Naphezu Ukwandisa Izinketho Zokwelapha, Imiphumela Ihlala Ngokukhululekile Mixed
I-lipodystrophy ehambisana ne-HIV yisimo esibonakala ngokuphindaphindiwe ngokuphindaphindiwe kwamafutha omzimba. Isimo sivame ukuveza ngokucophelela okubonakalayo kobuso, izintambo, noma iziphetho, kuyilapho ngokuvamile kubangela ukuqoqwa kwamafutha azungeze isisu, isifuba noma emuva kwentamo (okugcineni okubhekwa kuyo ngokuthi "i-buffalo hump" - kufana nokubukeka).
I-lipodystrophy ehlotshaniswa ne-HIV ivame ukuxhunyaniswa neminye imithi yemithi elwa negciwane lesandulela ngculazi , kuhlanganise ne- protease inhibitors (i-PIs) kanye ne- nucleoside reverse transcriptors (NRTIs) njenge-Zerit (stavudine) ne- Videx (didanosine) . Isimo singase sibe nomphumela wokutheleleka nge-HIV ngokwawo, ikakhulukazi ezithinta iziguli ezingakaqali ukwelashwa kwama-antiretroviral.
Nakuba i-lipodystrophy ibonakala ingaphansi kakhulu kubantu abanesandulela ngculaza kusukela ekusungulweni kwezidambisigciwane ezintsha, zihlala ziyinkinga ngoba lesi simo asivamile ukuguqulwa futhi sivame ukuphikelela ngisho noma imithi yokwaziswa imiswa.
Ukwelashwa kwe-Lipodystrophy: Ukufinyelela nokucabangela
Nakuba kungekho ukwelashwa kwe-lipodystrophy ehlotshaniswa ne-HIV, kunezinketho zokwelashwa ezingase ziguqule ezinye imiphumela yokubuyiswa kwamafutha, kanye nokubhekana nezinye zezinto eziphathelene nokukhathazeka kwezempilo ezihlobene ne-cholesterol ephakeme kanye namazinga e-triglyceride egazini.
Phakathi kwezinyathelo:
- Ukushintsha imishanguzo yegciwane lengculazi kungasiza uma udokotela wakho ekholelwa ukuthi izidakamizwa zakho ziyisizathu sakho sokusabalalisa amafutha okungaqondakali / Ukushintsha kulokhu kuhlale kunconywa uma kuphela ukuvimbela ukuqhuma okuqhubekayo kwalesi simo. Ngenkathi kungase kube khona ukuguqulwa kwesimo, ikakhulukazi ukushaywa kwebuso (okuyaziwa ngokuthi i-lipoatrophy ebusweni), ukuguqulwa okuningi kuncike ekunciphiseni ukulinganisela. Kubalulekile ukwazi ukuthi i-lipodystrophy ngezinye izikhathi ingaphikelela ngisho nangemva kokuthi ama-PIs amisiwe, nakuba isimo ngokuvamile sihamba isikhathi.
- Ukushintshela ku-tenofovir noma noma iyiphi i-regenen-based tenofovir (isib., ITruvada , Genvoya ) ingabuye ishintshe i-lipoatrophy ebusweni, ngokusho kwezifundo eziningana. Nakuba kungenakuqineka, lolu cwaningo lusekela ukusetshenziswa kwe-tenofovir noma abacavir ( Ziagen ) ezimweni ze-lipodystrophy ezinzima ngoba izidakamizwa zivame ukuhambisana nesimo.
- Ukuchaza u-Egrifta (tesamorelin) ezimweni zokuqoqwa kwamafutha esiswini nasegulini. I-Egrifta ivunyelwe ukwelashwa kwe-lipodystrophy ehlotshaniswa ne-HIV njengoba ibhekisela ekwakheni amafutha angama-visceral emkhatsini we-middlesection kanye nezitho zangaphakathi zesisu. I-Egrifta ibonakala ingenalutho, uma ikhona, umthelela olinganiselwe ekulahlekelweni / ukubuyiswa kwamafutha ebusweni, emathangeni, emathunjini, emhlane noma emaphethelweni.
