Maandooriyeyaasha HIV-ga ma ahan keli kaliya oo ah isbeddelada Fatta ee jirka
Lipodystrophy , marmarka qaarkood dib-u-qaybinta dufanka jidhka, ayaa muddo dheer loo arkaa saameyn dhinaca la xiriira daawooyin antiretroviral ah , gaar ahaan wakiilada jiilalka hore sida Zerit (stavudine) iyo Retrovir (AZT), oo ka tirsan fasalka darooga loo yaqaan nucleoside xanuunka transcriptase .
Sanadihii ugu danbeeyay, wakiilada kale ayaa lagu daray liiska dadka la tuhunsan yahay, oo ay ku jiraan Sustiva (efavirenz), Iskutagga (raltegravir), iyo daroogada daawooyinka HIV-da loo yaqaan " protease inhibitors" .
Iyadoo la sheegayo, sababta dhabta ah ee lipodystrophy -waxaa ku jira habka kicinta dufanka (lipohypertrophy) ama lumoatopophy -cemains -remains inta badan ma cadda. Kordhinta caddaynta ayaa soo jeedisay in HIV-gu laftiisa, iyo sidoo kale infakshanka joogtada ah ee infakshanka la xidhiidha infekshinka , ayaa laga yaabaa inay noqdaan kuwa wax ku biiriya, inkastoo ilaa dhawaa ay jiraan xog yar oo lagu xaqiijinayo tan.
Daraasad 2015-ka ah oo lagu soo bandhigay Shirka Retroviruses iyo Infekshadaha Fursadaha ee Seattle ayaa ka caawiyay iftiinka mawduuca. Sida laga soo xigtay cilmi-baarista, dadka qaba fayruuska sare ee bilowga daaweynta (in ka badan 100,000 nuqul / mL) waxay u muuqdaan in ay leeyihiin saameeyn weyn oo loogu talagalay lipodystrophy marka loo eego kuwa qaba fayraska hooseeya.
Daraasada Barashada iyo Natiijooyinka
Daraasada 96-usbuuc ah, oo ay sameeyeen cilmi-baarayaasha Jaamicadda Western Reserve University ee Ohio, ayaa qorey 328 bukaanno HIV ah oo aan horey u soo marin daaweyn. Da'da dhexdhexaadku waxay ahayd 36 sano; 90% waxay ahaayeen rag.
Mid kasta oo ka mid ah kaqeybgalayaasha ayaa loo qoray mid ka mid ah saddexda hababka kala duwan ee daroogada, oo ay ku jirto laf-dhabarka Truvada (tenofovir + emtricitabine) iyo
- Reyataz (atazanavir) + Norvir (ritonavir),
- Prezista (darunavir) + Norvir (ritonavir), ama
- Iskutarka (raltegravir).
Inta lagu gudajiro daraasaddan, bukaanka waxaa la siiyaa baaritaan joogto ah oo CAT iyo DEXA (raajo sawir-maskaxeed oo labajibbaaran) si loo cabbiro isbeddelada ka kooban halbeegga jirka.
In kasta oo la tuhunsan yahay in daawooyinka dawooyinka kala duwan ee daawada loo isticmaalo ay saameyn ku yeelan karaan natiijooyinka kala duwan ee bukaanka, saynisyahannada ayaa la yaabay inay ogaadaan in baruurta jidhku kor u kacday ay ahaayeen kuwa isku midka ah ee kooxaha oo dhan. Guud ahaan, tirada jidhka ayaa kordhay 3% ilaa 3.5%, dufanka limbku wuxuu kordhay 11% ilaa 20% iyo kordhinta dufanka caloosha 16% ilaa 29%.
Farqiga kaliya ee la ogaan karo ee ay heli karaan waxay ku jiraan culeyska fayraska ee fayraska. Kuwa ku jira culeysyo badan oo fayruus ah, baruur dareeraha (ie, gudaha gudaha caloosha) ayaa kordhiyay celcelis ahaan 35% iyadoo aan loo eegin daroogada ama daroogada. Taas bedelkeeda, bukaanka qaba fayruuska hoos yimaada 100,000 nuqul / mL waxay leeyihiin faa'iidooyin oo keliya 14% oo leh Isentress iyo in ka yar 10% oo ay la socdaan bakteeriyeyaasha.
Intaa waxaa dheer, kor u kaca Interleukin-6 (IL-6), oo ah sumadeeyaha firfircoonida difaaca, waxay la xiriirtay kororka dufanka xayawaanka ah (ie, dufanku si dhakhso ah uga hooseeya maqaarka). Tani waxay soo jeedinaysaa in infakshanka HIV-ku xiran yahay kaalin toos ah oo ku jirta faa'iidooyinka dufan-darrada subagga, oo ay ku jiraan wada-xaajoodka ama ka madax-bannaan ka-hortagga daaweynta.
Iyadoo aan loo eegin sababaha ama sababo wax ku ool ah, helitaanka dufanka viska ee 30% ee ka weyn laba sano ayaa ah mid halis ah, oo ay la socoto halista muddada dheer ee cudurrada wadnaha , sonkorowga iyo dyslipidemia .
Natiijooyinka waxaa laga yaabaa in ay bixiyaan caddayn dheeraad ah sida faa'iidooyinka daaweynta ee lagu ogaanayo cudurka , ka hor inta aan la qaadin culeyska fayruska ama kor u qaadista CD4 .
Ilaha:
McComsey, G .; Moser, C .; Ribaudo, H .; et al. "Isbeddelka Dhaqanka ee Isbedelka Kadib Marka La bilaabayo Raltegravir ama Protease Inhibitors." Shirka Retroviruses iyo Infekshinka Fursadaha (CROI); Seattle, Washington; Febraayo 23-26, 2015; abstract 140.
Virolet, C .: Delhumeau-Cartier, C .; Sartori, M .; et al. "Lipodystrophy oo ka mid ah bukaanada qaba cudurka HIV: Daraasad isweydaaris ah oo ku saabsan saameynta tayada nolosha iyo jirrooyinka maskaxda." Cilmi-baarista iyo Daaweynta AIDS-ka. 2015; 12-21: DOI 10.1186 / s12981-051-0061-z.