Izidakamizwa ze-HIV Akuyona Yodwa Icala lezinguquko zomzimba
I-Lipodystrophy , ukuphindaphinda kokunye okungaqondakali kwamafutha omzimba, sekuyisikhathi eside kuthathwa njengomthelela ohlangene ohambisana nemithi eminingi yezidambisigciwane , ikakhulukazi ezakhiweni zokuqala ezifana neZerit (stavudine) ne-Retrovir (AZT), eziseklasini lezidakamizwa okuthiwa i- nucleoside reverse transcriptase inhibitors .
Eminyakeni yamuva, amanye ama-agent ayenziwe ohlwini lwabasolwa, okufaka uSustiva (efavirenz), i-Isentress (raltegravir), kanye nekilasi lezidakamizwa ze-HIV okuthiwa i- protease inhibitors .
Uma kuthiwa lokho, imbangela eyinhloko ye- lipodystrophy -ingabe iyindlela yokuqoqwa kwamafutha (lipohypertrophy) noma ukulahleka kwamafutha (lipoatrophy) -kuyizinto ezicacile kakhulu. Ubufakazi obandayo buphakamisa ukuthi i-HIV ngokwayo, kanye nokuvuvukala okuphikisana okuhambisana nokutheleleka , kungase kube ngabanikeli abalulekile, nakuba kuze kube yamuva kube khona idatha encane yokuqinisekisa lokhu.
Ucwaningo olwenziwe ngo-2015 olwethulwa kwiNgqungquthela yamaRevrovirus kanye nezifo ezithathelwanayo e-Seattle lisize ekukhanyeni ngale ndaba. Ngokusho kocwaningo, abantu abanezinkinga eziphezulu zegciwane ekuqaleni kokwelapha (amakhophi angaphezu kuka-100,000 / mL) kubonakala sengathi banesifo esikhulu se-lipodystrophy kunalabo abanemithwalo ephansi yegciwane.
Idizayini Yokufundwa Neziphumo
Ucwaningo lwamaviki angu-96 olwenziwa ngabacwaningi e-Case Western Reserve University e-Ohio, ludinga iziguli ezingu-328 ze-HIV ezingenalo ukutholakala kokuqala kokwelashwa. Iminyaka yobudala yayineminyaka engama-36; Amaphesenti angu-90 ayengamaduna.
Omunye wabahlanganyeli wayemiswe enye yezinhlobo ezintathu zezidakamizwa ezahlukene, ezihlanganisa umhlane weTruvada (tenofovir + emtricitabine) noma
- I-Reyataz (atazanavir) + Norvir (ritonavir),
- I-Prezista (i-darunavir) + no-Norvir (ritonavir), noma
- Isentress (raltegravir).
Phakathi naleso sifundo, iziguli zanikezwa i-CAT njalo ne- DEXA (absorptiometry yama-ray amabili we-energy) ihlola ukukala izinguquko ekubunjweni komzimba.
Nakuba bekusolakala ukuthi izidakamizwa ezihlukene ze-antiretroviral zingathinta imiphumela ehlukene ezigulini, ososayensi bamangala lapho bebona ukuthi ukunyuka kwamafutha omzimba kwakunamanani kuzo zonke amaqembu. Ngokuvamile, umzimba womzimba wenyuka ngo-3% ukuya ku-3.5%, kanti amafutha omzimba akhula ngo-11% kuya ku-20% futhi ukwanda kwamafutha ngo-16% kuya ku-29%.
Uhlobo olulodwa olulinganiselwe ababengaluthola lwalusezindlini zegciwane lesiguli. Kulabo abanemithwalo ephezulu yegciwane lengculaza, amafutha angama-visceral (okungukuthi, ngaphakathi kwesikhumba esiswini) akhule ngokwesilinganiso sama-35% kungakhathaliseki ukuthi izidakamizwa noma izidakamizwa. Ngokuphambene nalokho, iziguli ezinemithwalo yegciwane engaphansi kwamakhophi angu-100,000 / mL zinezinzuzo ezingu-14% kuphela nge-Isentress futhi ngaphansi kuka-10% nge-protease inhibitors.
Ukwengeza, ikhuphuka ku-Interleukin-6 (i-IL-6), uphawu lokusebenza kwamagciwane, lihlotshaniswa nokwanda kwamafutha omzimba (okungukuthi, amafutha ngokushesha ngaphansi kwesikhumba). Lokhu kusikisela ukuthi ukuvuvukala okuhlobene negciwane lesandulela ngculaza kudlala indima eqondile ekuzuzeni kwamafutha angaphansi, noma ngokuzimela noma ngokuzimela kokungenelela kokwelashwa.
Kungakhathaliseki ukuthi izimbangela noma izimbangela, i-visceral fat gain of 30% ngaphezu kweminyaka emibili ingathà sina, ithwale inengozi yesikhathi eside yezifo zenhliziyo , isifo sikashukela , ne- dyslipidemia .
Okutholakele kunganikeza ubufakazi obengeziwe mayelana nezinzuzo zokwelapha ekuxilongweni , ngaphambi kokuba imithwalo yemvelo iphakanyiswe noma izibalo ze-CD4 ziphelile.
Imithombo:
McComsey, G .; UMoser, C .; I-Ribaudo, i-H .; et al. "Ukuguqulwa Kwemzimba Izinguquko Ngemva kokuqala kwe-Raltegravir noma iProtease Inhibitors." Ingqungquthela yama-Retroviruses kanye nezifo ezithinta amathuba (CROI); Seattle, Washington; Ngo-February 23-26, 2015; abstract 140.
Virolet, C: Delhumeau-Cartier, C .; I-Sartori, M .; et al. "I-Lipodystrophy phakathi kweziguli ezinegciwane lesandulela ngculazi: ukutadisha okuhlangenwe nakho okubambe iqhaza emthethweni wokuphila nokukhathazeka kwezempilo yengqondo." I-AIDS Research and Therapy. 2015; 12-21: DOI 10.1186 / s12981-051-0061-z.