HIV / AIDS ma HIV-ga ma daweeyaa?
Cilmi-baarista hadda ee cilmi-baarista ayaa muujisay in dadka qaba HIV ay 50 boqolkiiba ay u badan tahay in ay ku dhacaan wadna-daal ka badan dadka guud. Daraasad lix-sano ah oo lagu sameeyay qayb ka mid ah Daraasadda Daraasada Waayeelka (VACS) ayaa muujisay in boqolkiiba 41 ee kufsiga miyir-qaadiga (MI) uu ka dhacay dadka qaba HIV.
Marka la barbardhigo heerka qiimaha miisaanka ee kooxda da 'yarta ( eeg hoos ), baarayaashu waxay soo gabagabeeyeen in khatarta MI ay "si aad iyo aad u sarreeya" uga dhex muuqatay ka-qayb-galayaasha HIV-ga iyo si joogta ah u kordhey waqtigooda, iyada oo aan loo eegin isticmaalka mukhaadaraadka, cudurrada kale, ama khatarta kale ee wadnaha arrimaha.
Tirada Cudurka Miyokardiyadu (MY) Sanadkiiba 1,000 qof
| Da'da Range | Hawl-galayaasha HIV-ga | Hawl-gooyooyinka HIV-ga |
| 40-49 | 2.0 kiisaska | 1.5 kiis |
| 50-59 | 3.9 kiis | 2.2 kiisaska |
| 60-69 | 5.0 kiisaska | 3.3 kiis |
Tirada ayaa waxay la socotaa cilmi-baaris hore oo muujisay qiyaastii laba laab laabashada dadka qaba HIV, iyo sidoo kale kordhinta laba laab oo dheeraad ah ee bukaanka qaba HIV iyo cagaarshowga C.
Sidee HIV-gu ugu Dhacayaa Khatarta Weerarka Wadnaha?
In kastoo sababaha korodhkaasi aysan aheyn mid gebi ahaanba cad, caddaynta cadayntu waxay muujinaysaa in HIV lafteeda ay masuul ka tahay, taasoo ay ugu wacan tahay jawaab-celinta ka dhalatay caabuqa HIV-ga ee joogtada ah.
Daraasada 2012-ka ee Isbitaalka Faransiiska ee ku saabsan HIV (FHDH) ayaa soo gabagabeeyey in HIV-ga, iyo sidoo kale xaaladda bukaanka ee bukaanka, ay yihiin arrimo madaxbannaan oo khatar dheeraad ah leh. Waxaa intaa sii dheer, halista bukaanka ee wadno-qabadka wadnaha ayaa loo arkaa inuu kordhayo xiriirka tooska ah ee hoos u dhaca tirada CD4 iyo kordhinta fayraska .
Bukaanka bukaanka CD4 (heerka ugu hooseeya ee tirinta CD4 ayaa hoos u dhacay) ayaa sidoo kale loo tixgeliyaa furaha muhiimka ah.
Waxyaabahan oo dhan waxay u muuqdaan in ay tilmaamayaan in cudurka infekshinka HIV-ga uu qofka ku dhejiyo culeyska joogtada ah, taas oo saameyn ku yeelan karta nidaamka wadnaha iyo xididada labadaba.
Cilmi-baaris lagu sameeyey Jaamacadda California, San Francisco waxay ku qeexday isku-dhafnaanta tirada CD4 iyo caafimaadka arterial, taas oo bukaannada qaba tiro yar oo CD4 ah (ama aan daweyn HIV ) waxay la kulmeen adkeyn weyn oo adag iyo adkayn marka la barbardhigo bukaanada leh CD4 adag, daaweynta hore, iyo xakamaynta fayruuska oo joogto ah.
Miyir-qabka HIV-ga ma Dhibaato Wadnaha?
Iyadoo daawooyinka qaarkood ee daawada antiretroviral, gaar ahaan Ziagen (abacavir), ayaa lagu soo warramey in ay kordhinayaan halista wadno-galinta wadnaha, cilmi-baarista hadda waxay u qaybsan tahay mawduuca. Guud ahaan, khatarta ayaa guud ahaan loo arkaa inay ka sarayso kuwa qaba xaalad wadna xanuunka ka hor ama kuwa leh shan ama wax ka badan oo ku xiran xaaladaha halista wadnaha (sida sigaarka, sonkorowga ama kolestaroolka sare).
Inkastoo cilmi-baarista qaarkood ay sidoo kale soo jeedisay in daawooyinka hormoonada HIV-da ee fasalka (PI) guud ahaan ay kordhiyaan khatarta MI, haddana dad badani waxay isku raaceen in halis kasta oo suuragal ah ay la xiriirto wakiil shaqsi halkii laga qaadan lahaa dhammaan daroogooyinka. Labo daraasadood oo dhowaan ayaa lagu soo gabagabeeyay in seddex ka mid ah dadka looga shakisan yahay PI-Reyataz (atazanavir), Viracept (nelfinavir), iyo Invirase (saquinavir).
