Utachiona hweHIV Husiyo Chete Nyaya yeMafuta Matambudziko
Lipodystrophy , iyo dzimwe nguva isingatarisirwi kugadziriswa kwemafuta emumuviri, yakanga yava nenguva yakaonekwa sechidimbu chinokonzerwa nemishonga yakasiyana-siyana yemishonga inorwisa mabhakitiriya , kunyanya kare vashandi veZerit (stavudine) uye Retrovir (AZT), iyo iri yeboka remishonga inonzi nucleoside reverse transcriptase inhibitors .
Mumakore achangobva kupfuura, mamwe masangano akawedzerwa kune urongwa hwevangangodaro vanokanganisa, kusanganisira Sustiva (efavirenz), Isentress (raltegravir), uye kirasi yemishonga yeHIV inonzi protease inhibitors .
Nezvo izvo zvataurwa, chikonzero chaicho che lipodystrophy- kana kuti munzira yekuunganidza mafuta (lipohypertrophy) kana kurasikirwa kwemafuta (lipoatrophy) -remain kunyanya kusanzwisisika. Uhu huri kuwedzera huri kuratidza kuti HIV pachayo, pamwe chete nekuputika kunoramba kuchibatana nehutachiona , kunogona kuva vatsigiri vanokosha, kunyange kusvikira munguva ichangopfuura kune zvishoma zvinyorwa zvekusimbisa izvi.
Chidzidzo che 2015 chakataurirwa paChirangarudzo pamusoro peRevroviruses uye Zvirwere Zvisingaoneki muSeattle akabatsira vamwe kujekesa nyaya yacho. Maererano nekutsvakurudza, vanhu vane hutachiona hwepamusoro pakutanga kwerapi (inopfuura 100 000 makopi / mL) inoita seine chinzvimbo chikuru chepododystrophy pane avo vane mitero yakadzika midzi.
Chigadziro Chekudzidza uye Mhinduro
Chidzidzo chevhiki makumi matanhatu nematatu, chakaitwa nevatsvakurudzi paCatherine Western Reserve University muOhio, chakashandura 328 varwere veHIV vasina kunyatsoona kurapwa. Zera remakore raive makore makumi matatu; 90% vaiva varume.
Mumwe nomumwe wevatori vechikamu akatarirwa chimwe chezvikamu zvitatu zvakasiyana zvakasiyana zvemishonga, izvo zvaisanganisira musana weTruvada (tenofovir + emtricitabine) uye
- Reyataz (atazanavir) + Norvir (ritonavir),
- Prezista (darunavir) + Norvir (ritonavir), kana
- Isentress (raltegravir).
Pamusoro penzira yekudzidza, varwere vakapiwa CAT nguva dzose uye DEXA (maviri-simba X-ray absorptiometry) inoongorora kuchinja kuchinja kwemuviri.
Kunyange zvazvo zvakange zvichishushikana kuti mishonga yakasiyana-siyana yemishonga inorwisa mahara inogona kuchinja migumisiro yakasiyana nevarwere, masayendisiti akashamisika kuona kuti mafuta emuviri anowedzera akanga akaenzana kune mamwe mapoka. Pasi pose, muviri wehumu hwakawedzerwa ne3% kusvika ku3,5%, asi mafuta emakumbo akawedzerwa ne11% kusvika 20% uye mafuta emuviri anowedzera ne16% kusvika 29%.
Kusiyana kwakasiyana kunogona kuwanika kwavaigona kuwana kwaiva mumatachiona evarwere. Mune avo vane hutachiona hwepamusoro, mafuta episere (kureva, mukati mechidziro chemuviri) yakawedzera nevhareji ye 35% pasinei nemishonga kana madhiragi. Kusiyana neizvi, varwere vane utachiona hwehutachiwana pasi pe 100 000 makopi / mL vaiva nezvikamu zve 14% chete neIsentress uye pasi pe10% neprotease inhibitors.
Uyezve, inowedzera muEntleukin-6 (IL-6), chiratidzo chekushandiswa kwemasimba, yakabatanidzwa nekuwedzera mumafuta ekumusoro (ie, mafuta pakarepo pasi peganda). Izvi zvinoratidza kuti kuputika kweHIV kunobatanidzwa zvakananga mumagetsi echinhu chinowanikwa pasi, kana muchibvumirano kana kuzvimiririra kwekupindira kwekupindira.
Pasinei nezvinokonzera kana kuti zvinokonzera, hutachiona hunowanikwa hwema 30% pamakore maviri hwakaoma, hutakura nawo nguva yakareba yengozi yehutano hwehutano , chirwere cheshuga , uye dyslipidemia .
Zvakawanikwa zvinogona kupa humwe humwe uchapupu hunobatsira hwekurapa paunorwara , zvisati zvaitika kana utachiona hwepamusoro huri hukuru kana kuti maCD4 akazorora.
Sources:
McComsey, G ;; Moser, C .; Ribaudo, H ;; et al. "Kuumbwa Kwemuviri Kuchinja Pashure Kokutanga kweRaltegravir kana Protease Inhibitors." Musangano weRevroviruses uye Mikana Yakasangana (CROI); Seattle, Washington; February 23-26, 2015; abstract 140.
Virolet, C .: Delhumeau-Cartier, C .; Sartori, M .; et al. "Lipodystrophy pakati pevarwere vane hutachiona hweHIV: kuongorora-maitiro ekudzidza pamusoro pehupenyu hwehupenyu uye hutano hwepfungwa." AIDS Research uye Therapy. 2015; 12-21: DOI 10.1186 / s12981-051-0061-z.