Labadaba HIV iyo Is-bahaysiga Dawooyinka ee HIV-da oo loo arkay inay sii kordhayaan Khatarta
Nooca 2aad ee sonkorowga ayaa inta badan lala xiriiriyaa infekshanka HIV - ga ee muddada dheer ah , sababtuna waxay sababtay in la isticmaalo duroogooyinka daawooyinka antiretrovoviral (ARVs) -waxaa laga helaa daawoyin " hormoon " protease inhibitor ah sida daroogada Crixivan (indinavir) iyo awood buuxda Norvir (ritonavir) .
Inkastoo aysan caddayn inta uu le'eg yahay ARV-yada ay wax ku biirinayaan, waxaynu og nahay in halista cudurka macaanka ee qofka qaba HIV uu badanaa ku salaysan dhowr arrimood oo wax ku ool ah, oo ay ka mid yihiin:
- Da 'weyn (guud ahaan 40 iyo ka weyn)
- Taariikhda qoyska
- Cayilka
- Cagaarshow B (HBV) iyo cagaarshow C (HCV) isku dhejinta
- Cadaadis dhiig oo sarreeya
- Kolestarool sare
- Uurka hadda
- Asal ahaan (Aasiya, Afrika-Mareykan, Hispanic)
Sannadihii ugu danbeeyay, cilmi-baaris ayaa soo jeedisay in labada caabuq ee joogtada ah ee la xidhiidha infekshinka muddada dheer iyo daaweynta dabadheeraadka loo isticmaalo in lagu daaweeyo xaaladaha HIV-ga la xidhiidha, dhab ahaantii, waxay kordhin kartaa halista cudurka macaanka.
Sonkorowga iyo Hurgunka Xanuunka HIV-da
Xitaa marka uu HIV-gu yahay mid aan cillad lahayn ama si buuxda loo xakameynayo daaweynta antiretroviral therapy (ART) , joogitaanka fayrasta qarsoon waxay keenaysaa jawaab joogto ah oo socota iyada oo nidaamka difaaca ee jirka looga tago feejignaan sare.
Inta lagu jiro infekshanka joogtada ah ee HIV-ga, calaamadaha caabuqa ee lagu magacaabo C-reactive protein (CRP) iyo interleukin-6 (IL-6) Cilmi-baaristii dhawayd waxay soo jeedinaysaa in kororka calaamadahaas ay si weyn u kordhinayaan suurtogalnimada cudurka macaanka ee dadka ku jira ART.
Cilmi-baarayaasha oo la socda kooxaha cilmi-baarista INSIGHT SMART iyo ESPIRIT ayaa baaray heerka cudurka macaanka ee ka mid ah 3,695 bukaan-socodka qaba HIV-ga ee ART celcelis ahaan 4.6 sano. Tirada celceliska CD4 ee ka mid ah ka qaybgale ayaa loo tixgeliyey in ka badan 523 unug / mL.
Iyadoo ku saleysan xogta, bukaanada leh CRP iyo IL-6 waxay u badan tahay inay yeeshaan horumarinta nooca 2aad ee sonkorowga, iyada oo laba-laab ka mid ah CRP iyo IL-6 laga bilaabo saldhigga taasoo keentay khatarta 20% iyo 33% ka badan.
Dhammaantood waxay sheegeen, in 137 qof ay diabetes ku kormeereen inta lagu gudajiray tijaabada tii ugu badnayd ee 8.18 halkii sano ee bukaan-socodka.
Inkasta oo walxaha dhaqameed ee loo arko in ay gacan ka geystaan horumarka sonkorowga ka qaybgalayaasha daraasad-oo ay ku jiraan miisaanka culeyska jirka ee jirka (BMI), da 'weyn, ciribtirka cagaarshowga iyo dawooyinka Statin -ta xaqiiqda ah in xitaa heerka caabuqa hooseeya uu wax ku biirin karo , kaas oo siinaya qaab guud kaas oo si fiican u aqoonsan kara shakhsiyaadka halista sare ugu jira nooca 2aad ee sonkorowga iyo hubinta waxqabadyada haboon ka hor bilowga ART.
