Izimpawu Zingahle Zivele Kubucayi Kuya Ekusongeni Ukuphila
Uhudo luhlala lubonakala kubantu abaphila negciwane lesandulela ngculaza, kanti abaningi abangama-60% abhekene nokunyakaza okuyisithathu noma ngaphezulu kwamathumba noma amanzi amaningi ngosuku ngenxa yocingo lezimbangela, kubandakanya:
- amathumbu
- imiphumela emibi ye- antiretroviral therapy (ART)
- imiphumela eqondile yokutheleleka ngegciwane lesandulela ngculazi emaphethelweni emathunjini
- ezinye imithi
- ukukhathazeka
Isifo sohudo esingapheli (esichazwa ngokuthi siqhubeka isikhathi esingaphezu kwamasonto amane) singathinta kakhulu izinga lempilo yabantu abanegciwane lesandulela ngculazi, okufaka ukungabaza nokwesaba mayelana nokwelashwa, okwenzela imizwa yokucindezeleka nokukhathazeka, nokuyehlisa ikhono lomuntu lokulondoloza ukunamathela kwezidakamizwa ezingaphazanyiswa.
Njengabo bonke abantu, abane-HIV noma cha, isifo sohudo singabangela ukungcola kanye nokunciphisa izakhi ezibalulekile kanye ne-electrolyte, kuhlanganise ne-potassium ne-sodium. Kodwa-ke, kubantu abanesandulela ngculazi, isifo sohudo singavimbela ukungena kwemithi ethile ye- antiretroviral , okufaka isandla ekulawuleni izifo ezibangelwa yi-viral and, kwezinye izimo, ukuthuthukiswa kwesikhathi esingakapheli kokumelana nezidakamizwa .
Ukulahlekelwa ngokweqile koketshezi kungaba nokusongela abantu abanamasosha omzimba okweqile, ikakhulukazi labo abanokuchitha (okungukuthi, ukulahlekelwa isisindo sika-10% noma ngaphezulu).
Izifo Zomzimba
I-diarrhea ingabangelwa amagciwane ajwayelekile, njengama-bacteria, isikhunta noma amagciwane. Amathuba alakhulelwe ayenyuka uma umsebenzi wokuzivikela omzimba usuphelile, njengoba uvame ukulinganiswa nomuntu we- CD4 count . Ngenkathi ukutheleleka kwamathumbu kungenzeka kunoma yisiphi isigaba se-HIV, ububanzi nokuqina kwezifo ezinjalo kuvame ukwanda njengoba inani le-CD4 liwela ngaphansi kwama-200 / mL.
Phakathi kwezinto ezivame kakhulu kulawa yi- Clostridium difficile- isifo sohudo esithintekayo, isifo sohudo esithinta ama-bacterial, okuphindwe izikhathi eziyishumi ukuba kwenzeke kubantu abane-HIV kunabo bonke abantu. Ezinye izidalwa ezivame ukuhuda ehudo zifaka:
Nakuba kwenzeka kancane kancane, ezinye izimbangela ezingabangela ukubandakanya i-pancreatitis, i-malignancies yesigcawu sesisu, ngisho nezifo ezithile ezithathelwana ngocansi ezingabangela i-proctitis (ukuvuvukala kwe-rectum lining) noma izilonda zangasese / izilonda.
Imiphumela emibi ye-Antiretroviral Therapy
Uhudo luwumphumela ovamile wemizimba eminingi yezidambisigciwane, nakuba isimo ngokuvamile sizithiba futhi sizixazulule ngokuncane uma kukhona, ukungenelela. Eqinisweni, ukuhlaziywa kwe-meta eyenziwa ngo-2012 kwaphetha ngokuthi cishe amaphesenti angu-20 abantu abathintekayo ku-ART bazobhekana nesifo sohudo esiphuthumayo ngenxa yezidakamizwa.
Nakuba isifo sohudo singabangelwa yi-antiretrovirals yazo zonke izigaba, ama-ritonavir anama- protease inhibitors (i-PIs) yizidakamizwa ezivame ukuhambisana nesimo. Kuye kwaphakanyiswa ukuthi izidakamizwa zingathinta kakhulu amangqamuzana e-epithelial ahamba emathunjini, okwenza kube nokuvuza kwamanzi. Abanye balandisa ukuthi izidakamizwa zivuselela i-chloride ion secretion, okuholela ekuphumeni okukhulu kwamanzi kusuka esibhedlela se-intestinal.
Ezimweni ezinzima zehudo oluhlobene ne-ART, izidakamizwa noma izidakamizwa ezisolakala zingadingeka ukuba zifakwe endaweni uma ukwelashwa okuphawulekayo kungaphumeleli.
Imiphumela Yegciwane lesandulela ngculaza Emkhakheni Wezinsipho
Sekuyisikhathi eside i-HIV ibizwa ukuthi ibangela ukulimala kwamagciwane emgodleni wamathumbu, ikakhulukazi kumaseli we-mucocal ahlanganisa izicubu okuthiwa i -lymphoid okuthiwa i- gut-ezihambisana ne-gut . I-GALT iyindawo yokuqala yokuphindaphinda kwe-HIV kanye nokwehla kwamaseli e-CD4 uma kwenzeka ukutheleleka. Uma kushiywa kungalashwa, i-HIV ingabangela ukulimala okungenakuguquka kulezi zinhlayiya ngisho nangemva kokuqala kwe-ART.
Ukuvuvukala okungapheli okuhlobene nokutheleleka kwesikhathi eside nakho kungathinteka kakhulu umsebenzi we-mucosal wamathumbu, okwethulwa ngezimpawu ezinjengezifo ezivuthayo .
