Izimbangela, Ukwelashwa Nokuvimbela Ukulahlekelwa Isisindo Esingaqondakali
I-HIV yokuchitha i-syndrome ichazwa ngokuthi ukulahleka kwesisindo okuqhubekayo, okungazibandakanyi okubonakalayo kuziguli ezine-HIV. Ama-US Centers for Disease Control and Prevention (CDC) ahlukanisa ukuthi i-HIV ishaywa njengesimo esichaza i- AIDS ngo-1987, futhi sichazwa yizici ezilandelayo:
- Ukulahlekelwa kwesisindo okungenani u-10%;
- okwenzeka phambi kwehudo noma ubuthakathaka obungapheli;
- nomkhuhlane oqoshiwe;
- isikhathi esingenani izinsuku ezingama-30;
- okuyinto engeyona into ehambisana nesimo esifanayo ngaphandle kokutheleleka nge-HIV ngokwayo.
Ukunciphisa (i-cachexia) akufanele kudidaniswe nokulahleka kwesisindo, okugcina okusho ukulahlekelwa isisindo somzimba. Ngokuphambene, ukuchithwa kubhekisela ekulahlekelweni kwesayizi nomzimba, ikakhulukazi isisindo somzimba. Kungenzeka, isibonelo, ukuthi umuntu onesandulela ngculazi alahlekelwe umthamo omkhulu wemisipha ngenkathi ehola ukwanda kwamafutha omzimba.
Yini Ebangelwa Ukunciphisa I-HIV?
Ngesikhathi sokutheleleka nge-HIV, umzimba ungadla amandla amaningi okugcina amandla. Eqinisweni, ucwaningo luye lwabonisa ukuthi abantu abanesandulela ngculaza-ngisho nalabo abaphilile futhi abanempilo-bazoshisa ama-khalori angu-10% ngaphezu kwabantu abangenakho ukutheleleka. Njengoba amaprotheni anamafutha aguqulelwa kalula kunamandla kunamafutha, umzimba uzovamise ukuguqula amaprotheni kuqala lapho izinto ziphelile noma zingatholakali egazini.
Ukususwa kwesiprotheni se-serum kungaba umphumela wokungondleki noma ukugula okungenayo i-malabsorptive lapho umzimba ongakwazi ukuwuthatha izakhi. Ezimweni zokuchitha isandulela ngculaza, isifo sohudo esingajwayelekile sivame ukuhlotshaniswa nokuhlukunyezwa kokudla okunomsoco, futhi kungaba umphumela we-HIV ngokwayo njengoba igciwane lidala ukulimala kwamathisini omzimba emathunjini.
Ukulahlekelwa kwesisindo samathambo (kancane futhi ngokujulile) kuvame ukuphawulwa kubantu abane-AIDS, nakuba kungenzeka kunoma isiphi isigaba sokutheleleka nge-HIV .
Ukwelashwa kwegciwane lesandulela ngculaza kanye ne-Antiretroviral Therapy
Ngaphambi kokuba kutholakale ukwelashwa kwama-antiretroviral (ART) , ukusabalalisa kokuchitha kwakulinganiselwa ku-37%. Kodwa-ke, naphezu kokusebenza kwe-ART, ukuchithwa kusalokhu kukhathazeka kakhulu, kanti ezinye izifundo zikhomba ukuthi noma yikuphi okuvela ku-20% kuya ku-34% weziguli kuzothola izinga elithile lokuchitha, nakuba kungekho emazingeni amabi ngaphambili ayengabonwa.
Ngenkathi i-ART yaziwa ngokuthuthukisa ukulahlekelwa kwesisindo nokuntuleka kwesondlo kubantu abaphila negciwane lesandulela ngculazi, kungase kungavimbele ukulahlekelwa kwesisindo somzimba noma ukuyibuyisela lapho isisindo somzimba siphindwa. Okunye okuphathelene nokuthi ukulahlekelwa okungenani u-3% wemisipha yomzimba kungandisa ingozi yokufa ezigulini ezine-HIV, kanti ukulahlekelwa okungaphezu kwezingu-10% kuhlotshaniswa nobungozi obukhulu obuningi kuya kwesithupha.
Ukwelapha Nokuvimbela Ukunciphisa I-HIV
Okwamanje ayikho indlela eqinisekisiwe yokwelapha ukushaywa i-HIV njengoba kunezici ezivame ukungenelela ezithintekayo esimweni (isb; izifo ezithintekayo, imiphumela yokwelapha izidakamizwa, ukungondleki).
Kodwa-ke, kuneziqondiso ezijwayelekile okufanele zilandelwe ukuze kuphumelele ukubhekana nokulahlekelwa kwesisindo nokulahleka kubantu abane-HIV:
- Ukuqaliswa kwama-ART ukunciphisa ingozi yokutheleleka okuthengelayo , kuhlanganise nalabo abathintekayo emathunjini.
