwinqanaba elithile. Nangona i- T-cell yomntu, ephakathi kwendlela yokuphendula omzimba, ibe yinto encinane engaphantsi yokukwazi ukuchonga kunye nokunciphisa amanxusa angaphandle xa phantsi komthwalo wale mpendulo ephikisayo. Ukunyanzela izinto ngakumbi, i-HIV kunye nenani le-antiretroviral izidakamizwa ziye zaxhunywa ngokunyuka kwi-visceral (intra-esiswini) inqatha kubantu abanentsholongwane kaGawulayo, okongeza kuphela umthwalo ngokufihla iiprotheni ezingaphangeliyo ngqo kwigazi.
Ngoko ke umntu unokuyenza ntoni ukuze aphile impilo enemtsholongwane kaGawulayo kwaye ugweme izifo kunye neemeko ezinxulumene nosulelo lwexesha elide?
U vavanyo namhlanje
Ingabonakala ebonakalayo, kodwa ama-20 ekhulwini ama-Amerika aphila ne-HIV abazange bavavanyelwe intsholongwane kwaye, ngokutsho kwe-World Health Organisation (WHO), ubuninzi bama-50 ahlukeneyo kwi-HIV yabemi behlabathi abanokungafunyanwa .
Ukhokelo lwangoku oluvela kwi-US Preventive Services Task Force ifowuni yovavanyo lwexesha elilodwa lwabantu baseMelika abaneminyaka eli-15 ukuya ku-65 njengenxalenye yokutyelela ngokugqithisa ugqirha. Amanye amaqela omngcipheko ophezulu, kuquka amadoda asebenza ngokwesondo abalala ngokwesini (MSM), bakhuthazwa ukuba bavavanywe rhoqo ngonyaka. Ngaphandle kokuvavanya, akukho ndlela yokuphumeza into enye kunokuba unokuqinisekisa ngokugqithiseleyo impilo yesikhathi eside kubantu abaphila ne-HIV, kwaye ke ...
Qala unyango lweNtsholongwane namhlanje
NgoJulayi 2015, uphando olwenziwe kwiNgqungquthela ye-8 ye-AIDS kwi-Vancouver yabiza ukuqaliswa kwe-antiretroviral (ART) ngokukhawuleza kubantu bonke abane-HIV, kungakhathaliseki ukuba isifo sesigaba okanye i- CD4 count . Uphononongo, owaziwa njengeSicwangciso soPhuhliso lweNtsholongwane ka-Antiretroviral (START), uqinisekisile ukuba ukucacisa i-ART ekuxilongweni kwanciphisa amathuba okugula kunye nokufa ngama-53 ekhulwini, ngelixa ubeka ingozi kwimimandla engahambelana ne-HIV, njengezifo zesifo se-HIV (i-CVD ) kunye namanye amachiza, malunga neyesibini-ntathu.
Ngokwahlukileyo, abo bantu abangaqhelekanga bakwazi ukugcina imithwalo engabonakaliyo yentsholongwane ngaphandle kwe-ART-abantu ababizwa ngokuba "ngabalawuli abakhulu" -baphindwe kabili ukuba bangene esibhedlele, kathathu kangangoko bangeniswa esibhedlele kwi-CVD, kwaye kananjalo banokuvunywa iimeko zeengqondo xa kuthelekiswa nabalawuli abangabalingani kwi-ART ecuthayo. Ukuba kukho "umele" ukuba aphile ixesha elide kwaye enesifo ne-HIV, oku kunjalo. Yona yindawo enye kuphela ukuqala.
Yeka Ukubhema
Oku akusona nje esinye isaziso senkonzo kawonkewonke. Inyaniso ephazamisayo namhlanje kukuba abantu abaphila ne-HIV banokuphindwa kabili ukuba bangabhemi njengabantu abangenasifo (iipesenti ezingama-42 nxamnye neepesenti ezingama-21 ngokulandelanayo), okubangelwa phantse kabini umngcipheko wesifo senhliziyo esichukumisayo, kabini amathuba okufa ngenxa yezifo zokuphefumula , kunye nokunyuka kwe-14 kwenyango yomngcipheko wamaphaphu.
