Ukuze uphathe kahle i- HIV yakho, ukuhlolwa kwegazi okuvamile kwenziwa njalo ngesikhathi sokuvakasha kukadokotela ngamunye. Uma kuboniswa imiphumela yalezi zivivinyo, iningi labantu lizobuka inani labo le- CD4 kanye nomthamo wegciwane lesandulela ngculazi kanye ne-skim enhle kakhulu. Ngisho noma amanye amagama noma izibalo ziba nengqondo, ngokuvamile kunzima ukuqonda ukuthi zisho ukuthini ngempela noma ukuthi zisebenza kanjani kuwe njengomuntu ngamunye.
Okubalulekile ukuthi lezi zivivinyo zemihlahlandlela zibaluleke kakhulu njengezici ezithile ze-HIV. Kungaba ukubikezela isifo esithathelayo noma ukukala impendulo yakho emithini enqunyiwe-ukuthola noma ukuvimbela imiphumela emibi eyenzeka ngezinye izikhathi. Ngokuthola ukuqonda okuyisisekelo kweminye yalezi zivivinyo eziyinhloko, uzokwazi ukuhlanganyela kangcono ekulawulweni okuqhubekayo kwe-HIV yakho ngendlela esebenzayo futhi enolwazi.
Iyini imiphumela "evamile"?
Lapho ufunda umbiko welebhu, imiphumela ngokuvamile iboniswa ngenani lezinombolo. Lezi zimiso ziqhathaniswa nebala "evamile" elichazwe embikweni, okuboniswa ngezinga eliphakeme nelincane. Ukunakwa kunikezwa ngamagugu awela ngaphandle kobubanzi obuvamile njengoba lokhu kungase kusiphakamise ukukhathazeka okungenzeka. Amagugu angavamile ngezinye izikhathi agcizelelwe ngesibindi noma aboniswe ngo- "H" ngokuphakeme no- "L" ngokuphansi.
Ububanzi obuvamile busekelwe kumagugu umuntu angalindela ukuthola ngaphakathi kwesibalo sabantu besifunda sakho esithile sezwe.
Ngenxa yalokho, abahlale bebonisa lokho okuyoba "okuvamile" kumuntu ophila negciwane lesandulela ngculaza. Uma umphumela uwela ngaphandle kwebanga elilindelekile, akufanele neze kubangele i-alamu. Vele uxoxisane ngalokhu nodokotela wakho ongakwazi ukucacisa kangcono ukulingana kwalo.
Kubalulekile ukuthi uqaphele ukuthi imiphumela ingahluka kusuka ebhodini kuya kubhethri, kungenxa yezinqubo zokuhlola noma imishini yokuhlola.
Ngakho-ke, kungcono ukusebenzisa lebhu efanayo nazo zonke izivivinyo zakho. Ngesikhathi esifanayo, zama ukwenza izivivinyo zakho ngokuningi-noma-kancane ngesikhathi esifanayo ukuvakashelwa ngalunye. Amagugu enkolo angakwazi ukushintsha ngokwemvelo phakathi nenkathi yosuku, njengoba angakwazi uma umuntu egula, egugile noma esanda kugonywa. Uma ungezwa kahle ngosuku lokuhlolwa kwakho, ungase uthande ukucubungula kabusha kabusha olunye usuku uma uzizwa ungcono.
Gcwalisa i-Blood Count
Inani eliphelele legazi (i-CBC) lihlola imakhemikhali kanye ne-makeup yegazi lakho. Iphaneli lokuhlola libheke amaseli anesibopho sokuthutha i-oxygen ne-carbon dioxide emzimbeni kanye nalawo alwa nokutheleleka futhi asize ukuyeka ukuphuma kwegazi.
I-CBC ingasiza ekuxilongweni kokutheleleka, i-anemia, isifo se-autoimmune, kanye nokunye okukhathazayo kwezempilo. I-anemia ingenye yemiphumela emibi ehlotshaniswa ne- Retrovir (AZT) , isibonelo, ukuhlolwa okungabonisa amazinga okuncipha komnyoba obangelwa yisidakamizwa.
Phakathi kwezingxenye zeCBC kukhona:
- I-Hemoglobin (Hb) -Lona amaprotheni atholakala kumaseli abomvu ahlanganisa i-oksijeni futhi ayiphakamise ngqo kumathishu. Amagugu aphansi we-hemoglobin ahlobene ne-anemia. Ngezinye izikhathi ama-iron supplements anikezwe ezimweni ezinzima zokwelashwa kwe-iron anemia.
- Ama-Platelets (PLT) -Lezi zisele zithwale ukusiza ukuyeka ukuphuma kwegazi. Nakuba abantu abanesandulela ngculazi banamanani aphansi e-PLT kunabantu abaningi, uma bumnene, lezi zimiso ngokuvamile azikhathazi. Kokubili i-nucleoside reverse transcriptase (i-NRTI) ne-HIV ngokwayo ingahlotshaniswa namazinga we-PLT anciphile (okuthiwa i-thrombocytopenia) kanye nezifo ezihlobene ne-HIV, njenge-lymphoma ne- mycobacterium avium complex (MAC) .