- Ukulungiswa kokudla ukwandisa ukudla kwe-caloric ngo-10% (futhi kufinyelele ku-30% kulabo abaphulukisa ekuguleni). Ukulinganisela kokudla kwamafutha, ama-carbohydrate namaprotheni kufanele ahlale efana. Imfundo yokudla okunempilo kanye nokululekwa kufanele kuhlolwe kulabo abanezinkinga zesisindo (kufaka phakathi isisindo esincane noma isifo se-metabolic) noma ukungabi nokufinyelela kokudla okunempilo.
- Qinisekisa ukuzivocavoca njalo, ugxile ekuqeqesheni ukumelana nokwakha noma ukugcina ubuhlungu besisindo.
- Ngenkathi ukusebenza kwe- testosterone yokwelashwa esikhundleni sokuhlala kusalokhu kungacacile uma kwenzeka i-HIV ishabalalisa, kungase kubizwe ezimweni lapho ukwehluleka kwe-testosterone (hypogonadism) kuphawulwa.
- Imikhiqizo yokudla okunomsoco (njengokukhuthaza i-VHC, Qinisekisa noma i-Nestlé Nutren) ingaba usizo kubantu abanenkinga yokudla ukudla okuqinile noma labo abadlayo kodwa abakwazi ukuthola isisindo. Kodwa-ke, njengazo zonke izithako zokudla, lezi zinto azihloswanga ukufaka ukudla okunempilo okuhle.
- Ngenkathi i-multivitamin yansuku zonke inconywa ukuqinisekisa ukuthi ukudla okunomsoco okunempilo, kunobuncane bokufakazela ukuthi ukuxhaswa komkhiqizo ngamunye kunomthelela noma inzuzo ezimweni zokuchitha i-HIV (futhi empeleni kungase kukhulise isifo sohudo kanye ne-malabsorption uma kuthathwe ngokweqile).
- Uma kwenzeka uhudo oluqhubekayo noma olungapheli, uphenyo lwezokwelapha kanye nokuxilongwa lunconywa ukukhomba izimbangela ezikhona. Imithi yokulwa nesifo sohudo kufanele imiswe ukuze kusize noma kuncishiswe ukuqina komhudo nokucindezeleka kwamathumbu. Isidakamizwa Mytesi (crofelemer) samukelwa yi-US Food Administration and Drug Administration ngo-2012 ekwelapheni isifo sohudo kubantu abane-HIV.
- Uma kunzima ukuchitha, ukusetshenziswa kwe- hormone yokukhula komuntu (HGH) kungasiza ekubuyiseleni ubuhlungu besisindo kwezinye izimo, nakuba ukwelashwa kuyabiza kakhulu futhi imiphumela iyancipha uma kwenzeka ukwelashwa.
Imithombo:
UMelchior, J. "Izici ze-Metabolic ze-HIV: ukuchithwa okuhambisanayo." I-Pharmotherapy Pharmaceuticals. 1997; 51 (10): 455-460.
Wanke, C .; USilva, uM .; I-Knox, T .; et al. "Ukulahlekelwa isisindo nokulahleka kuhlale kuyinkimbinkimbi evamile kubantu abanegciwane lesandulela ngculaza ngesikhathi sokusebenza kabi kwe-antiretroviral." Izifo Ezithathelwanayo Emitholampilo . September 2000; 31 (3): 803-5.
I-Tang, A .; I-Forrester, J .; I-Spiegelman, D .; et al. : Ukulahlekelwa isisindo nokusindiswa kweziguli ezinegciwane lesandulela ngculaza ngesikhathi sokuphathwa kwe-antiretroviral esebenzayo. "I- Journal of Acquired Immune Deficiency Syndromes, Okthoba 1, 2002; 31 (2): 230-6.
Nerad, J .; I-Romeyn, M .; I-Silverman, E .; et al. "Ukuphathwa kokudla okunomsoco ezigulini ezinegciwane le-immunodeficiency virus." Izifo Ezithathelwanayo Emitholampilo. Ngo-Ephreli 1, 2003: 36 (Ungezelelo 2): S52-62.
Izinsiza zezeMpilo kanye nokuPhathwa kwezinsizakalo (HRSA). "Ukudla okunomsoco - Izinhlelo ze-HIV / AIDS ze-HRSA." I-Rockville, e-Maryland; Januwari 2011.
Grinspoon, S. "Ukusetshenziswa kwe-Androgens ngamadoda nabesifazane abathintekayo nge-HIV." Odokotela Research Network Notebook. Mashi 2005.
Fawzi, W .; Msamanga, G .; I-Spiegelman, D .; et al. "Isivivinyo esingahleliwe se-multivitamin supplements kanye nesifo se-HIV nesifo sokufa." I-New England Journal of Medicine. Julayi 2004; 351 (1): 23-32.
I-US Food and Drug Administration (FDA). "I-FDA ivumela izidakamizwa zokulwa nesifo sofuba lokuqala kubantu abanegciwane lesandulela ngculazi nengculaza." I-Silver Spring, e-Maryland; ukushicilelwa okukhishwe ngoDisemba 31, 2012.