Chirwere cheHIV kana HIV chinokonzera here?
Dare rezvino rekutsvakurudza rakaratidza kuti vanhu vane HIV vane makumi mashanu kubva muzana inowanzova nekurwadziwa kwemoyo kudarika vanhu vakawanda. Chidzidzo chegore rechitanhatu chakaitwa sechikamu cheVeterans Aging Cohort Study (VACS) yakaratidza kuti 41 muzana yemakumbo emyocardial (MIs) akaitika kune vanhu vane HIV.
Pakufananidza MI mazera ekukwegura boka ( ona pasi apa ), vatsvakurudzi vakagumisa kuti mhirizhonga yeMI "yakakosha uye yakaramba yakakwirira" pakati pevatori vechikamu vaHIV uye vakaramba vachiwedzera kwenguva, pasinei nekushandisa zvinodhaka, chirwere chinorwara, kana zvimwe zvirwere zvepfungwa zvinhu.
Nhamba yeMyocardial Infarctions (MIs) Paka 1 000-Munhu Makore
| Age Range | Veterans vane HIV | Veterans vasina HIV |
| 40-49 | 2.0 matambudziko | 1.5 matambudziko |
| 50-59 | 3.9 matambudziko | 2.2 mhaka |
| 60-69 | 5.0 mhaka | 3.3 matambudziko |
Nhamba idzi dzinopindirana nekutsvakurudza kwakamboitika kwakaratidza kuwedzera kwemazana maviri kuMIs pakati pevanhu vane HIV, pamwe nekuwedzerwa kwemazana maviri kune varwere vane HIV uye hepatitis C kukanganisika .
Utachiwana hweHIV hunoita sei kuti mwoyo uwedzere njodzi?
Kunyange zvazvo zvikonzero zvekuwedzera izvi zvisina kunyatsojeka, uchapupu huripo hunoti hutachiona hweHIV pachahwo hunogona kunge huine mhosva, zvichida nekuda kwekupopota kwechikonzero chinokonzerwa nehutachiona hweHIV huripo.
Chidzidzo che2012 kubva kuFrench Hospital Database pamusoro peHIV (FHDH) yakagumisa kuti HIV, pamwe nehutachiwana hwehutano hwemurwere, ndeyezvikonzero zvekuzvidzivirira kune ngozi yakawanda. Uyezve, mukana wevarwere wekurwadziwa kwepamuviri unoonekwa kuti unowedzera kuwirirana zvakananga kuderera muCD4 count uye kuwedzera muwandu hwehutachiona .
CD4 murwere anedir (iyo yakaderera pasi iyo CD4 count yawa) inonziwo inobatsira.
Zvimwe zvose izvi zvinoratidzika kuratidza ndezvokuti nguva refu yekutapukirwa kweHIV inoisa munhu pasi pekutakura kwekudzivirira kuputika, izvo zvinogona kukanganisa hutano hwemagetsi pamasero uye mazamu.
Kutsvakurudza kwakaitwa paYunivhesiti yeCalifornia, kuSan Francisco yakatsanangura kusangana pakati peCD4 count uye hutano hwehutano, apo varwere vane CD4 yakawanda (kana pasina HIV ) vakawana kuoma kukuru kwekuwedzera uye kuwedzera kana vachienzaniswa nevarwere vaiva neCD4 yakasimba, kurapwa kwekutanga, uye kuronga kwehutachiona hunogara.
Ko utachiona hweHIV hunokonzera matambudziko emwoyo here?
Kunyange zvazvo mamwe madhiragi anorapwa, kunyanya Ziagen (abacavir), akataurwa kuti awedzere njodzi yekurwadziwa kwemoyo, tsvakurudzo yezvino inoparadzaniswa pamusoro pehurukuro. Kakawanda, njodzi inowanzoonekwa ichikwirira pakati pevaya vane mwoyo wakagara uripo kana avo vane zvishanu kana kupfuura zvakagadziriswa nehutano hwepfungwa (zvakadai sokusvuta, chirwere cheshuga kana kuti cholesterol yakakwirira).
Kunyange imwe tsvakurudzo yakaratidzawo kuti HIV protease inhibitor class (PI) zvinodhaka zvakanyanya kuwedzera MI ngozi, vakawanda vanobvumirana kuti chero njodzi inogona kuitika inogona kusanganiswa nemumwe munhu anoshanda pane imwe boka rezvinodhaka. Zvidzidzo zviviri zvenguva pfupi zvakagumisa kuti zvitatu zvePI zvakakanganisika-Reyataz (atazanavir), Viracept (nelfinavir), uye Invirase (saquinavir) -kusava neshamwari chero ipi neImungozi.
