Ukufunda kubonisa ukuthi ukubhema kuyingozi ngaphezu kwe-HIV ngokwayo
Ukubhema ugwayi kuhlala phakathi kwezinkinga ezibuhlungu kakhulu futhi ezilimazayo ezibhekene nabantu abane- HIV namuhla. Uma kuqhathaniswa nomphakathi jikelele wase-US, lapho ukubhema kokubhema kuye kwehla eminyakeni yamuva kuya ezingamaphesenti angaba ngu-21, abaningi abangamaphesenti angu-42 abantu abaphila negciwane lesandulela ngculaza bahlukaniswa njengababhemayo bamanje. Lokhu kuyisibalo esesabekayo futhi esihlobene ngokuqondile nokwanda kokubili ukuhlukunyezwa okuhlobene ne-HIV nokufa ngaphambi kwesikhathi.
Abantu abanegciwane lesandulela ngculaza banamathuba amabili kunomusi
Kunokucwaninga okuncane okutholakala ukuchaza ngokugcwele amazinga aphakeme kakhulu okubhema ngaphakathi kwe-HIV. Ucwaningo oluthile luphakamisa ukuthi amazinga aphezulu okukhathazeka nokucindezeleka ayingxenye ebalulekile futhi abaningi baphendukela kwi-nicotine njengendlela yokubhekana nokucindezeleka kwansuku zonke kwe-HIV.
Kodwa akucaci ukuthi lezi zindaba ezingokomzwelo ziyisizathu sokusebenzisa ugwayi, noma uma nje benza imizamo yokuyeka ingasebenzi kangcono kulabo abaphila negciwane lesandulela ngculazi.
Idatha iphikisana. Ngokuhlaziywa kwezibalo ezivela e-US Centers for Disease Control and Infection (CDC), ababhemayo abane-HIV e-US bavame ukuba badala kunokuba bancane, abanamaphesenti angu-58 abaneminyaka engama-45 ubudala nangaphezulu, amaphesenti angu-40 abaneminyaka engu-25 kuya ku-44, futhi kuphela amaphesenti amabili abaneminyaka engu-18 kuya ku-24.
Lezi zinombolo zikhomba ukuthi ukucindezeleka okuhlobene negciwane lesandulela ngculazi akuyona neze into ebangela ukubhema, ikakhulukazi abasha abashaya igciwane lesandulela ngculaza-abathola amaphesenti angama-26 okutheleleka okusha-abakwazi ukubhema kakhulu kunokuba abalingani babo abangenayo i-HIV (amaphesenti amabili kuqhathaniswa namaphesenti angu-19).
Esikhundleni salokho, lezi zibalo ziveza ukujwayela okujwayelekile e-US, lapho abantu abasha ababhemayo bengaphansi kwamathuba okuhlola ukubhema kokubhema kunabashayeli abasha (amaphesenti angama-84 kuya kuma-66 amaphesenti).
Ngokuphambene, ukuziphatha ngokocansi akusebenzi kancane ekutheni ukubhema. Eqinisweni, izinombolo ziyinto engafani nhlobo, kanti abantu abaningi abesilisa nabesifazane ababhemayo (51 amaphesenti) njengama-gay, ama-lesbians, noma abesilisa nabesifazane (amaphesenti angu-49) -ngaphezu kokuthi ukutheleleka okusha kwamadoda alala namadoda (MSM) izikhathi ezintathu ephakeme kunalabo abathandana nabo.
Lokhu kusho ukuthi amaphesenti amakhulu abantu ababhemayo abanegciwane lesandulela ngculaza, empeleni, abesilisa nabesifazane. Okwenza lokhu kuhlale kungacacile-ikakhulukazi njengoba izinga lokubhema phakathi kwama-gay, abesilisa besifazane kanye nabalingani bobulili emphakathini jikelele sekucishe kube kabili kwezingqingili, ngokusho kombiko we-2010 we-American Lung Association.
