Zviratidzo Zvinogona Kubva Kubva Panyoro kusvika kuUpenyu-kutyisidzira
Dhairrhea inogara iripo kune vanhu vanogara neHIV, uye vazhinji vanosvika 60% vane zvitatu kana kupfuura zvakasununguka kana kushambadza kwemahombe zuva nezuva sechikonzero chemhando ipi zvayo inokonzera, kusanganisira:
- utumbo
- migumisiro yema antiretroviral therapy (ART)
- kurondedzera migumisiro yehutachiona hweHIV pamatomu emimba
- mamwe mishonga
- kuzvidya mwoyo
Kurambana kwemashure (kunotsanangurwa sekuenderera mberi kwevhiki dzinopfuura mana) kunogona kuchinja zvakanyanya kunaka kwehupenyu hwevanhu vane HIV, zvichiita kuti kusava nechokwadi uye kutya kwezverapa, kuwedzera kunzwa kwekuora mwoyo uye kuzvidya mwoyo, uye kukanganisa kukwanisa kwomunhu kuchengetedza kusanamatira kushandiswa kwemishonga .
Sezvo nevanhu vose, HIV-positive kana kwete, chirwere ichi chinogona kukonzera kupera mvura uye kupera kwezvinhu zvinokosha zvemiti uye electrolytes, kusanganisira potasium uye sodium. Zvisinei, kune vanhu vane HIV, chirwere chisingaperi chinogona kukanganisa kushandiswa kwemishonga inorwisa mabhakitiriya , zvichiita kuti zvirwere zvisingagadziriswe uye dzimwe nguva, kukura kusati kwatanga kwezvinodhaka .
Kurasika kwakanyanya kwehutachiona kunogona kutyisidzira upenyu kune vanhu vane zvirwere zvekuzvidzivirira zvakanyanya, kunyanya avo vane kuparara (kureva, kuora kwema 10% kana kupfuura).
Gastrointestinal Infections
Dhairrhea inogona kukonzerwa nezvirwere zvakajairika, zvakadai sebhakitiriya, fungi kana mavairasi. Mikana yehutachiona ichi inowedzera sezvo muviri wevanhu uchidzivirira, sezvinowanzoenzaniswa neCD4 yemunhu. Kunyange zvazvo hutachiona hutachiona hunogona kuitika pane imwe nhanho yeHIV, uwandu uye hutsinye hwehutachiona hwakadaro hunowedzera sezvo CD4 count inoderera pasi pe 200 masero / mL.
Pakati pezvakanyanya kuwanda izvi ndezveClostridium difficile-mararamiro akabatanidza, chirwere chebhakitiriya chinowanikwa kazhinji kune vane HIV vane hutano kupfuura avo vari vanhu vakawanda. Zvimwe zvirwere zvinokonzerwa nehutachiona-zvinokonzera zvinosanganisira:
Kunyange zvazvo zvichiitika zvishoma, zvimwe zvinokonzera zvinosanganisira pancreatitis, malignancies yechipfuva chemuviri, uye kunyange dzimwe zvirwere zvepabonde zvinogona kukonzera proctitis (kuvhiringidza rectum lining) kana anal / rectal ulcers.
Migumisiro Yechirwere yeAntiretroviral Therapy
Dhairrhea inowanzova nemigumisiro yechirwere yemishonga yakasiyana-siyana yemishonga inorwisa mabhakitiriya, kunyange zvazvo mamiriro acho kazhinji ari kuzvidzora uye anogadzirisa pachedu kana pasina, kupindira. Kutaura zvazviri, meta-analysis yakagadzirwa muna 2012 yakagumisa kuti vanenge makumi maviri kubva muzana yevanhu vari paART vanozoona zvishoma nezvishoma kuti vasunungurwe nemaradhi zvichibva pamishonga.
Kunyange apo chirwere chekurara chinogona kukonzerwa nema antiretroviral emakirasi ose, ritonavir-containing protease inhibitors (PIs) ndiyo mishonga inowanzobatanidzwa nemamiriro acho ezvinhu. Izvo zvave zvataurwa kuti mishonga inogona kukuvadza zvakanyanya masero epithelial anowedzera mumatumbo, zvichikonzera kuparara kwemvura. Vamwe vanotaura kuti mishonga iyi inokurudzira chloride ion kudzivirira, zvichiita kuti kubuda kukuru kwemvura kubva mumukaka epithelium.
Mune zviitiko zvakakomba zvehutachiona hweHIV, anokanganisa mushonga (s) angada kuve akatsiviwa kana chirwere chinoratidzika chisina kubudirira.
Migumisiro yeHIV muGwara reMatumbo
Utachiona hweHIV hwave huchizivikanwa kwenguva refu huchiita kuti hutachiona huparadzwe pamatumbo, zvikurukuru kune mucocal masero ayo anonzi zvinonzi gut-associated lymphoid tissue (GALT). GALT inzvimbo yekutanga yekupindurwa kweHIV uye kupera kwemaCD4 masero kamwe kana utachiona hukaitika. Kana ikasatenderwa, HIV inogona kukonzera kukanganisa kusingakanganisiki kumatekisi aya kunyange pashure peART inotangwa.
Iko kusingaperi kusuruvara kunobatanidza nehutachiona hwekugara kwenguva refu kunogonawo kukanganisa zvakanyanya mucosal basa rematumbo, kuratidza nezvirwere zvinoputira zvirwere -zvakaita sezviratidzo.
