Kudzidza kunoratidza kusvuta kunowedzera kukuvadza kupfuura HIV pachayo
Kusvuta fodya kunoramba iri pakati pezvinetso zvinotyisa uye zvinokuvadza zvinotarisana nevanhu vane HIV nhasi. Kuenzaniswa nehuwandu hwevanhu veUnited States, uko kupararira kwekupisa kwakaderera mumakore achangopfuura kusvika kune 21 kubva muzana, uye vazhinji se 42 muzana yevanhu vanorarama neHIV vanotsanangurwa sevanoputa zvino. Iyi inhamba inotyisa uye iyo inobatanidzwa zvakananga nekuwedzera kwehutano hwehutachiwana hwehutachiwana uye kufa kusati kwasvika.
Vanhu vane hutachiona hweHIV-Vakanaka Maviri Sezvingaita Kumusvi
Kune zvishoma zvitsvakurudzo zvinowanikwa kuti zvijekese zvizere maitiro asingaverengeki akakwirira ekusvuta mukati mehutachiona hweHIV. Zvimwe zvidzidzo zvakaratidza kuti kukwirira kwekuzvidya mwoyo uye kuora mwoyo kunoita chikamu chakakosha uye kuti vazhinji vanoenda kunotinini senzira yekugadzirisa zvinetso zvezuva nezuva zveHIV.
Asi hazvina kunyatsojeka kana izvi zvinetso zvepfungwa zvinokonzera kushandiswa kwefodya, kana kuti kungoita kuti kupedza kushanda kusanyanya kushanda kune avo vanorarama neHIV.
Dhiyabhorosi inopesana. Maererano nenhamba yekuongorora kubva kuU.S. Centers for Disease Control uye Infection (CDC), vane vatsva vane HIV vane hutachiwana hweHIV muUnited States vanowanzove vakwegura pane vaduku, vane 58 muzana vane makore makumi mashanu nemashanu uye vanopfuura, 40 muzana vane makore 25 kusvika ku44, uye chete vaviri muzana vane makore 18 kusvika ku24.
Nhamba idzi dzinoratidza kuti kushungurudzwa kweHIV-hakusi iyo inokonzera kushandiswa kwefodya, zvichienderana nevechidiki vane utachiona hweHIV-vanoita 26 muzana yehutachiona hutsva-havafambidhiri kusvuta kudarika vamwe vavo vasina HIV (maviri muzana inopesana ne19 muzana).
Asi, nhamba idzi dzinofananidzwa nemafungiro akawanda muUnited States, umo vakwegura vakwegura vanenge vashoma kudarika kusvuta kusvuta kudarika vasikana vasvuta (84 muzana kusvika 66%).
Kusiyana neizvi, kuratidzira zvepabonde hakuiti zvishoma mukusvuta fodya. Nekudaro, nhamba idzi dzakasiyana-siyana, pamwe chete nevakadzi vakawanda vanopfungaira (51 muzana) sevanhurume, vevabhangi, kana vevakadzi (49 muzana) -kuda kwekuti hutachiona hutsva pakati pevarume vanoita zvepabonde nevarume (MSM) katatu yakakwirira kudarika pakati pehupombwe.
Izvi zvinoreva kuti kuwandisa kukuru kwevatachiona vane hutachiona hweHIV, ikoizvo, vanoita zvepabonde. Chikonzero nei izvi zvisinganzwisisike-kunyanya sezvo kusvuta mumitambo pakati pevamwe varume, vakadzi vechibharo, uye vakaroorana muhuwandu hwevanhu vanowanzoita kaviri yehupombwe, maererano neshumo ra2010 kubva kuAmerican Lung Association.
Kusvuta kunobata sei vanhu vane HIV
Kusvuta kunonyanya kukonzerwa nekufungidzira kwevanhu vanotapukirwa nehutachiwana munyika yakagadzirirwa kupfuura hutano hwehutachiona hweHIV. Izvi zvinoenderana nekudzidza kwa2013 kubva kuCopenhagen University Hospital, iyo yakaratidza kuti kusvuta, mukati uye pachako, kunoderedza kutarisira kwehupenyu kune vanhu vane HIV kuburikidza nemakore 12.3.
Uyezve, mungozi yekufa (ingava yehutachiona hweHIV uye isiri yeHIV) yakaratidzwa kuva yakawandisa kaviri kune vane utachiwana hweHIV kune vanhu vane HIV vasina kumboputa.
Pakati pezvimwe zvinetso zvekutengesa HIV:
- Kusvuta ndiro imwe yenjodzi yakakura inokonzerwa nehosha yakaipa yemwoyo (ACS) kune vanhu vane HIV. Maererano nekutsvaga kubva kuYunivhesiti yeBarcelona, mupiro wekusvuta kuAACS mune vanhu vakuru vane hutachiwana hweHIV hwakanga hukuru kune zvipo zvehuga wehuga kana huwandu hwehutachiona uye hwakanga hwava kaviri kana hwepamusoro seyevanhu vakuru vasina HIV (54 muzana kusvika 31 muzana) . Kushandiswa kwema antiretrovirals kana kuti CD4 count yemunhu / hutachiona hwehutachiona hwakaonekwa kuti hauna hanya-kwete-zvinopesana kana vane vane HIV vane tsvina vakagadzira ACS kana kwete.
- Kusvuta kunonzi inonyanya kukonzera kukanganisa kenza yemapapu . Kutaura zvazviri, pane kuwedzera kwemazana emapapiro emapapu emapapu pakati pevasikana vane HIV, vasina huwandu hweCD4 yemunhu kana nhoroondo yezvirwere zvemapapu zvine chokuita neHIV. Tsvakurudzo inobva kuSwitzerland HIV Cohort Yokudzidza inoratidza kuti kuponeswa kwevanhu vari varombo kune vane HIV vane utachiona hunoita zvirwere zvemapapu, uye vane 14 muzana chete vachiri vapenyu makore maviri mushure mekuongororwa. Izvozvo zvakati, vekare vaisvuta vakaratidzwa vane dambudziko rakanyanya kuderera kudarika vanoputa zvino, vachiratidza kukosha kwekusvuta kusvuta kune avo vane HIV.
