Cudurrada fangasta faafa waxay sii wadaan inay sabab u noqdaan cudur iyo dhimasho dadka qaba HIV, halka cudurrada aan caadiga aheyn ama aan la isku haleyn karin badanaa la sheego. Waxaa ka mid ah infekshanka fangasta fursadaha inta badan la xiriira HIV :
- Afka iyo hunguriga cadaadiska ( xanuunka )
- Cryptococcosis (oo ay ku jiraan meningitis-ka cryptococcal)
- Histoplasmosis
- Coccidioidomycosis (Xummad Dareer)
Noocyo kale oo infakshan fungal ah (oo ay ku jiraan aspergillosis, penicillosis, iyo blastomycosis) ayaa sidoo kale la xusay, inta badan dadka shakhsiyaadka leh CD4 ayaa ka hooseeya 250 unug / mL.
Waxaa jira tiro ka mid ah wakiilada sida badan loo isticmaalo in lagu daaweeyo infakshanka fangasta la xiriira. Daawooyinka waxaa lagu qoondeeyey habka gaarka ah ee ficilka, waxaana loo jajabin karaa afar kooxood oo guud:
I. Dabaysha Dabaysha
Antifungal Polyene ayaa shaqeynaya iyada oo la jebinayo sharafta miisaanka unugyada fungal, taas oo ugu dambeyntii keenta dhimashada unugyada. Antifungal badanaa loo yaqaan 'anti-polyps' oo loo isticmaalo HIV waa:
- Amphotericin B : Caadi ahaan waxaa loola jeedaa daaweynta cudurada fangaska (sida jirka oo dhan) sida meningitis-ka cryptococcal. Marka la qaato xididada amphotericin B, waxaa la yiraahdaa waxyeelo halis ah, badanaaba leh falcelin ba'an oo dhacaya waqti gaaban ka dib (tusaale, qandho, qarqaryo, cadaadis, lallabbo, matag, madax xanuun, iyo murqo / xanuun xanuun). Sidaa daraadeed, maamulka xididada amfotericin B guud ahaan waxaa lagu muujiyaa dadka bukaanka ah ee difaaca jirka ama daran. Diyaargarow afka ah ayaa loo heli karaa si loogu isticmaalo daaweynta xanuunka, taas oo amaan u ah isticmaalka sunta daroogada yar.
- Nystatin : Waxaa loo maamulaa oral ahaan ama gebi ahaanba loogu talagaley afka-maskaxda, maskaxda, iyo shubanka indhaha. Nystatin ayaa sidoo kale loo isticmaali karaa daaweynta ka hortagga (daaweynta) ee bukaanka qaba HIV-da oo halis weyn ugu jira infekshanka fangas (CD4 tirada 100 unug / mL ama ka yar). Nystatin waxaa loo heli karaa sida kiniinno, dhar gacmeed, maraqyo, budo, kiriim, iyo boomaato.
II. Azole Antifungals
Antifungal Azole wuxuu joojiyaa kobcinta enzymes loo baahan yahay si loo ilaaliyo daacadnimada xuubka fungal, taas oo joojinaysa awoodda fungus ee 'koritaanka'. Waxyeellooyinka caadiga ah waxaa ka mid ah finan yaryar, madax-xanuun, madax-wareer, lallabo, matag, shuban, calool-xanuun, iyo enzymes oo sarreysa.
- Diflucan (fluconazole) : Argagax leh mid ka mid ah antifungal ugu habboon adduunka oo dhan, Diflucan waxaa loo isticmaalaa daaweynta infekshanka fangasta iyo nidaamyada fangasta, oo ay ku jiraan kicinta, codadka, cryptococcosis, histoplasmosis, iyo coccidioidomycosis. Diflucan waxaa laga heli karaa qaabka kiniiniga, sida budada loogu talagalay ka joojinta afka, ama sida xalka nadiifka ah ee loo isticmaalo xididka.
