Dhiyabhorosi inosangana neHIV uye vamwe
Sezvo zita rayo rinoratidzira, hutachiona hwehutachiwana hutachiona hweHIV hunoita kuti hutachiona huve nehutachiwana. HIV inonyanya kurwisa masero ezvirwere anonzi CD4 positive T-cells . Sezvo aya masero anofa, muviri unowedzera kukanganisa kutapurirana uye zvirwere izvo vanhu vane utano vanogona kurwisana.
Zvimwe vanhu vasingazvizivi ndezvokuti utachiwana hweHIV pachahwo hunogona kukonzera zvinetso zvakakomba kunyange pasina humwe hutachiona hunobatanidzwa.
Imwe yezvinetso izvi HIV-Associated Dementia (HAD) , inozivikanwawo seHIV encephalopathy kana AIDS kukumanikidza dambudziko.
Kunyange zvazvo yaisimbofungidzirwa kuti YAKABADZIKA chete muhutachiwana hweHIV, isu tava kuona ikozvino kuvanhu vasina kumbogadzikana pamishonga yavo uye vane maCD4 akawandisa.
Zvinokonzerwa neHIV-Yakabatana Neurocognitive Disorders
Mhando dzehutano hwekunzwisisa hunobatanidza neHIV huripo pamusana pekunyanyisa. Panoongororwa pamwe chete, izvi zvinokonzerwa nehutachiona hweHIV-Yakabatana Neurocognitive Disorders.
Nzira yakanyanya yehutachiwana hweHIV inobatanidza Neurocognitive Disorder inogadziriswa neurocognitive dispairment, iyo mumwe munhu anonyatsotarisa pane zvimwe zvekuongorora kweuropiychological, asi hupenyu hwavo hahuna kuonekwa. Kana hupenyu hwomunhu hunove hwakakanganiswa asi husingaregi, vamwe vanachiremba vacharamba vachiziva kuti murwere ane chirwere chiduku-motor disorder (MCMD).
Kana dambudziko racho rose rinoonekwa pamapurogiramu epfungwa uye rinopesana nehupenyu hupenyu hwezuva nezuva, kuongororwa kunogona kuitwa neHIV-Associated Dementia.
Zviratidzo zveDhiyabhorosi inosanganiswa neHIV
Vanhu vazhinji vanofungidzira kuti HIV-Associated Dementia (HAD) ichave yakafanana nemhando dzinozivikanwa zviri nani dzehutano hwemangara dzakadai seAlzheimer's disease.
Izvi hazviwanzo zvakadaro. Kunyange zvazvo chiyeuchidzo chinogona kupera simba sezvinogona muhosha yeAlzheimer, vanhu vane HIV-Associated Dementia vanogonawo kuoma kuisa pfungwa kana kutarisira, izvo zvisingaonekwi nguva dzose muAlzheimer's disease. Vanhu vane hutachiwana hweHIV-vakabatana neDementia vanonoka kudarika zvavanenge vari, kwete kungofunga, asi kazhinji pakufamba zvakare. Nenzira iyi, dhementia inokonzerwa neHIV inogona kutevedzera Parkinson's disease dementia (PDD).
Vanhu vane HAD vanogonawo kuchinja mune manzwiro avo akadai sokusava nehanya, uko vasina chavanoda kuita zvakawanda. Sezvo chirwere ichi chichifambira mberi, vanogona kuwedzera kuvhiringidzika, uye anenge 5 kusvika ku8 kubva muzana vanoita AIDS mania nemafungiro epfungwa zvakadai separanoia uye mazano.
Chikonzero cheHAND
HIV inopinda munharaunda yehutano yenyika (CNS) nguva pfupi mushure mokunge utachiona hwekutanga. Kunyange zvazvo uropi hunochengetedzwa nehutatu hwemashupu anonzi ropa-uropi hunopinza , mamwe masero omumunodzivirira, akadai macrophages , anogona kupinda. Izvi zvinoita kuti tive nemafungiro ezvimwe. Kazhinji, masero aya anoshandiswa kurwisa utachiona. MuHIV, kunyange zvakadaro, masero ari kunyanya kutakura utachiona. Zvakangofanana nekupfekedzwa semurindiri kuitira kuti apinde muimba yakasimba.
Kamwe kacho muuropi, hutachiona hahupindi masero ehutano pachahwo asi hukuvadza ivo nenzira isina kukodzera kuburikidza nekukonzera kupopota kwekupindura.
