Hormonal Changes Zvinogona Kuisa Vakadzi Pangozi Yakakwirira yeHIV
Ngozi yeHIV yakakwirira kwazvo kubva kuvarume kusvika kuvarume kupfuura vakadzi kubva kuvarume nekuda kwechikamu chikuru kumatambudziko emukadzi, chirwere uye (zvichida) chibereko. Hakusi chete kuti kune mishonga yakakura munzvimbo yevakadzi yekuberekwa (FRT) kana ichienzaniswa nepenis, kushanduka muhupenyu hunoita kuti hurumende dzive dzakakonzerwa neFRT kunyangwe inogona kutapukirwa.
Kunyange zvazvo mucosal membranes yemukadzi ari yakanyanya kudarika kupfuura rectum, nepamativi gumi nemaviri akashongedza zvikamu zve epithelial tissue zvinopa chigadziro chakakonzerwa kubva kuhutachiona, HIV inogona kugona kuwana muviri kuburikidza nemasero ane utano. Uyezve, chirwere chechivharo, chinotapira mucosal membranes kupfuura chikadzi, chakabatanidzwa neCD4 + T-cells , masero ezvirwere zvemuviri anoshandiswa neHIV zvakasarudzwa.
Zvinhu zvizhinji zvinogona kuita kuti mukadzi ave nehutachiwana hweHIV, kusanganisira bhakitiriya vaginosis (iyo inogona kugadzirisa maruva emukadzi) uye chibereki ectopy (inozivikanwa se "chibereko" chechivivix).
Asi humwe uchapupu hunowedzera hwakaratidzawo kuti kuchinja kwehomoni, zvichiitika zvichiitika kana kuti kunokonzerwa, kunotora chikamu chikuru mukuwedzera kwevakadzi vanogona kuwana HIV.
Kusvika kumwedzi uye HIV
Chidzidzo che2015 kubva kuvatsvakurudzi veDartmouth University yeGeelel School of Medicine vakaratidza kuti kuchinja kwemasodhoni panguva yekugara kwemazuva ose kunopa HIV uye zvimwe zvirwere zvepabonde (zvirwere zvepabonde) "mukana wemukana" wokutapukira.
Zvirwere zvekudzivirira muviri, zvose zvisinganzwisisiki (zvakasikwa) uye zvinogadziriswa (zvakapiwa mushure mekutachiwana kwekare), inozivikanwa kuti inotungamirirwa nehomoni. Panguva yekuenda kumwedzi, mahomoni maviri aya aireva kuita kuti mamiriro ekugadzirisa uye kubata-estradiol uye progesterone- akanganise ma epithelial cells, fibroblasts (masero anowanika mumagetsi anogadzirisa), uye masero ezvirwere zvinotarisana neFRT.
Mukuita kudaro, maitiro ezvirwere zvekuzvidzivirira pamuviri anowedzera simba, uye njodzi yekuwana HIV inowedzera.
Kana ichinyatsosimbiswa, chidzidzo chinogona kubatsira kubatsira nzira yekurapa iyo inogona kuwedzera kushandiswa kwehutachiona hwemabasa uye / kana kuti hutungamirire tsika dzepabonde (kureva, kuzivisa nguva dzakachengeteka kuti uite zvepabonde) panguva iyi inonzi "hwindo remukana."
Kuswedera kumwedzi uye njodzi yeHIV
Kusiyana neizvi, imwe yedzidzo yegore ra2015 kubva kuYunivhesiti Pittsburgh Medical Centre yakaratidza kuti kuchinja kweFRT kunogona kuita kuti pave nehuwandu hwehutachiona hweHIV mumashure evanhu vanonzi menopausal.
Zvinonyatsozivikanwa kuti maitiro ezvirwere zvemuviri wepabonde anobva apera nokukurumidza panguva uye pashure pokunge apera, nekuderera kwepithelial tishu uye kuderedzwa kwakaderera mumucosal barrier. (Mucosa, inozivikanwa kuti ine mishonga inorwisa maantimicrobial, inotsigirwa nezvinyorwa zvepamusoro kweFTR zvinopa kuchengetedza kwakadzika kumucheto wechidiki wepasi.)