Diabetesku ma wuxuu ku xiran yahay Isticmaalka Daroogada Statin?
Mid ka mid ah dhibaatooyinka ka hortagga cudurka macaanka ee dadka qaba HIV waa saameynta dawooyinka dawooyinka ee horumarinta cudurka. Daawooyinka, oo loo isticmaalo daaweynta daboolka sare (gaar ahaan kolestaroolka sare ee LDL), ayaa loo tixgeliyaa mid muhiim ah oo ka fogaanaya cudurrada wadnaha iyo xididada ee dadweynaha oo suurtogal ah in weerarrada wadnaha ay ku dhow yihiin labanlaaban dadka guud.
Si kastaba ha ahaatee, cilmi-baaris cusub oo ka socda Daraasada HIV-ga ee socda (HOPS) ayaa muujisay in isticmaalka daawooyinka xasaasiga ah ee dadka qaba HIV ay kordhin karaan qatarta diabetes by 10% boqolkiiba sannad kasta.
Falanqaynta falanqaynta 10-kii sano ee soo socota, oo la raacay 4,962 bukaanno qaba HIV-ga laga soo bilaabo 2002 ilaa 2011, waxay eegeen xaaladaha nooca 2aad ee sonkorowga ka mid ah dadka loo siiyay dawooyinka Statin (590) marka loo eego kuwa aan ahayn (4,372).
Isku hagaajinta nooca da'da, jinsiga, qowmiyadda, isticmaalka ARV iyo BMI, baarayaashu waxay awoodeen inay ku soo gabagabeeyaan in halista diabetesku ay kor u kacdey muddada dheer ee statin.
Si kastaba ha ahaatee, waxay sidoo kale si dhakhso ah u qeexeen in kororka ay sidoo kale si toos ah ula xiriiraan da 'da'da weyn iyo BMI sare, iyo sidoo kale jinsiyada / qowmiyadeed (oo leh 50% qiimaha sare ee madow iyo in ka badan labalaab ee Hispanics). Si aan caadi aheyn, xaalado yar ayaa laga soo sheegay bukaannada yar yar, iyada oo saameyntii korontada ka hortagga loo yaqaan "protease inhibitors" loo arko in ay tahay mid aan qiimo lahayn.
Laga soo bilaabo talo bixinta, cilmi baarayaasha HOPS waxay si adag ugu taliyeen in "statin" aan laga fogeyn haddii ay calaamaduhu tilmaamaan "sababtoo ah" faa'iidooyinkooda oo muujinaya ka hortagga cudurka wadnaha. "
Sidaas daraadeed marka daawooyinka dawooyinka ay weli muhiim u yihiin sida lipids ee dadka qaba HIV, waa in aan loo isticmaalin si gooni ah. Si dhab ahaan loo yareeyo khatarta waxay u baahan tahay nidaam guud, oo ay ka mid yahiin cunto yari yareeyey , jimicsiga joogtada ah , joojinta sigaarcabka , iyo bilowga habaynta ART iyada oo la raacayo si loo hubiyo in lagu xakameynayo cirbadaha (si loo yareeyo jawaabta bararsan ee cudur aan la daaweyn).
Ilaha:
Béténé A Dooko, C .; De Wit, S .; Neuhaus, J .; et al. "Interleukin-6, Dareenka sare ee C-reaktif, iyo Horumarka Nooca 2aad ee Sonkorowga Ka mid ah dadka qaba HIV-da ee daaweynaya daaweynta antiretroviral." Wargeyska Nidaamka Immune Deficiency Immunities. Diisambar 15, 2014; 67 (5): 538-546.
Lichtenstein K .; Debs, R .; Wood, K. et al. "Isticmaalka Statin wuxuu la xiriiraa cudurka sonkorta cudurka mellitus ee bukaan-jiifka ku jira Daraasada HIV-ga. Shirka 20aad ee Retroviruses iyo Infekshinka Fursadaha (CROI). Maarso 3-6, 2013; Atlanta, Georgia; abstract 767.
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.