Njodzi Zviitiko zveHAD
Dambudziko guru reHAD rinosanganisira kutadza kushandiswa kwemishonga inorwisa mahararetroviral uye kuonekwa kwehutachiona hwehutachiona . Nguva yakareba iyo mumwe munhu akatapukirwa neHIV haina kukosha kudarika uko kuderedzwa kweCD4 yakawanda sei.
Kuongorora kweHAD
Nemhaka yokuti HIV inoita kuti vanhu vave nyore kune mamwe matambudziko anogona kukonzera kushanduka kwemagariro, zvakadai sezvirwere uye kanzira, kuongorora kwakakwana kunodanwa apo mumwe munhu ane HIV ane shanduko mukufunga kwavo.
Izvi zvinonyanya kuitika kana mumwe munhu ari kukurumidza kukurumidza. Dhementias yakawanda inononoka, uye nzira yekukurumidza inogona kureva kuti kune dambudziko rakasiyana riri kuenderera mberi, kana kuti HIV inenge isingakwanisi kudzora.
Kubatwa nehutachiwana hweHIV kunofanira kusanganisira MRI yehuropi kutarisa zviratidzo zvehutachiona kana kenza. Dhementia inosangana neHIV inokonzera kuchinja kukuru mumufananidzo wehuropi hutorwa neMRI. Uropi hunogona kuratidzirwa kuva hunopisa, uye kune huwandu huwandu hwemvura yakachena yemafuta, iyo inenge yakajeka nzvimbo dzisingabvi.
Kurapa kweHAD
Kufanana nemamwe marudzi mazhinji evanhu vane dhementia, hazvisi pachena kuti chii, kana chiripo, kurapa kunogona kubatsira munhu ane HIV-Associated Dementia. Imwe yemishonga inowanzoshandiswa muAlzheimer's disease, Memantine, yakaratidza kuti haibatsiri, uye hapana chaicho chikonzero chekutenda kuti mamwe mishonga inoshandiswa kuAlzheimer ingabatsira.
Kuteerera kwakanaka kune antiretroviral therapy kwave kuchibatanidzwa nehupenzi huri pasi hweHAD, asi hazvina chokwadi kana kuwedzera kana kuchinja mishonga kune mumwe munhu ane HAD kune chero ipi zvayo inobatsira. Mune rumwe ruzivo, kuchinja mishonga inorwisa mabhakitiriya yakaita kuti vanhu vawedzere. Zvisinei, kana mumwe munhu ane zvakanyanya pamusoro peHIV-Associated Dementia, vanhu vazhinji vachachinja mishonga, kunyanya kana mishonga murwere aripo haazivikanwe nekupinda mukati memagetsi yenyika (CNS). Mishonga yakadai saTenofovir, zalcitabine, nelfinavir, ritonavir, saquinavir uye enfuviritide zvose zvakaratidzwa kuva nepfungwa yakanaka muNCS, kunyange zvazvo kubatsirwa kwechirwere ichocho kuchiramba chiri mubvunzo, uye kunogona kukonzera kukuvadza kupfuura kunaka.
Vamwe vanhu vanoshandisa methylphenidate (Ritalin) kuti vabatsire nekuziva zvishoma nezvishoma. Muzhinji, kugara mupfungwa, mune zvehupfumi uye mumuviri zvinoshandiswa.
Utachiona hweHIV huri dambudziko rakakomba, uye zvinosuruvarisa, isu tisingazivi zvakawanda nezvayo. Kusiyana nedzimwe mhando dzakawanda dzedementia, vanhu vane hutano hweHIV dzimwe nguva vanovandudza, uye zvino zvakakosha kukurukura zviratidzo izvi nechiremba anokwanisa.
Sources:
Antinori A, Arendt G, Becker JT, et al. Yakagadziriswa tsvakurudzo yeduology yeHIV-ine chokuita neurocognitive disorders. Neurology 2007; 69: 1789.
Nenenclature uye kutsvakurudza nyaya tsanangudzo yehutano hwezvirwere hwehutachiona hwehutachiona hwehutachiona hwechirwere chetachiona (HIV-1). Nhoroondo yeboka rekushanda reAmerican Academy of Neurology AIDS Task Force. Neurology 1991; 41: 778.
Mutengo RW. Zvinetso zvehutano hwehutachiona hweHIV. Lancet 1996; 348: 445.