Indlela Ukubhema Kuthinta Ngayo Ngokuqondile Abantu abane-HIV
Ukubhema kunomthelela omkhulu ekuchazeni kwabantu abanesandulela ngculaza ezweni elithuthukile kunanoma yikuphi ukugula okuhlobene ne-HIV. Lokhu kulandela isifundo se-2013 esivela e-Copenhagen University Hospital, esibonisa ukuthi ukubhema, futhi ngokwakho, kunciphisa isikhathi sokuphila kubantu abane-HIV eminyakeni eyi-12.3.
Ngaphezu kwalokho, ingozi yokufa (ukuthi ngabe ihlobene ne-HIV kanye nokungenayo i-HIV) ibonakala ingaphezu kwezikhathi ezinhlanu ezibhemayo abanegciwane lesandulela ngculazi kunabantu abange-HIV abangakaze babheme.
Phakathi kwezinkinga zokubhema eziqondene ne-HIV:
- Ukubhema kuyisici esisodwa esikhulu kunazo zonke esihlobene nesifo senhliziyo esibi (ACS) kubantu abane-HIV. Ngokusho kocwaningo oluvela eNyuvesi yaseBarcelona, umnikelo wokubhema ku-ACS kubantu abadala abane-HIV wawukhulu kunomnikelo wesifo sikashukela noma umfutho wegazi ophakeme futhi wawungaphezu kokuphindwe kabili kunalokho kubantu abadala abangenayo i-HIV (amaphesenti angu-54 kuya kuma-31%) . Ukusetshenziswa kwezidambisigciwane noma inani le- CD4 lomuntu / umthamo wegciwane lesandulela ngculaza kubonakala sengathi kunomthelela omkhulu ekubhekeni kwababhemayo abane-HIV noma ngabe cha.
- Ukubhema kubhekwa njengengozi enkulu ekuthuthukiseni umdlavuza wamaphaphu . Eqinisweni, kukhona ukwanda kwamaphesenti angu-14 emdlavuza wamaphaphu phakathi kwabokubhema abanegciwane lesandulela ngculazi, abazimele ngokwezibalo ze-CD4 yomuntu noma umlando wesifo se-lungs. Ucwaningo olusuka eSwitzerland lwe-HIV Cohort Study lubonisa ukuthi amazinga okusinda ayampofu kubantu ababhemayo abanegciwane lesandulela ngculazi abakha amaphilisi amaphaphu, kanti amaphesenti angu-14 kuphela asaphila eminyakeni emibili ngemuva kokuxilongwa. Lokhu kusho ukuthi ababhemayo bebevele beboniswa ukuthi banengozini ephansi kakhulu kunabokubhema, abaqokomisa ukubaluleka kokuyeka ukubhema kulabo abane-HIV.
- Ukubhema kuqhubeka futhi kuphakamisa ingozi yezifo ezingenasifo sokuphefumula (COPD) kanye ne-pneumonia ye-bacterial. Ababhemayo abakhona abane-HIV abanalo kuphela izimpawu zokuphefumula kunabalingani abangabhemi, banokunyuka okuphindwe kabili engcupheni yokufa. Ezinye izifundo zibonise ukuhlobana phakathi kokubhema kanye ne- candidiasis esophage .
- Kukhona ubudlelwane obuqinile phakathi kokubhema nokutheleleka komuntu we-papillomavirus (HPV) kokubili abesifazane nabesilisa abane-HIV. Abesifazane abane-HIV ababhemayo basuke besengozini yokutheleleka kwe-HPV kunebesifazane abane-HIV abangabhemi. Ngokufanayo, ukubhema kwamadoda anesandulela-ngculazi kuhlotshaniswa nengozi eyengeziwe yokuthuthukiswa kwezilonda ze-HPV ezinqandekile. Izifo ezithathelwanayo ze-HPV zixhunyaniswa ngokuqondile nengozi enkulu yomdlavuza womlomo wesibeletho kubantu besifazane kanye nomdlavuza wesilisa emadodeni. Ucwaningo oluningi lubonisa ukuthi ukubhema kunemiphumela emibi emzimbeni womuntu, kokubili systemic kanye mucosal (okugcina okubandakanya amangqamuzana eLangerhans ezivikelo ezihlanganisa umlomo wesibeletho kanye ne-anus). Izibalo ze-CD4 ezingaphansi kuka-350 amaseli / mL nazo zibhekwa njengengxenye yabahlanganyeli.