- Ukubala kwegazi elimhlophe (i-WBC) -Amaseli amaningi egazi (leukocytes) angumzimba wamaseli alwa nokutheleleka. Nakuba i-WBC engezansi ingavamile kubantu abane-HIV, amazinga aphansi kakhulu angase abe uphawu lokutheleleka okukhulu. I-CD4 lymphocyte iphakathi kwamaseli ahlanganisa i-WBC. Ezinye zihlanganisa i-neutrophils (okuyinto ehlose amabhaktheriya nezinye izidumbu zangaphandle), ama-eosinophils (ama-parasites, amachiza), kanye nama-basophils (abhekene nokukhulula i-histamines ngesikhathi sokubanda noma ukugula).
Amafutha Wegazi
Lezi zivivinyo zenziwa ukukala izinga lamafutha ahlukene (noma "lipids") egazini, kuhlanganise ne- cholesterol ne-triglycerides . I-HIV ngokwayo ixhunyaniswe namazinga okwanda kwe-triglyceride ne-LDL cholesterol ("i-cholesterol embi") kanye namazinga wehla ye-cholesterol ye-HDL ("i-cholesterol enhle").
Ezinye izidambisigciwane, ezifana ne- protease inhibitors (i-PIs) , zingathinta amazinga e-lipid kanye. Ukuqapha lezi zindinganiso kubaluleke kakhulu kubantu abane-HIV njengoba banamathuba angama- 50 amakhulu okuthuthukisa isifo senhliziyo kunabantu abaningi.
I-lipids ehlukene ihlanganisa:
- I-low-density lipoprotein cholesterol (i-LDL) -I-lipoprotein ye- Low-density ithwala i-cholesterol esesibindi kuya kwezinye izingxenye zomzimba futhi ihlotshaniswa nokuvalwa kwe-arteries. Uma umuntu ekhulise amazinga e-LDL, izinguquko zokudla kanye / noma izidakamizwa zokunciphisa i-cholesterol zingaboniswa, ikakhulukazi kulabo abakwi-PIs.
- I-high-density lipoprotein cholesterol (i-HDL) -Ngaphandle kwalokho, lolu hlobo lwe-cholesterol linciphisa ingozi yesifo senhliziyo ngokusiza ukususa i-cholesterol embi emathisini bese uyibuyisela isibindi ngokumisa umzimba.
- I-Triglycerides -Lona uhlobo lwamafutha umzimba ogcina amandla. Amazinga aphezulu we-triglyceride ngokuvamile ahlotshaniswa nesifo se-metabolic noma i- pancreatitis .
Ukuvivinya ukusebenza kwesibindi
Lena iphaneli lokuhlola elikala ukuthi isibindi sisasebenza kangakanani. Isibindi siyilungu elibhekisela ekusetshenzisweni kwemvelo, ama-carbohydrate, namaprotheni kanye nokukhiqiza amakhemikhali e-biochemicals adingekayo ukugaya. Lezi zivivinyo zingasiza ngokuthola izifo zesibindi noma isifo sofuba kanye nomonakalo obangelwa ukusetshenziswa kwezidakamizwa, utshwala noma ezinye izinto ezinobuthi.
Isibindi sibheka imithi njengento eyingozi futhi, njengoba kunjalo, ibenza njengengxenye yomsebenzi wayo wokuxoshwa. Lokhu kungase kube "ngezikhathi eziningi" isibindi, okuholela ekulimaleni (okuthiwa i-hepatotoxicity). Ezinye iziguli ezithinta izidakamizwa ze-HIV Viramune (i-nevirapine) noma i-Ziagen (abacavir) zingase zithole ukusabela okubangelwa yi-hypersensitive ezingabangela ukushisa kwegazi ngokujwayelekile phakathi kwamasonto okuqala noma izinyanga zokuqala ukwelashwa.
Ukwengeza, cishe ingxenye yesithathu yabaseMelika abanesandulela ngculazi isifo esithintekile nge- hepatitis B (HBV) noma i- hepatitis C (HCV) . Ukuqapha i-LFTs kuyisihluthulelo ekuboneni lezi zifo.
Izivivinyo zokwazi zifaka:
- I-Alanine aminotransferase (ALT) -ALT iyi-enzyme etholakala esibindi. Lokhu kuhlolwa kusetshenziselwa ukuthola ukukhubazeka kwesibindi noma isifo eside. Amazinga we-ALT aphakanyisiwe angase akhombise ukutheleleka kwesifo sofuba. Ukwengeza kwesifo sofuba esibangelwa yi-viral, izidakamizwa ezingaphezu kwemithi kanye nemithi yokwelapha ngezinye izikhathi kungabangela amazinga e-ALT akhulayo kanye nokuphuza utshwala, izidakamizwa zokuzilibazisa, ngisho ne-vitamin A.
