4 Izenzo Ezilimaza Ukwelashwa Kwe-HIV

Indlela Okukhethwa Ngayo Indlela Yokuphila Kungakunciphisa Iminyaka Engu-15

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Ukungavumelani kwezidakamizwa ezimbi: Ukulahlekelwa kweminyaka eyi-10

Kuye kwacaca ukuthi ukuxilongwa kokuqala kanye nokuphathwa kwe-HIV kungakwandisa isikhathi sokuphila . Eqinisweni, ucwaningo olusuka ku-Multicenter AIDS Cohort Study (MAC) luphelile ngokuthi umuntu oqala ukwelashwa kwe-antiretroviral (ART) e-CD4 ebala ngaphezu kwama-350 amaseli / μL angaba nempilo engalingani noma enkulu kunaleyo engangenasifo ngabanye. E-US, lokho kuholela esikhathini sokuphila seminyaka engama-76 emadodeni naseminyaka engu-81 yabesifazane.

Ukucabangela namuhla ukuthi, kuyilapho i-ART ihambisana ngokuzuza okujulile eminyakeni yokuphila, imikhuba nezinqumo zansuku zonke esizenzayo zingathatha eziningi-uma kungezona zonke-zalabo abazuzayo. Okulandelako yimikhuba emi-4 enganciphisa impilo yakho ngeminyaka engama-15 kanye nezinyathelo ongayithatha ukuze uphendule lokho kulahlekelwa uma une-HIV.

Ukungabi nesilinganiso somuthi wakho we-HIV ngumuntu kuphela. Ukwenza njalo kungenye indaba, kungathinti nje kuphela ukuphumelela kwezidakamizwa zakho, kodwa inkambo yesifo sakho.

Nakuba imishanguzo ye-antiretroviral ilula kakhulu namuhla kunanini ngaphambili-ngamaphilisi ambalwa, imiphumela emibi yecala, kanye nemishanguzo elula yokulanda-njengoba bambalwa abangamaphesenti angu-60 alabo abakwelashwa abakwazi ukugcina amazinga okunamathela adingekayo ukuze aqede ngokuphelele igciwane. Ngokuhluleka ukugcina umthamo wegciwane elingenakutholakali, iziguli cishe zithola ukwehluleka kokwelashwa njengoba ziqhubeka zivinjelwa ezidakamizwa zabo ze-HIV. Ngenxa yalokho, izinketho zokwelapha ezibalulekile zilahlekile, njalo njalo.

Ukwehluleka kokwelapha kuvame ukuhlobana nokunamathela kwezidakamizwa ezimbi , ngisho naphakathi kwalabo abanomsebenzi ophansi kakhulu wegciwane. Ucwaningo oluvela eMyunivesithi yaseMcGill eMontreal luye lwasikisela ukuthi iziguli ezinemithwalo yegciwane eliseduze "etholakalayo" (okungukuthi, phakathi kwama-50 no-199 amakhophi / i-mL) zinengozi engamaphesenti angama-400 enkulu yokwelapha ukwelashwa kunelabo abanokucindezelwa okunamandla nokuphelele kwegciwane.

Ngonyaka wezi-2015, isifundo se-UK Coalborative Cohort (UK CHIC) Isifundo sabheka umthelela wokucindezela amagciwane emkhakheni wokuphila komuntu futhi waphetha ngokuthi indoda eneminyaka engu-35 ubudala ayikwazi ukufeza umthamo wegciwane elingatholakali ngenkathi i-ART ingalindela ukulahlekelwa yi-10 iminyaka yokuphila, ngisho noma inani le-CD4 lingaphezu kwamangqamuzana angu-350 / μL.

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Ukujova Ukusetshenziswa Kwedakamizwa: Ukulahlekelwa Iminyaka engu-11

Ukujova ukusetshenziswa kwezidakamizwa akuhlanganisi nje kuphela engozini enkulu yokuthola i- HIV nesifo sofuba sesifo sofuba , futhi singandisa amathuba okufa ngenxa yokutheleleka okuhlobene nengculazi, ngisho nalabo abakwazi ukufeza ukwelashwa okubangelwa yi-HIV.

Ucwaningo oluvela eBrithani Columbia Centre for Excellence kwi-HIV / AIDS eVancouver lihlolisise izinga lokuphila lokuphila kwabantu abalinganiselwa ku-2 637 abasebenzisa izidakamizwa zegciwane lesandulela ngculaza (ama-IDU) ngaphezulu kweminyaka engama-20, ukuqoqa isikhathi nezimbangela zokufa kwabahlanganyeli abangu-200 abafile phezu kwesikhathi seminyaka eyisikhombisa. Ngesikhathi ukudlula ngokweqile nokuzibulala kudla ngamaphesenti angu-19 okushona, i-HIV kanye nezifo ezihlobene nazo zaziningi kakhulu, ezihlobene nokulahlekelwa iminyaka engaphezu kwengu-11 yokuphila kungakhathaliseki ukuthi isimo sezokwelapha.

