Vose vane HIV neHIV-vakabatanidzwa nemishonga yekurapa inoratidzwa kuti kuwedzere njodzi
Rudzi rwechipiri rwechirwere cheshuga rinowanzobatanidzwa nehutachiona hweHIV hutachiona , chikonzero chacho chave chakabatanidzwa munguva yakapfuura kushandisa mamwe ma antiretroviral madhiragi (ARVs) -kunze "yakare" protease inhibitor -chirwere chemishonga seCrixivan (indinavir) uye simba rakazara Norvir (ritonavir) .
Kunyange zvazvo zvisizvo zvisingave pachena zvakajeka kuti ARV inopa zvipi, tinoziva kuti chirwere cheshuga chekuti munhu anogara neHIV anowanzotarisana nezvimwe zvinhu zvinokonzera, kusanganisira:
- Age akwegura (kazhinji 40 nepamusoro)
- Nhoroondo yemhuri
- Kuwedzera muviri
- Hepatitis B (HBV) uye hepatitis C (HCV) coinfection
- High blood pressure
- High cholesterol
- Current pregnancy
- Ethnicity (Asian, African-American, Hispanic)
Mumakore achangobva kupfuura, kutsvakurudza kwakaratidza kuti zvose zvirwere zvisingaperi zvisingabatanidzwi nehutachiona hwehutachiona uye zvirwere zvisingagumi zvinoshandiswa mukurapa hutachiona hweHIV zvinogona, kuwedzera, kuwedzera ngozi yechirwere cheshuga zvikuru.
Chirwere cheshuga neHIV-Yakabatanidzwa neHure Inflammation
Kunyange kana hutachiona hweHIV huripo kana kuti huchidzivirirwa zvizere nemishonga ye antiretroviral therapy (ART) , kuvapo kwechirwere chetachiona chinokonzera kugadziriswa kwekuputira kwechirwere sezvo muviri wechirwere chemuviri unosara uri wakakwirira.
Munguva yeHIV-inosangana nekuputika kusingaperi, zvimwe zviratidzo zvinoputira-zvinonzi C-reactive protein (CRP) uye interleukin-6 (IL-6)-inozivikanwa kuwedzera. Kutsvakurudzwa kwemazuva ano kunoratidza kuti kubuda mumakadhi aya kunowedzera kuwanda kwechirwere cheshuga kuvanhu vane ART.
Masayendisiti neInSIGHT SMART neESPIRIT mapoka emapurogiramu akaongorora chirwere cheshuga pakati pe 3 695 varwere vane HIV vane hutachiwana hweHIV pamusoro pehuwandu hwemakore 4.6. Avhareji yeCD4 count pakati pemubatanidzwa aionekwa sepamusoro pa 523 cell / mL.
Kubva pane deta, varwere vane CRP yakakura uye IL-6 vainyanya kuwedzera chirwere cheshuga chechirwere chechirwere chechirwere, nekaviri yeCRP neI-6 kubva pachiyero chinoita kuti 20% uye 33% mungozi huru, zvichienderana.
Zvose zvakataurwa, vanhu 137 vakagadziriswa chirwere cheshuga munguva yekutongwa pamwero we 8.18 per 1 000-murwere wemakore.
Kunyange zvazvo maitiro ezvakagadzirwa evanhu akaonekwa achiita kuti kuve nekushusha kwechirwere cheshuga pakati pevatori vechidzidzo-kusanganisira yakakura mumuviri index (BMI), kukwegura, hepatitis coinfection nemishonga yemasimoni -yo chokwadi chokuti kunyange kupera kwekwenyuka kwepabonde kunogona kuonekwa sekukosha , kupa hurumende iyo inonyanya kuzivisa vanhu vari pangozi yekurudzi rwechirwere cheshuga uye kuve nechokwadi chekugadzirisa kwakakodzera kusati kwatanga ART.
Chirwere cheshuga chinobatanidza neStatin Drug Use?