- Ukubhema ugwayi kungandisa ingozi yowesifazane yokudlulisela i-HIV kumntanakhe ngesikhathi sokubeletha, kanti ukukhishwa kwesikhumba ngaphambi kwesikhathi kunomama owake waphuza ngesikhathi sokuqala kokukhulelwa. Konke okukhulunywe ngakho, ingozi yokudlulisa okubonakalayo iboniswe ukuthi iphakeme kangako kathathu kwabesifazane abangabhemi abane-HIV.
- Ukubhema kuhlotshaniswa nengozi eyengeziwe yokulahlekelwa kwamathambo (isib. I-osteopenia, i-osteoporosis), futhi kubhekwe njengengozi eyimvelo yokuzihlukumeza phakathi kwalabo abane-HIV. Ubudala obudala kanye nohlanga olumhlophe nazo zibikezela izigameko ezenzekile.
Izinzuzo Zokuyeka
Izinzuzo eziyisikhathi eside nesikhathi esifushane zokushiya yizo zombili ezingenakuphikwa futhi ezicacile. Ukuyeka ukubhema kunciphisa ingozi yesifo senhliziyo kubantu abanesandulela ngculazi, ngokuhlola okukodwa okubonisa ukunciphisa ingozi yama-65% emva kweminyaka emithathu. (Ucwaningo olusuka e-Aquitaine Cohort Study eFrance lukhombisa ukuthi ukuyeka ukuphela kungase kube yiyona kuphela into ehlobene nokuthuthukisa ingozi yomzimba kubantu abanesandulela-ngculaza nangaphezu kwezidakamizwa ezinciphisa izidakamizwa noma ukwelashwa kwama-antiretroviral.)
Ngokufanayo, ingozi yomdlavuza wamaphaphu ingancishiswa ngamaphesenti angaba ngu-50 kubantu ababhemayo abanegciwane lesandulela ngculazi abaye bayeka unyaka noma ngaphezulu. Imiphumela efaniswayo ibonakala kuziguli ezine-COPD, i-pneumonia ye-bacterial, nezinye izimo zokuphefumula ezingenasifo.
Kubaluleke kakhulu ukucindezeleka ukuthi kungekudala kuncono uma kulandela ukuyeka, ikakhulukazi kulabo abanamasosha omzimba ahlaselekile. Ucwaningo oluvela esikhungweni se-Anderson Cancer eNyuvesi yaseTexas lubonise ukuthi ukuyeka ukubhema kunganciphisa umthwalo wezimpawu ezihlobene ne-HIV phakathi nezinyanga ezintathu futhi ukuthi izimpawu zingaqhubeka nokunciphisa njengoba isikhathi singazange sibhebhe.
Ngaphezu kwalokho, ukubhema ukuzithiba kuhambisana nokuzibophezela okunamandla kulabo abakwelashwa ngezidambisigciwane.
Imithombo:
UMdodo, R .; I-Frazier, E .; UMattson, C .; et al. "Ukubhema ugwayi phakathi kwabantu abadala abane-HIV: ukunakekelwa kwezokwelapha, i-US, 2009." Ingqungquthela ye-20 yama-Retroviruses kanye nezifo ezivame ukubhekana nazo (CROI 2013). I-Atlanta, Georgia; Mashi 3-6, 2013: Abstract 775.
I-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 wamangqamu esifundweni seSwitzerland se-HIV: indima yokubhema, ukuzivikela komzimba kanye nokutheleleka kwe-pulmonary." I-British Journal of Cancer. NgoJanuwari 12, 2012; 106 (3): 447-452.
Ama-Crothers, K .; Griffith, T .; McGinnis, K .; et al. "Umthelela wokubhema ugwayi ekufeni, izinga lokuphila, kanye nokugula okwenziwe yi-comorbid phakathi kwama-veteran abane-HIV." I-Journal of General Medicine Internal. Disemba 2005; 20 (12): 1142-1145.