Ucwaningo olufanayo oluvela eTufts-New England Medical Centre lubuye lubuye lubuke ama-IDU angu-656 ngaphezu kweminyaka emihlanu futhi iphetha ngokuthi iningi labantu abafa phakathi kwabasebenzisi abane-HIV (amaphesenti angu-66) babhekwa i-HIV noma ukutheleleka okuhambisanayo, kuyilapho owesithathu ayehlobene ngokuqondile nokusebenzisa kabi izidakamizwa noma ubudlova.

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Ukubhema: Ukulahlekelwa kweminyaka engu-12

Ukubhema , njengesici esizimele, kubhekwa ukuthi kunomthelela omkhulu kakhulu ekufweni nasekufeni kubantu abanegciwane lesandulela ngculaza kunezinye izifo ezithinta i-HIV noma ezingenayo i-HIV. Okwenza lokhu kube nzima nakakhulu ukuthi abantu abanesandulela ngculaza banamathuba amabili okubhema kunabantu abangenalo igciwane futhi bathambekele ekuhlakuleleni izifo ezihlobene nokubhema 10 kuya eminyakeni engu-15 ngaphambili ngaphambili jikelele.

Isifundo se-2013 esivela eCopenhagen University Hospital sabika ukuthi ukubhema, futhi ngokwakho, kunciphisa isikhathi sokuphila ngokulinganiselwa kweminyaka engu-12 kubantu abane-HIV-kabili engozini yesifo senhliziyo esicindezelayo, ngokuphindaphindiwe ingozi yokufa kwesifo se-chronic obstructive pulmonary (COPD) ), nokwandisa ingozi yomdlavuza wamaphaphu ngamaphesenti angama-1400 uma kuqhathaniswa nomphakathi jikelele.

Ngokuphambene nalokho, ukuyeka ukubhema phakathi kwabantu abane-HIV kuhlotshaniswa nokunciphisa izinga lokunciphisa isifo senhliziyo emva kokuphela kweminyaka emithathu kanye namaphesenti angu-50 awela phansi engozini yomdlavuza wamaphaphu emva konyaka owodwa kuphela.

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Ukulahla Ukwelashwa Kwe-HIV: Ukulahlekelwa Kweminyaka Engama-15

Ukuziqhenya nokugwema kukhona imikhuba emibili umuntu onesandulela ngculazi akakwazi ukuzitholela, ikakhulukazi uma kuziwa nge-HIV yokwelapha. Ngokubambezela ukwelashwa iminyaka namashumi eminyaka, uvumela ukuthi igciwane lingadli isidingo sokuzivikela ngomzimba wakho ngenkathi ithumela umzimba wakho iminyaka yokuvuvukala okungabangela ukuthuthukiswa ngaphambi kwesikhathi sokugula okuhambisana nokuguga .

Abacwaningi be-UK CHIC Study baphetha ngokuthi umuntu ophuza ukwelashwa kuze kube yilapho inani lakhe le-CD4 liwela ngaphansi kwama-350 cells / μL lingalindela ukuphila iminyaka engaphansi kwengu-15 kunomuntu oqala ngaphezu kwama-350 cells / μL. Ehlangothini le-flip, ukuqala ukwelashwa ngesikhathi sokuxilongwa , kungakhathaliseki ukuthi i-CD4 count, akugcini nje ukwandisa amathuba okuphila okuvamile kodwa kunciphisa ingozi ye-HIV-nezifo ezingahlobene ne-HIV ngamaphesenti angu-53.

> Imithombo:

> I-INSIGHT START Study Group. "Ukuqaliswa Kwethemishana Ye-Antiretroviral In HIV Early Infection." I-New England Journal of Medicine. Julayi 20, 2015; I-DOI: 10.1056 / NEJMoa1506816.

> Laprise, C .; de Pokomandy, A .; I-Baril, J .; et al. "Ukungaphumeleli kwe-virologic ngemuva kwe-viremia eqhubekayo yezinga eliphansi eqenjini leziguli ezinegciwane lesandulela ngculazi: imiphumela evela eminyakeni engu-12 yokubona." Izifo Ezithathelwanayo Emitholampilo. Novemba 2013; 57 (10): 1489-96

> May, M .; Gompels, M .; Delpech, V .; et al. "Ngiyaphila ekulindeni kokuphila kwabantu abane-HIV-1 abathandekayo be-CD4 + count and response response load on antiretroviral therapy." AIDS. Ngo-Meyi 15, 2014; 28 (8): 1193-1202.

> Helleberg M .; U-Afzal, uS .; I-Kronborg, G .; et al. "Ukufa okubangelwa ukubhema phakathi kwabantu abanegciwane lesandulela ngculazi-1: isifundo somphakathi esivela kubantu abaningi." Izifo Ezithathelwanayo Emitholampilo. Mashi 2013; 56 (5): 723-734.

> Clifford G .; ULise, M .; UFranceschi, uS .; et al. "Umdlavuza we-Lung esifundweni seSwitzerland se-HIV: indima yokubhema, i-immunodeficiency kanye nokutheleleka kwe-pulmonary." I-British Journal of Cancer. NgoJanuwari 12, 2012; 106 (3): 447-452.