Panewo kusava nechokwadi pamusoro pekuti mamwe maPI, akadai se Kaletra (lopinavir) neCrixivan (Invirase), anobatsira kubva pakushandiswa kwePIs hakusi kungofanirwa kuti ndiyo chete inokonzerwa nehutachiona hwehutachiona hweHIV nehutano hwemwoyo.
Zvisinei, kupesana kwekutsvakurudza-pamwe nekutsigira uye zvimwe kubvisa zvinotaurwa-zvinosara munzvimbo yekuchenjerera pakusarudza mishonga yakakodzera yemishonga kune varwere vane ngozi inozivikanwa yemwoyo. Iyo inoratidza zvakare kudiwa kwekugara kwepfungwa yekuongorora kwepfungwa kune vose varwere vane HIV, nekupindira kwepakutanga kuti vaderedze njodzi dzakadai dzinogona kushandiswa sekusvuta , kudya, nehutachiona.
Kurapa Utano Hwehutano Muvanhu Vane HIV
MuAIDS vane varwere vane hutachiona hwehutachiona hwehutano kana hutachiona hwepakutanga hunoratidzira zvirwere, kutumira kune chiremba wehupenyu kunokurudzirwa zvikuru. Kufungidzirwa kunofanira kuitwa kuti kutanga kana kuchinja marapirwo okuisa ma antiretroviral agents ane zvishoma pamagariro e serum lipid.
Uyezve, kuongorora kunofanirwa kunzwisiswa kune vose vanorwara neHIV vari kupinda mukuchengetedzwa kuitira kuti vaongorore zvakakwana moyo womunhu ane ngozi, kusanganisira kuedza kwakadai se:
- kurara kunonyadzisa (kusanganisira LDL cholesterol, HDL cholesterol, uye triglycerides)
- chirwere cheshuga chekucherechedza (kusati kwatanga kurapa, nekugadziriswa kwechiitiko pashure)
- baseline electrocardiogram (ECG) yevarwere vane hunozivikanwa hwehutano hwepfungwa
- kazhinji kuwedzera kweropa kuongorora
- kushandiswa kwechisimba kune varwere vane njodzi yepfungwa kuitira kuti kuderedza kusvuta, kuneta, uye zvimwe zvinokonzera njodzi
Kunyange zvazvo pasina hutachiwana hwehutano hwehutachiona hweHIV huripo, maitiro emidzinza ekudzivirira njodzi anorayirwa-kwete chete kune varwere vane ngozi inozivikanwa nehutano hwehutano asi senzira yakakwana yekuchengetedza kwenguva refu kune vose vane HIV. Kusimbiswa kunofanira kuitwa kuve nechokwadi:
- kugara uchirovedza muviri, kusanganisira aerobic fitness
- kuderedza kushandiswa kwemafuta akazara
- Kupera kusvuta kwehutachiona hweHIV
- kuderedza doro kushandiswa kuzvikamu zvitatu pazuva kana zvishoma
- kunyatsoteerera kweraretroviral therapy
Sources:
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.
Freiberg, M ;; Chang, C .; Skanderton, M .; et al. "Ngozi yechiitiko chinonzi coronary heart disease pakati peveterans uye uye neHIV uye hepatitis C." Kutenderera: Mwoyo Yehutano neMigumisiro. July 2011; 4 (4): 425-432.
Lang, S ;; Mary-Krause, M., Simon, A., uye al. "Kudzokorora kweHIV nehutachiona hwezvirwere zvekudzivirirwa kwezvirwere zvinodzivirira zvakazvimirira zvehutachiwana hwemyocardial infarction mune vanhu vane HIV." Clinical Infectious Diseases. August 2013; 5 (4): 600-607.
Hsue, P .; Tarira, J .; Franklin, A .; et al. "Kuwedzerwa kwehutano hwezve atherosclerotic kune varwere vane HIV: Basa rezvetsika uye remunological mungozi." Tenth Conference pamusoro peRevroviruses uye Mikana Dzakasangana (CROI 2003); Boston, Massachusetts; February 10-14, 2003; abstract 139.
Monforte, A .; Reiss, P .; Ryom. L .; et al. "Atazanavir haisanganiswi nehuwandu hwehutachiona hwehutachiona kana hutachiona." AIDS. January 28, 2013; 27 (3): 407-415.