Mune zvimwe zviitiko, kunyange neurons yemukumbo inokanganisa, zvichikonzera kukanganisa kwakagadzikana kunogona kuunza zvakananga kuhutachiona hweHIV.
Zvimwe Zvisina-HIV Mishonga
Kunyange zvazvo chinonyanya kutaurwa chinowanzoiswa pamishonga yeradhiroretroviral kana murwere ichiitika, dzimwe nhengo dzinogona kugovera.
Mishonga inorwisa mabhakitiriya, semuenzaniso, inogona kuuraya mamwe mabhakitiriya mumatumbo ayo akasiyana zvimwe zvakakosha kuti hutano huve hwakanaka. Iyi mishonga inosanganisira Bactrim (trimethoprim / sulfamethoxazole), inowanzoshandiswa seprophylaxis yepneumocystis jirovecii pneumonia (PCP); uye rifampin inoshandiswa mukurapa kubatwa kweTiberculosis (TB) coinfection.
Saizvozvowo, mishonga inokonzera magasium inogona kukonzera chirwere uye ichiita kuti iwedzere, pamwe chete nevakakurumbira, pamusoro pemiti inonzi Tagamet (cimetidine), Nexium (esomeprazole), uye Prilosec (asomeprazole).
Mishonga yemishonga ine seni , yakashandiswa nokuda kwe "detoxification" uye kuora kurasikirwa, inozivikanwawo kuti ine mararamiro anokonzera.
Kuongorora nekurapa
Mune vanhu vane chirwere chemahara chinononoka kusvika pamwero, vamwe vanopfuura-the-counter uye mishonga inorayirika inowanika kurapa chiratidzo. Izvi zvinosanganisira Imodium (inowanika mune zvose-in-counter uye simba remishonga), Lomotil (chiremba), uye Sandostatin (mishonga).
MunaDecember 2012, US Food and Drug Administration (FDA) yakabvumira mushonga weMytesi (crofelemer) kunyanya kubvisa zviratidzo kubva kune hutachiona husingatapuri muvanhu vane HIV vanotora mishonga inorwisa mahara.
Kune varwere vane chirwere chisingaperi kana chirwere chakanyanya kuoma, kuongorora kunofanira kuitwa pamwe chete nemunhu anokwanisa HIV . Kuongorora kunofanira kusanganisira kuongorora kwakakwana kwehutano hwehutano uye hwehutachiona hweHIV, pamwe nekuongorora kwepanyama.
A sempol sample inokurudzirwa kuti iongorore hutachiona. Kana pasina chikonzero chinotapukira chinozivikanwa, saka kuongorora kwenguva refu kunofanira kufungwa. Izvi zvinonyanya kuitika kuvarwere vane chirwere chakanyanya (kureva, 10 kana kupfuura mamwe mafuridziro ezuva) kana kune vanhu vane zvirwere zvakanyanya zvekudzivirira muviri kana kuti zviratidzo zvechirwere cheHIV . Kuongororwa kwemapurisa ndezvokurumbidza kune varwere vane chokwadi chekunyengera.
Zvokudya zvekudya zvinofanira kusanganisira kuderedza kana kudzivisa mafuta kana zvokudya zvinonaka; caffeine (kusanganisira kofi, tei, uye chokoti); insoluble fibers ("roughage"); high-sugar foods (kunyanya avo vane high-fructose corn syrup); uye zvokudya zvakasvibirika kana zvisina kudya.
Probiotics -inobatsira, inorarama tsika inoshandiswa yebhakitiriya inowanikwa mumukaka, yogurt, uye keffir-inogona kukanganisa marwere anokonzerwa nemishonga inorwisa mabhakitiriya kuburikidza nekuvandudza maruva emasikirwo emukati. Kana i-lactose isinganzwisisiki, mapiritsi kana kuti capsule formulations inowanikwawo.
Paunenge uine diarrhea, chengetedza zvakawanda zve hydration nekudya nguva dzose dzemvura, kuchengetedza ziso kunzvimbo yekushandura electrolytes yakarasika (zvichida kuburikidza nemafuta ekugadzirwa kwe electrolyte , zvokudya zvekudyidzana, kana zvinwiwa zvinotapira zvemashuga). Zviduku, zvokudya zvinowanzoitika zvinogonawo kuisa zvishoma kudzvinyirira mumatumbo munguva dzekurambana.
> Sources:
> MacArthur, R. uye DuPont, H. "Etiology uye Pharmacological Management ye N yehutachiona hwehutachiona hwevanhu vane hutachiona hweHIV MuHurumende yeAnteretroviral Therapy Era." Clinical Infectious Diseases. Svondo 2012; 55 (6): 860-867.
> Lima, A .; Kashuba, A .; Bushen, O .; et al. "Dhairrhea uye Nharaunda Dzakatapudzwa dzeAnterretroviral Drugs: Kuvandudza neG Glutamine neAlanyl-Glutamine MuRandomized Controled Trial muNortheastern Brazil." Clinical Infectious Diseases. December 31, 2003; 38: 1764-1770.
> Sanchez, T .; Brooks, J .; Sullivan, P .; et al. "Bacterial Diarrhea muvanhu vane HIV, 1992-2002." Clinical Infectious Diseases. 2005; 41 (11): 1621-1627.