Enyanisweni, uphando oluninzi luye lwagqiba ekubeni ukutshaya kuseyona nto ebalulekileyo yengozi ekuphuhliseni ukuxhatshazwa nokufa kubantu abaphila ne-HIV, ekunciphiseni ixesha lokuphila elidlulileyo kwiminyaka engama-12.3 xa kuthelekiswa nabangenayo i-HIV abanesifo.
Nangona iiprogram zokuyeka ukutshaya azihlali zilula-zidinga ukulingana kwemizamo yesibhozo ngaphambi kokuyeka ukuphumelela-ukufikeleleka kwonyango kuye kwaba lula phantsi koMthetho woNonophelo ongenakunqwenelekayo , kunye nemigudu emibili yonyaka yokuyeka ukuvavanywa ngamayeza kunye neenkqubo ezahlukeneyo zonyango ezinikezwa ngeMedicaid. onke ama-50 athi.
Fumana i-Shots yakho
Kuyamangalisa inani labantu abane-HIV abaye baphephe, bangayihoyi, okanye baqaphele nje ngeentlobo zamashitshi okanye izitofu zomlomo abangayimfuneko . Ezi ziquka uchungechunge olunjalo lokugonywa njenge-hepatitis B, i- papillomavirus yabantu (i-HPV) , i-pneumococcal pneumonia, kunye (ewe) i- quadrivalent fri shot shot .
I-ounce yothintelo ithatha intsingiselo entsha xa umzekelo, umngcipheko wesifo somhlaza wesi sifo (unxulumene kakhulu ne-HPVsuleleko) uyaziwa ngamaxesha angaphezu kwama-25 kubantu abanentsholongwane kaGawulayo, ngelixa umhlaza wesibeleko ukhula ngokuphindaphindiweyo kwesihlanu. I-vaccine ye-HPV yokuthatha isitofu esilula, i-dose yonke iyakuyithatha ukunqanda umngcipheko wale khansa ngokumalunga nama-56 ekhulwini.
Ngaphambi kokuba uqalise naluphi na uchungechunge lokugonywa, qiniseka ukudibana nogqirha wakho ukuze uxoxe ngokukhetha kunye nomngcipheko. Nangona abaninzi banokunciphisa kakhulu umngcipheko we-HIV ochaphazelekayo, abanye bangakwenzakalisa ngokwenene , ngokukodwa ukuba isistim somzimba sakho siphephe kakhulu.
Xoxa ngeeNkcazo kunye noDokotela wakho
Ngokutsho kwesifundo esivela kwiYunivesithi yeYunivesithi yaseYohn Hopkins, ukusetyenziswa kwezidakamizwa zokunciphisa i-cholesterol, kunye ne-ART, kunokunciphisa umngcipheko wokufa kubantu abane-HIV ngama-67 ekhulwini. Abaphandi babika ukuba, ngaphezu kokunciphisa amazinga e-cholesterol eyingozi, i-statins nayo ibonakala iyanciphisa kakhulu ukuvutha okungapheliyo.
Nangona oku akuthethi ukuba izidakamizwa ze-statin ziboniswa kubo bonke abantu abaphila ne-HIV, ibonisa iingcebiso ngokujonga rhoqo kweepidid kunye nezinye izibonakaliso zezifo zengqondo-ikakhulukazi kwizigulane ezithe zadala okanye kwiimeko ezinobungozi (umzekelo, intsapho imbali, ukutshaya, njl.).
Cinga nge-Vitamin D & Calcium Supplementation
Ubunzima bezithambo zesibane samathambo (BMD) ngokuqhelekileyo kuphawulwa kubantu abane-HIV, okubangelwa amazinga aphakamileyo amathambo kunye namaqabunga e-hip, kunye nokuphuhliswa kwexesha lokuqala ngaphambi kokunyuka kwe- osteoporosis . Ukulahlekelwa kwe-BMD phakathi kweepesenti ezimbini kunye neyesithandathu kwipesenti kubonakala ngokubonakalayo kwiminyaka emibili yokuqala yokuqala i-ART, isantya esifana neyabasetyhini kwiminyaka emibini yokuqala yokuphuma kwesisu.