- I-Aspartate aminotransferase (i-AST) -I-enzyme eyenziwa ngamasipha kanye nezicubu kuwo wonke umzimba, kuhlanganise nesibindi. Lokhu kuhlolwa kusetshenziselwa kanye ne-ALT ukubona izinkinga zesibindi esebenzayo noma ezingapheli. Uma amazinga aphakanyisiwe kokubili atholakele, ukulimala kwesibindi kolunye uhlobo cishe kukhona.
- I-alkaline phosphatase (ALP) -Iyinye yemisebenzi esemqoka yesibindi ukukhiqiza i-bile, eyasiza ekugayeni amafutha. I-ALP iyi-enzyme etholakala ku-bile duct yesibindi. Lapho ukugeleza kwe-bile kunciphisa noma kuvinjelwe, amazinga we-ALP ayanda. Amazinga aphakanyisiwe e-ALP angase akhombise inkinga yesibindi noma inkongo yesibindi ebangelwa ukuvimbela (njengamatshe ensimbi) noma ukutheleleka. Amazinga aphezulu e-alkaline e-phosphate angabonisa futhi inkinga yethambo. Umhlinzeki wakho wezokwelapha uzohlose ukuqonda ukuthi kungani amazinga aphakeme nokuthi ngabe ukwanda kungenxa yesibindi noma amathambo.
- I-Bilirubin -Bilirubin yinto ephuzi etholakala nge-bile. Ukuphakama kwamazinga e-bilirubin kubangela ukuthi i-jaundice ibonakale ekutheleleni kwesifo sofuba. Isidakamizwa se-HIV Reyataz (atazanavir) singabangela futhi amazinga e-bilirubin aphakanyisiwe kwezinye, okwenza kube nokuphuziza kwesikhumba namehlo. Nakuba lokhu ngokuvamile kungabhekwa njengokulimazayo noma okubonisa inkinga yesibindi, kungabangela ukucindezeleka kulabo okuthinta.
Izivivinyo zemiSebenzi yamaRenal
Lezi yizivivinyo ezilinganisa umsebenzi wezinso ezihambelana nesistimu ye-urinary, okwenza njengezihlungi egazini nokusiza ngokulawula ama-electrolyte, amazinga omzimba we-pH, nokucindezelwa kwegazi. Lezi zivivinyo zingakwazi ukubona i-nephropathy-umonakalo noma isifo sezinso-noma ukuhlolisisa izidakamizwa ezibangelwa imithi nezinye izinto.
I-nephropathy ehlobene ne-HIV ihlotshaniswa nengozi eyengeziwe yokufa, ngesilinganiso sabantu abangamaphesenti angu-12 emhlabeni jikelele. Imithi eminingi ingathinta izinso, yingakho umsebenzi wezinso kufanele uhlolwe njalo. Lokhu kubaluleke kakhulu kunoma iyiphi imithi ye-HIV equkethe i-tenofovir (isb., I- Truvada , i- Atripla ) ngoba iyaziwa ngenxa yokulimala kwezinso ngisho nokuhluleka kwamanye.
Yini okufanele uyibuke:
- I-Creatinine -Creatinine iwumphumela wesimiso semetabolism, esakhiwe ngesilinganiso esingaguquguquki futhi sidalwe ngezinso. Izinguquko emazingeni e-creatinine zingabonisa inkinga ngezinso, kodwa zingaba umphumela wokusetshenziswa kwezidakamizwa ezithile noma izithako ezingaphezu kwamakhompiyutha, njengama-enhaninine boosters adumile ngabadlali bezemidlalo.
- I-Urea -Urea iyinhlangano yeprothemitha yemetabolism, ekhishwa emzimbeni kumchamo. Amazinga aphezulu e-urea angase abe nesiphakamiso sokungasebenzi kahle kwe-renal, ubuthi bezinso noma ukuphelelwa amandla kwamanzi.
- Isilinganiso sokuhlunga kwe-glomerular (iGFR) esilinganiselwe -Ukulinganisa kulinganisa inani legazi izihlungi zezinso ngomzuzu. Amagugu anciphayo akhombisa ukukhubazeka kobuqili. Ukuqapha lezi zimiso kubaluleke kakhulu kulabo abanoma yimiphi imithi engathinta izinso
> Imithombo:
> Islam, F .; I-Wu, J .; Jansson, J .; et al. "Ingozi ephathelene nesifo senhliziyo phakathi kwabantu abaphila negciwane lesandulela ngculazi: ukubuyekezwa okuhlelekile nokuhlaziywa kwemeta." I-HIV Medicine. Ngo-Mashi 13, 2012; 13 (8): 453-468.
> Alter, M. "Epidemiology ye-virus yesifo sofuba nesandulela ngculaza." Journal of Hepatology. Uhlu lwe-Hepatitis Viral, Amasevisi e-US for Control and Prevention (CDC), e-Atlanta, GA. 2006; 44 (1): S6-S6.
> Joint United Nations Program on HIV / AIDS (UNAIDS). "Umbiko we-UNAIDS ka-2015 we- Global AIDS Epidemic ." I-Geneva, eSwitzerland; I-ISBN: 978 92 4 1508934.