Kwezinye izimo, ngisho ne-neurons yamathumbu ayathinteka, okwenza umonakalo ongokwenyama ongabangela ngokuqondile ukuhudo oluhambisana ne-HIV.
Ezinye iziMithi ezingezona i-HIV
Ngenkathi ukugxila kubhekwa kakhulu emithini ye-antiretroviral yesiguli lapho isifo sohudo sibonakala, amanye ama-agent angakwazi ukufaka isandla.
Ama-antibiotics, isibonelo, angabulala amabhaktheriya athile emanzini okubaluleke kakhulu ekusebenzeni kwesilwane esinempilo. Lezi zidakamizwa zifaka i-Bactrim (trimethoprim / sulfamethoxazole), evame ukusetshenziswa njenge-prophylaxis ye-pneumocystis jirovecii pneumonia (PCP); kanye ne-rifampin esetshenziselwa ukwelashwa kwesifo sofuba (TB).
Ngokufanayo, ama-antacids aqukethe i-magnesium angase abangele uhudo noma enze kube kubi nakakhulu, kanye nemithi ethandwa kakhulu, i-Tagamet (cimetidine), i-Nexium (esomeprazole), ne-Prilosec (asomeprazole).
Ama-Herbal teas aqukethe i-senna , asetshenziselwa "ukuxoshwa kwe-detoxification" kanye nesisindo sokulahleka, ayaziwa nokuthi aneziphumo ze-laxative.
Ukuxilongwa Nokunakekelwa
Kubantu abahlangabezana nesifo sohudo esincane, kuya kutholakala nemithi ekhethiwe yokuthola lesi sifo. Lezi zifaka i-Imodium (etholakalayo kokubili kwe-counter and counter and amandla kadokotela), i-Lomotil (imithi), ne-Sandostatin (imithi).
NgoDisemba 2012, i-US Food and Drug Administration (FDA) ivume i-Mytesi (crofelemer) yezidakamizwa ngokukhethekile ukukhulula izimpawu ezinganeni ezingenasifo ezithathelwanayo kubantu abane-HIV ethatha imishanguzo ye-antiretroviral.
Kulezi ziguli ezine-diarrhea ezingapheli noma ezinzima, ukuhlolwa kufanele kwenziwe ngokubambisana nomchwepheshe onguchwepheshe we-HIV . Ukuhlolwa kufanele kufaka ukubuyekezwa okuphelele kokubili komlando wezokwelapha kanye ne-HIV, kanye nokuhlolwa ngokomzimba.
Isampuli se-stool sinconywa ukuhlolwa kwe-microbiological. Uma kungabikho imbangela esithathelwanayo, kubonakala ukuthi ukuhlolwa okungapheli kufanele kucatshangelwe. Lokhu kuyiqiniso ikakhulukazi ezigulini ezinehudo ezinzima (okungukuthi, ukunyakaza kwezinyanga eziyi-10 noma ngaphezulu ngosuku) noma kubantu abanokucindezelwa okukhulu kwamagciwane noma izimpawu zomtholampilo ze-HIV . Ukuhlolwa kwezidakamizwa yizincomo zeziguli ezinezinsolo zokusola.
Ukucabangela ukudla kufanele kufake ukunciphisa noma ukugwema ukudla okunamafutha noma okubabayo; i-caffeine (kuhlanganise ikhofi, itiye, nelekholethi); izintambo ezingenayo ("roughage"); ukudla okunoshukela oluphezulu (ikakhulukazi labo abaqukethe isiraphu ye-high-fructose corn); kanye nokudla okuluhlaza noma okungaphekiwe.
Ama - probiotics -isiko esiwusizo, esiphilayo sebhaktheriya esitholakala ebisi, i-yogurt, ne-keffir-kaningi ukuvimbela isifo sohudo esibangelwa ama-antibiotics ngokuvuselela izitshalo zemvelo zamathumbu. Uma i-lactose engaxolisi, i-pilisi noma i-capsule formulation nayo iyatholakala.
Uma uthola isifo sohudo, qiniseka ukuthi uthola amanzi amaningi ngokudla kwamanzi, ubeka amehlo ekuthatheleni ama-electrolyte alahlekile (kungakhathaliseki ukuthi usebenzisa ukudla okune-electrolyte-rich supplementation, noma iziphuzo ezithandwa kakhulu zamashukela). Ukudla okuncane, okuvame ukuphindaphindiwe kungase kube nokucindezela okuncane emathunjini ngesikhathi sokudla kwesifo sohudo.
> Imithombo:
> MacArthur, R. kanye noDuPont, H. "I-Etiology kanye Nokuphathwa Kwemithi Ye-Diarrhea Engenasifo Abantu abanegciwane lesandulela ngculazi Abantu ku-Eystly Active Antiretroviral Therapy Era." Izifo Ezithathelwanayo Emitholampilo. Septemba 2012; 55 (6): 860-867.
> Lima, A .; Kashuba, A .; Bushen, O .; et al. "Umhudo kanye namazinga okunciphisa ama-antiretroviral Drugs: Ukuthuthukiswa noGlutamine no-Alanyl-Glutamine Ekulinganisweni Okulawulwa Ngalokhu E-Northeastern Brazil." Izifo Ezithathelwanayo Emitholampilo. Disemba 31, 2003; 38: 1764-1770.
> Sanchez, T .; Brooks, J .; Sullivan, P .; et al. "I-bacterial Diarrhea kubantu abane-HIV Infection, 1992-2002." Izifo Ezithathelwanayo Emitholampilo. 2005; 41 (11): 1621-1627.