Ngenxa yolu nanye manani, ngoku kunconywa ukuba bonke abesifazana abasemagunyeni abane-HIV banikezelwe i- DEXA (ukusasazwa kwe-radial-ray-ray-ray-absorptometry) ukuhlola ukulahlekelwa kwethambo okunokwenzeka, kunye nawo onke amadoda aphethwe yi-HIV. uneminyaka engama-50.
Ngokolondolozo, uphando oluthile lucebise ukuba ukulawulwa ngokubambisana kwe-vitamin B kunye ne-calcium yongezelelo kunokuncedisa ukunciphisa umngcipheko wesifo seethambo. Nangona uphando luhlala lude kakhulu, izikhokelo zamanje zase-US zincoma phakathi kuka-800 ukuya ku-1000 mg we-vitamin D yomlomo ngosuku kunye no-1000 ukuya ku-2000 mg we-calcium yomlomo ngosuku. Izigulane ezine-osteoporosis zingenelwa kwiiyeza zokuqala ezifana ne-alendronate (i-Fosomax) kunye ne-zoledronic acid (i-Zometa) enokukunceda ukukhusela i-osteoporotic fragility fractures.
Ukutya kunye nokuzivocavoca
Mhlawumbi ngaphezu kokutshaya, amagama athi "ukutya" kunye "nokuzilolonga" athambekele ekuvuseleleni izigulana (kunye nokugqithiswa kwamehlo) kwizigulane, njengokungathi bezinye iindawo zokuhlala ekhaya ngaphandle kweengcebiso zonyango. .
Kodwa qwalasela oku-abantu abaphila neNTSHOLONGWANE KAGAWULAYO baxhomekeke ekunyuseni okunyameko-kwindleko zomzimba ezibangelwa kungekhona kuphela kwi-HIV ngokwayo kodwa kwiziyobisi ezisetyenziselwa ukunyanga kwesi sifo. Kwaye kwanabo abakwi-ART ngokunyanisekileyo, akuqhelekanga ukubona ama-40 ekhulwini athola amafutha amanqina kunye neepesenti ezingama-35 zifumana amanxeba esiswini, kunye nokwanda kwenyango kwi-CVD kunye nohlobo lwe-2 lwengozi yesifo sikashukela.
Ukongezelela kumalungiselelo eziyobisi ze-statin, ulawulo lwemihla ngemihla lwe-HIV kufuneka lubandakanye ukutya okuncinciweyo, okunciphise ukutya kunye nokuhlanganiswa okunolwazi lwe-aerobic nokunyanzelisa uqeqesho , kungakhathaliseki ubudala, i-CD4 count, okanye isigaba sesifo. Ngaphambi kokuba uqalise i-ART, zombini iipilisi kunye namazinga e-glucose egazi kufuneka zihlolwe ngokubeka esweni rhoqo emva koko ukulandelela ukuphuhliswa kweCVD kunye / okanye isifo sikashukela.
Eyona nto: musa ukuthembela kwiipilisi okanye ukutya kwedwa ukujongana nemiba yesisindo okanye uthathe indlela yokulungisa i-aerobics kuphela yokulungisa ukulahleka kwesisu. Sebenzisana nogqirha wakho kwaye ucele ukuba uhanjiswe kubafundi bezondlo kunye neengcali zempilo kwindawo yakho, ngokukodwa ukuba ukhuluphele, unempilweni embi, unenkxalabo ye-cardiovascular or diabetes, okanye ufuna nje isikhokelo.
Fumana rhoqo iimvavanyo zePap kunye neMammograms
Ingqwalasela ekhethekileyo kufuneka yenziwe kubasetyhini abaphila ne-HIV, kungekuphela nje ukuqinisekisa ukukhusela umhlaza wesibeleko kunye nezinye izinto ezinxulumene nazo, kodwa ukujongana nemiba ephathelene nokukhulelwa , i- HIV serodiscordancy (oko kukuthi, apho iqabane elinye linesifo se-HIV kunye nelinye i-HIV -negative), kunye nokuthintela ukuhanjiswa kwe-HIV kumama ukuya komntwana .