Chimwe chezvigadziriswa zvekudzivirira chirwere cheshuga kuvanhu vane HIV ndezvekugadziriswa kwemishonga yemagetsi ekugadzirwa kwezvirwere. Mishonga iyi, inoshandiswa kurapa yakakwirira lipids (kunyanya yakakwirira yeLDL cholesterol), inoonekwa seinokosha mukudzivirira hutano hwehutano muhuwandu uko huwandu hwekutsamwa kwemwoyo hunenge huviri hwehuwandu hwevanhu.
Zvisinei, kutsvakurudza kutsva kubva kuHIV Outpatient Study (HOPS) kwakaratidza kuti kushandiswa kwemishonga yemagetsi muvanhu vane HIV kunogona kuwedzera dambudziko rekushaya chirwere cheshuga nemamwe 10% negore rekushandiswa.
Iko makore gumi ekucherechedza kuongorora, kwakatevera 4 962 varwere vane hutachiona hweHIV kubva muna 2002 kusvika muna 2011, vakatarisa mumamiriro ezvinhu echirwere cheshuga chevanhu varipo vanopiwa mishonga yemagetsi (590) pamwe nevaya vakanga vasina (4 372).
Kugadzirisa muenzaniso wezera, zvepabonde, rudzi, kushandisa maARV uye BMI, vatsvakurudzi vakakwanisa kugumisa kuti njodzi yechirwere cheshuga yakaramba ichiwedzera nguva yakanyanya kufanana nemamiriro ekudzivirira.
Zvisinei, vakakurumidza kuona kuti kuwedzera kwacho kwakabatanidzwa zvakananga nekukwegura uye yepamusoro yeBMI, pamwe nekusarura / rudzi rwevanhu (pamwe ne50% yepamusoro yevatendi uye vazhinji vari vaviri pakati peSpainics). Zvinoshamisika, mashoma mashoma akaudzwa pakati pevarwere vaduku, nepo huwandu hweprotease inhibitors hwakaratidzwa kunge husingaverengeki.
Kubva pakuona mazano, vatsvakurudzi veHOPS vakakurudzira zvikuru kuti statin "isingadzivirirwa kana kliniki inoratidzwa" nekuda kwe "yakaratidza kubatsirwa kwehutano hwehutano hwehutano."
Saka kunyange zvazvo mishonga yemishonga inoramba iri inokosha senzira yekuderedza lipid kuvanhu vane HIV, havafaniri kushandiswa vari voga. Kunyatsogadzirisa njodzi kunoda nzira yakakwana, kusanganisira kuderedzwa kwemafuta , kuitisa muviri nguva dzose , kusvuta kusvuta , uye kutangwa kweAIDS panguva yakakodzera nekuchengetedza kwakakwana kwehutano kuitira kuti zvirwere zvinenge zvichisvibiswa (kunatsiridza kuderedza kupisa kwechirwere chechirwere cheHIV chisina kutorwa).
Sources:
Béténé A Dooko, C .; De Wit, S ;; Neuhaus, J .; et al. "Interleukin-6, High Sensitivity C-Reactive Protein, uye Kuvandudzwa kwechirwere chechirwere cheshuga pakati pevarwere vane HIV-vakanaka Vanotora Antiretroviral Therapy." Zvinyorwa zveAkawana Immune Defence Syndromes. December 15, 2014; 67 (5): 538-546.
Lichtenstein K .; Debes, R .; Wood, K. et al. "Statin use rinosanganiswa nechiitiko chinokonzera chirwere cheshuga mellitus pakati pevarwere muHIV Outpatient Study." Musangano we20 pamusoro peRevroviruses uye Mikana Inopesana (CROI). March 3-6, 2013; Atlanta, Georgia; chinyorwa 767.
Freiberg, M ;; Chang, C .; Kuller, L .; et al. "Utachiona hweHIV uye hutachiwana hwemyocardial infarction." Zvinyorwa zveAmerican Medical Association (JAMA) Mushonga Wemukati. April 22, 2013; 173 (8): 614-622.