- Nizoor (ketoconazole) : Nizoral waxay ahayd daawada ugu horreysa ee daawada antifungal, hase yeeshee waxaa badanaa lagu xayiray kuwa kale ee yar yar ee leh sunta yar iyo nuugista ka sii weyn. Waxaa laga helaa qaabka kiniinka, iyo sidoo kale codsiyada mawduucyada kala duwan ee loo isticmaalo infekshannada fangas-maskaxeed, oo ay ka mid yihiin kicinta.
- Sporanox (itraconazole) : Caadi ahaan waxaa loo isticmaalaa infekshanka nidaamka (sida ciraaq ama kiriifto), marka antifungal kale aysan waxtar lahayn ama aan habbooneyn. Sporanox waxaa laga heli karaa qaabka kabbashka ama xalal afka ah (waxaa loo tixgeliyaa si ka sarreeya marka loo eego nuugista iyo bioavailability). Diyaargarowga xididada kuma sii jiri karo Maraykanka. Sababtoo ah hoos u dhigista hooseeya ee dareeraha maskaxda, Sporanox waxaa guud ahaan loo isticmaalaa kaliya marka labaad marka la daaweynayo meningitis-ka cryptococcal.
Noocyada kale ee loo isticmaalo daaweynta cudurrada fangasta ee fursadaha waa VFend (voriconazole) iyo Posanol (posaconazole).
III. Antimetabolite Antifungal
Waxaa jira hal dawo oo antimetabolite ah (Ancobon) oo loo yaqaano qalabka antifungal, taas oo ay ku fulinayso faragalinta labada RNA iyo DNA synthesis labadaba.
- Ancobon (flucytosine) : Waxaa loo adeegsadaa daaweynta xaaladaha halista ah ee kookaskais iyo cryptococcosis, Ancobon marwalba waxaa lagu maamulaa fluconazole iyo / ama amphotericin B sida horumarinta caabbku waa caadi marka la isticmaalo kaligiis. Isku-darka amphotericin B iyo Ancobon ayaa lagu xaqiijiyay in uu ku wanaagsan yahay daawaynta qoorgooyaha Cryptococcal. Ancobon waxaa laga heli karaa foomka kaabsoolka. Dhibaatooyinka kale waxaa ku jiri kara xanuunka caloosha iyo mindhicirka laf dhabarta (oo ay ku jiraan dhiig yari). Xanuun, madax-xanuun, jahawareer, hallucination, suuxdin, iyo hawlaha beerka oo sareeya ayaa sidoo kale la soo sheegay.
IV. Echinocandins
Fasal cusub oo antifungal ah oo loo yaqaan 'echinocandins' ayaa sidoo kale loo shaqeeyaa daaweynta cirridisis iyo aspergillosis. Echinocandins waxay ka shaqeyneysaa kiniiniyada dabiiciga ah ee polysaccharides ee derbiga fungal. Guud ahaan, echinocandins waxay bixisaa sunta hoose iyo isdhexgalka daroogada oo yar, inkastoo ay inta badan daaweeyaan bukaanka oo aan loo dulqaadan karin dawooyinka kale ee antifungal. Dhammaan saddexda waxaa lagu maamulaa xididada, oo leh amaan, isku-filnaan, iyo dulqaad.
- Eraxis (anidulafungin)
- Cancidas (caspofungin)
- Mycamine (micafungin)
Ilaha:
Marty, F. iyo Mylonakis, E. "Isticmaalka antifungal ee caabuqa HIV." Farshaxanka Farshaxanka Farshaxanka. Febraayo, 2002; 3 (2): 91-102.
Mei, H .; Kok, L .; Shariff, M .; et al. "Isticmaalka Antifungal ee Hurgumada Faa'iidada ee Bukaanka HIV: Isbarbardhiga Hufnaanta iyo Badbaadada." Xarunta Cilmi-baarista AIDS-ka. 2011; 2 (12): WMC002674.
Machadyada Qaranka ee Caafimaadka (NIH). "Tilmaamaha Ka-hortagga iyo Daaweynta Cudurrada Fursadaha ee Dadka Qaangaarka ah ee HIV-ga qaba iyo Dhalinyarada." Bethesda, Maryland; updated September 27, 2013.