Abasetyhini bafanele bathethe ngentshiseko naziphi na iiplani okanye iinjongo abanokuba nazo malunga nokukhulelwa ekuqalisweni kwenkathalo, ngelixa beqinisekisa ukuhlolwa kwenyameko rhoqo njengokuba kubonisiwe (ngonyaka ngonyaka kwabesetyhini abangaphezu kwama-50 kunye kunye ngabanye abafazi phakathi kweminyaka engama-40 no-49). Abasetyhini abane-HIV kufuneka banikezwe i-Pap smear yomlomo wesibeleko, kwakhona xa kuqalwa ukunyamekelwa, kunye nokuhlolwa okuphinda kwenziwa emva kweenyanga ezintandathu emva koko.
Ungalokothi uthathe i-HIV kwi-Isolation
Enye yeengcamango ezingalunganga malunga nokulawulwa kwe-HIV kukuba libophelelwe ngenani elinqunyiwe leemvavanyo zebhu (i-CD4 count, umthamo wentsholongwane) kunye neenkcukacha zovavanyo oluqhelekileyo (STDs, hepatitis) kwaye zidibaniswe nokutyelelwa rhoqo kwi-HIV ingcali yakho. Kwaye yinto enhle kakhulu.
Xa kugxininiswa ngakumbi kwixesha elide, abaninzi baye baqala ukubiza ukulungelelaniswa kwe-HIV, ukuyiphatha njengenkalo yokunyamekela okuphambili kunokuba ibe yodwa ekhethekileyo. Oku kuthetha ukutshintsha indlela esibheke ngayo kwi-HIV namhlanje, zombini izigulane kunye noogqirha. Kuthetha ukuqonda ukuba i-HIV ayikwazi ukuphathwa ngokwahlukileyo, kodwa kunokuba ibe yinxalenye edibeneyo yokunakekelwa kwezempilo kwexesha elide.
Ngaloo nto, kubalulekile ukuba uhlale ucebisa ugqirha wakho we-HIV malunga naluphi na unonophelo lwengcali onokuyifumana, kubandakanywa nayiphi na indawo yokubhedlele okanye ukutyelela. Futhi ungacingi ukuba into "ayihambelani" ne-HIV, ingakumbi ukususela ekubeni eso sifo singabonakalisa naluphi na inani leengxaki ezinxulumene nazo, kwiingxaki zamehlo ukuya kwisifo somlomo / isifo sezinyo kwiingxaki ze-neurologic.
Ukuba ugqirha wakho osisiseko uhlukile koogqirha wakho we-HIV, qiniseka ukuba bahlala bebelane neziphumo, kubandakanywa iimvavanyo zebhabhi kunye nezinye iingxelo ezibalulekileyo ekunyamekelweni kwexesha elide.
> Imithombo:
> Amasebe okuLawula nokuVimbela (iCCDC). "INTSHOLONGWANE KAGAWULAYO Phakathi Kwabantu Abagugile 50 Nabantu abadala." Atlanta, Georgia; Agasti 3, 2015.
> ISIGABA SOKUQALA IQela lokuFunda. "Ukuqaliswa kweNtsholongwane kaGawulayo kwi-Antiretroviral Infection." I-New England Journal of Medicine. Julayi 20, 2015; INGXELO: 10.1056 / NEJMoa1506816.
> Mdodo, R .; Frazier, E .; Mattson, C; okqhubekayo. "Ukubhema i-cigarette phakathi kwabangama-HIV + abadala ekunakekeleni: Iprojekthi yokuLawulwa kwezeMpilo, i-US, ngo-2009." INgqungquthela ye-20 kwi-Retroviruses kunye neZifo eziHlangeneyo (i-CROI 2013). Atlanta, Georgia; Ngo-Matshi 3-6, 2013: Isiqendu 775.
> Isebe lezeMpilo laseMelika kunye neeNkonzo zoLuntu (DHHS). "Kunconywe ukugonywa kwe-HIV kubantu abadala." EWashington, DC; Agasti 3, 2015.
> Cannon, J. "Ukugcina Ufanelekile ngeHIV - Izikhokelo ze-ACSM Yenza umonakalo owenzela iziguli." Idaytician yanamhlanje. Oktobha 2011; 13 (10): 86.