- Kusvuta kunowedzera kukonzera njodzi yezvirwere zvisingagoneki zveplummoni (COPD) uye inharaunda-inowanikwa bhakitiriya pneumonia. Mazuva ano vanosvuta neHIV vane zviratidzo zvakawanda zvekufuridzirwa kupfuura kusasvuta kushamwaridzana navo, vanowedzera kaviri panjodzi yekufa. Zvimwe zvidzidzo zvakaratidza ukama huri pakati pekusvuta uye esophageal candidiasis .
- Pane kushamwaridzana kwakasimba pakati pekuvhima uye hutachiona hwepillomavirus (HPV) muhutano nevarume nevarume vane HIV. Vakadzi vane hutachiona hweHIV vanosvuta vane pakati pematatu uye katatu mukana wekutapukirwa kweHIVV kupfuura vakadzi vane HIV vane utsi. Saizvozvowo, kuputa mune varume vane hutachiwana hweHIV kwakabatanidzwa nehuwandu hwehutano hwekuvandudzwa kwezvipembenene zve HPV. Kudzokorora HPV zvirwere zvakabatana zvakananga nehuwandu hwehutano hwechirwere chepervical muvakadzi nekenza yemuviri mune varume. Kuongorora kwakawanda kunoratidza kuti kusvuta kune migumisiro yakaipisisa pamusana pemunhu, izvo zvinogadziriswa uye mucosal (iyo yekupedzisira iyo inosanganisira kudzivirirwa kweLangerhans masero anokonzera chivharox uye anus). CD4 nhamba pasi pe350 masero / mL inonziwo ishamwari inobatsira.
- Kusvuta fodya kunogona kuwedzera mungozi yevakadzi yekuendesa HIV kune mwana wavo panguva yekubereka, uye kuputika kwepabonde kusati kwaitika kunowanzoitika kakawanda mumadzimai avo vakanga vatsva panguva yekutanga kwekuita kwavo pamuviri. Zvose zvakataurwa, mungozi yekuendesa mberi yakaratidzwa kuva yakakwirira katatu yevakadzi vasina kusvuta vane HIV.
- Kusvuta kunobatanidzwawo nehuwandu hwehutachiona hwehutachiona kurasikirwa (semuenzaniso osteopenia, osteoporosis), uye inonzi inozviisa pangozi inokonzera kuputsika kune avo vane HIV. Zera rakwegura uye rudzi rwemutsvuku ndezvekufananidzira kwechiitiko chinoputika.
Batsirwa Rokurega
Nzira dzenguva refu uye dzenguva pfupi yekurega zvachose hadzina kutenderwa uye zvakajeka. Kubvisa kusvuta zvishoma nezvishoma kunoderedza ngozi yehutano hwemwoyo kune vanhu vane HIV, pamwe nekuongorora kunoratidza kuderedzwa kwengozi inoda kusvika 65 muzana mushure memakore matatu. (Ongororo inobva kuAkitaine Cohort Yokudzidza muFrance inoratidza kuti kupera kungangove ndiyo chete iyo inobatanidza nekuvandudzwa kwehutano hwemwoyo kune vanhu vane HIV-yakakura kunyange kupfuura kunyadzisa-kuderedza zvinodhaka kana remishonga inorwisa mahara.)
Saizvozvowo, mungozi wekenza yemapapu inogona kuderedzwa nehuwandu makumi mashanu kubva muzana muhutachiona hweHIV avo vakasiya gore kana kupfuura. Zvimwe zvakaenzaniswa zvinowanikwa kune varwere vane COPD, bhakitiriya pneumonia, nezvimwe zvinotapukira uye zvisingaiti zvinopfurikidza nemapfupa ekufema.
Zvakakosha zvakaenzana kugadzirisa kuti nokukurumidza zviri nani kupfuura gare gare kana zvasvika pakurega, kunyanya kune avo vane maitiro ekudzivirira zvirwere. Tsvakurudzo inobva kuAnderson Cancer Center paYunivhesiti yeTexas yakaratidza kuti kusvuta kusvuta kunogona kuderedza mutoro wezviratidzo zvine hutachiona hweHIV mukati memwedzi mitatu uye kuti zviratidzo zvinogona kuramba zvichiderera sezvo nguva isina kusvuta inowedzera.
Uyezve, kusvuta kuzvidzora kunofambidzana nehutano hwakanaka kune avo vane antiretroviral therapy.
Sources:
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Helleberg M .; Afzal, S ;; Kronborg, G ;; et al. "Kufa kunokonzerwa nekusvuta pakati pevanhu vane HIV-1: rudzi rwevanhu vose vanoongorora boka." Clinical Infectious Diseases. March 2013; 56 (5): 723-734.
Clifford G.; Lise, M .; Franceschi, S .; et al. "Kenza yemaperembudzi muSwitzerland HIV cohort study: basa rekusvuta, immunodeficiency and pulmonary infection." British Journal of Cancer. January 12, 2012; 106 (3): 447-452.
Crothers, K .; Griffith, T .; McGinnis, K .; et al. "Izvo zvinosvuta kusvuta fodya pamusoro pekufa, hupenyu hwehupenyu, uye kurwara kwechirwere pakati pevarwere vane HIV." Zvinyorwa zveGeneral Internal Medicine. December 2005; 20 (12): 1142-1145.