Waxaa sidoo kale shaki ku jira in haddii kale PI, sida Kaletra (lopinavir) iyo Crixivan (Invirase), ay gacan ka geystaan isticmaalka PI-ga aan loo tixgelin in ay tahay arin kelida ah oo ah heerarka caadiga ah ee heerarka sareeya ee lagu arkay bukaannada qaba HIV-da ee wadnaha ku dhaca.
Si kastaba ha ahaatee, dabeecadda iska hor imanaysa ee cilmi-baarista -waxay qaar ka mid ah taageerayaan iyo kuwa kale ee diidaya sheegashooyinka - qolka ka baxaan si taxaddar leh marka la dooranayo daroogooyinka ku habboon ee daroogada loogu talagalay bukaanka qaba khatarta wadnaha ee loo yaqaan 'cardiovascular'. Waxa kale oo ay muujineysaa baahida loo qabo baaritaanka joogtada ah ee cudurrada wadnaha ee dhammaan bukaannada qaba HIV, iyada oo horey wax looga qabanayo si loo yareeyo arrimahan halista ah ee la bedeli karo sida sigaarcabka , cuntada, iyo hypertension.
Daweynta Cudurka Wadnaha ee Dadka qaba HIV
Bukaannada HIV qaba cudur halis ah ama baaritaano asaasi ah oo soo jeedinaya cudurka, u gudbinta dhakhaatiirta wadnaha ayaa lagu talinayaa. Tixgelinta waa in la sameeyaa si loo bilaabo ama loo baddalo daweynta si loogu daro wakiilada antiretroviral oo saameyn yar ku leh heerarka dhiigga 'serum lipid'.
Intaa ka sokow, baaritaanka waa in loo tixgeliyaa dhammaan dadka bukaanka qaba HIV ee soo galaya daryeelka si ay si buuxda u qiimeeyaan khatarta wadnaha ee shakhsiyadeed, oo ay ka mid yihiin:
- nadiifinta lipid profile (oo ay ku jiraan kolestaroolka LDL, kolestaroolka HDL, iyo triglycerides)
- baaritaanka sonkorowga (ka hor inta aan la bilaabin daaweynta, iyadoo lala socdo kormeerka joogtada ah)
- (ECG) ee loogu talagalay bukaanada qaba xaaladaha khatarta wadnaha ee loo yaqaan 'cardiovascular'
- kormeerka cadaadiska dhiiga ee joogtada ah
- faragelinta gardarrada ah ee bukaanka qaba halista wadnaha oo ah si loo yareeyo sigaar-cabista, cayilka, iyo khatarta kale ee la beddeli karo
Inkastoo aysan jirin istaraatijiyado kahortagga HIV-ga gaar ah, istaraatajiyadaha hoos-u-dhaca khatarta ah ayaa lagula talinayaa-ma aha oo kaliya bukaanka qaba halista wadnaha iyo xididada laakiin waa hab xeeladeysan oo ku saabsan daryeelka caafimaadka mudada dheer ee dhammaan bukaanada HIV. Muhiimad waa in la sameeyaa si loo xaqiijiyo:
- jimicsi joogto ah, oo ay ku jiraan jirdhiska jirka
- Isticmaalka hoos u dhaca dufanka buuxa
- Joojinta sigaar-cabista HIV-ga
- yaraynta isticmaalka khamriga illaa seddex qaybood maalintii ama ka yar
- xakameyn ku habboon daaweynta antiretroviral
Ilaha:
Freiberg, M .; Chang, C .; Kuller, L.; et al. "Cudurka HIV iyo khatarta kufsiga infekshanka miyir-doorsoonka." Wargeyska Ururka Caafimaadka ee Maraykanka (JAMA). Abriil 22, 2013; 173 (8): 614-622.
Freiberg, M .; Chang, C .; Skanderton, M .; et al. "Khatarta ay leedahay cudurka wadnaha wadnaha ee ka dhex dhaca hoyga leh ee leh HIV iyo cagaarshow C." Wareegga dhiigga: tayada iyo natiijooyinka wadnaha. Luulyo 2011; 4 (4): 425-432.
Lang, S .; Mary-Krause, M., Simon, A., et al. "Xaqiijinta HIV iyo Xaaladda Difaaca HIV waa halbeegyo madaxbannaan oo halis ugu jira in cudurku ku dhaco cudurka HIV-ga ee dadka qaba cudurka HIV." Cudurada Cudurrada Cudurrada ah. Agoosto 2013; 5 (4): 600-607.
Hsue, P .; Lo, J .; Franklin, A .; et al. "Korodhka kor u qaadista atherosclerotic ee bukaanka qaba HIV: Doorka astaamaha khatarta ah ee dabiiciga ah iyo kuwa difaaca jirka." Shirka tobnaad ee ku saabsan Retroviruses iyo Infekshinka Fursadaha (CROI 2003); Boston, Massachusetts; Febraayo 10-14, 2003; Abstract 139.
Monforte, A .; Reiss, P .; Ryom. L .; et al. "Atazanavir kuma xirna khatarta sii kordheysa ee munaasabadaha cudurka wadnaha iyo cerebrovascular." AIDS. Janaayo 28, 2013; 27 (3): 407-415.