Vatsvakurudzi vakapa 165 vakadzi vasingazivikanwe-kusanganisira vakadzi vemasmenopausal; vakadzi vepamberi vevarumekadzi vasati varove pamuviri; uye vakadzi pamusoro pekudzivirira kubata pamuviri-uye vakaenzana nehutachiona hweHIV nekuenzanisa cervicovaginal fluid yakawanikwa nekudiridza. Kushandisa kuongororwa kwehutachiwana hweHIV, vakaona kuti vakadzi vepasipo-menopausal vaiva nezvinhu zvitatu zvakashata zve "HIV" zvinokonzerwa neHIV (11% kana 34%) kupfuura imwe yemamwe mapoka maviri.
Kunyange zvazvo zvingagadziriswa zvakakosha kuburikidza nekugadzira kudzidza uye ukuru, zvinoratidza kuti kuchinja kwehomoni panguva uye shure kwekuguma kwemazuva kunogona kuisa vakadzi vakwegura kuwedzera hutachiwana hweHIV. Nokudaro, kusimbisa kukuru kunofanira kuiswa pane dzidzo yakachengeteka yepabonde kuvakadzi vakwegura, pamwe nekuvimbisa kuti HIV nezvimwe zvirwere zvepabonde hazvisi kudzivirirwa kana kunonoka.
Hormonal Contraceptives uye HIV Njodzi
Uchapupu hwekuti hutachiona hwemakemikari hunogona kuwedzera mungozi yevakadzi hweHIV yakange isingaenderani, zvichienderana nenzira yemuromo kana kuti injectable birth control drugs. Meta-yakakosha-meta-tsvakurudzo yezvidzidzo gumi nemasere-masere akaitwa munharaunda yevanhu vakawanda uye vana pakati pevakadzi vane ngozi -vakaratidza kuwedzera kwakanyanya, kuwedzera kwehutachiwana hweHIV kuvakadzi vanoshandisa nguva yakareba injectable, depot medroxyprogesterone acetate (DPMA, Aka Depo -Provera ).
Kune vakadzi vari vanhu vazhinji, njodzi yacho yakaonekwa sediki.
Kuongororwa, uko kwaisanganisira makumi maviri nemakumi maviri evanhukadzi vatori vechikamu, havana kuratidza kushamwaridzana kwakabatana pakati pemuromo wekudzivirira kubata pamuviri nehutachiona hweHIV.
Kunyange zvazvo nyaya yacho ichitarirwa isina kukwana kuratidza kusagadziriswa kweDPMA kushandiswa, vatsvakurudzi vanokurudzira kuti vakadzi vanoshandisa progestin-chete injectables kuti vazive nezvekusatenda maererano neDPMA neHIV, uye kuti vakurudzirwe kushandisa makondomu nekuongorora dzimwe nzira dzokudzivirira dzakadai se HIV pre-exposure prophylaxis (PrEP ).
Sources:
> Chappell, C .; Isaacs, C .; Xu, W .; et al. "Migumisiro Yekuguma Kwokuguma Kumunhu Asina Kushandiswa Kwemaitiro Antiviral Basa reCervicovaginal Lavage." American Journal of Obstetrics uye Gynecology. March 20, 2015; DOI: http://dx.doi.org/10.1016/j.ajog.2015.03.045.
Ralph, L .; McCoy, S .; Shiu, K .; et al. "Kushandiswa kweHormonal Contraceptive uye Dambudziko revakadzi reHIV Kuwana: A Meta-Analysis of Observational Studies." Lancet Infectious Diseases. January 8, 2015; 15 (2): 181-189.
Wira, C .; Rodriguez-Garcia, M .; uye Patel, M. "Basa reHaboroni rekuita zvekudzivirirwa kwekudzivirirwa kweMusununguko wekudzivirirwa kweMudzimai wekuberekwa kwechikadzi." Nature Reviews Immunology . March 6, 2015; 15: 217-230.