- Ukudla nokuzivocavoca kungase kungabi nomthelela olinganiselwe kwezinye izibonakaliso zomzimba ze-lipodystrophy, kodwa kungasiza kalula amazinga aphansi namafutha e-cholesterol avela ezigulini eziphathwe nge-PIs. Ukwengeza, zingasiza ekunciphiseni imiphumela ye-lipodystrophy ngokukhuphula isisindo semisipha emzimbeni, emilenzeni nasezintweni; noma ngokubhekana nezinkinga zesisindo (isb. ukukhuluphala , isifo se-metabolic syndrome) esenza ngcono ukuqoqwa kwamafutha esiswini, emuva nangamabele. Ukudla okunamafutha okuphansi kanye nezinhlelo zokuzivocavoca ezivamile kunconywa kubo bonke abantu abaphila negciwane lesandulela ngculaza, elikhulu noma elincane. Xhumana nomhlengikazi noma umsoco wokudla ukuze akusize ekuthuthukiseni imikhuba yokudla engcono.
- Thatha imithi ye-lipid ekunciphiseni ukunciphisa amazinga we-triglycerides ne-cholesterol egazini lakho. Ukusetshenziswa kwabo angeke kusize ekuthuthukiseni imiphumela yempilo yonke (isib. Ukwehlisa ingozi yesifo senhliziyo nokuthuthukiswa kwesifo sikashukela), kungase kunciphise ubukhulu be-lipodystrophy.
- I-hormonal therapy iye yahlolwa futhi ekwelapheni i-lipodystrophy ehlobene ne-HIV, kungaba ngesimo se- testosterone esikhundleni noma ekwelashweni ngokusebenzisa i-hormone-release hormone (GHRH) yokukhula. Ngesikhathi ukusetshenziswa kokubili kuhlotshaniswa nokwanda kwemisipha enomzimba, akuqiniseki ukuthi ngempumelelo kangakanani ukuphatha isimo sangempela ngokwayo. Ucwaningo oluningi lubonisa ukuthi kukhona ukuthuthukiswa okulinganiselwe ekusabalaleni kwamafutha, nakuba iningi lezinzuzo libonakala lilahlekile uma ukwelashwa kwama-hormone kumiswa.
- Ama-fillers e-Dermal , ethandwa kakhulu ekusetshenzisweni kwezimonyo, abuye akwazi ukulungisa ezinye zezinto ezibonakalayo ze-lipoatrophy, ikakhulukazi ebusweni nasezintweni. Imikhiqizo engakhiwa njenge- Sculptra (i-poly-L-lactic acid) ne-Radiesse (i-calcium hydroxylapatite) isetshenziswa kaningi kulezi zimo futhi ingadinga ukwelashwa okungaphezu kwesisodwa ngonyaka, Ngenkathi i-cosmetically esebenzayo uma isetshenziswe ngumchwepheshe oqeqeshiwe, izindleko eziphindaphindiwe zingavunyelwa kwezinye iziguli.
- I-liposuction ivame ukuhlolisiswa ngokususwa kwamafutha anqwabelene emhlane entanyeni (ngokuvamile ebizwa ngokuthi "i-bumpalo hump"). Ngesikhathi esheshayo futhi ephumelelayo, kusekhona ithuba lokuvuselelwa kabusha kwe-fat build-up ngisho nangemva kokuhlinzwa. Ukwengeza, i-liposuction ingasusa kuphela ama-fat subcutaneous ngaphansi kwesikhumba, okusho ukuthi ukuqoqwa kwamafutha emgodini wesisu akukwazi ukuphathwa ngale ndlela. Futhi njengazo zonke izinqubo zokuhlinzwa, i- liposuction ihilela ingozi ethile .
Noma ngabe yiziphi izinketho ozikhethayo, ungayeki imishanguzo yakho ye-HIV ngaphandle kokuqala ukukhuluma nodokotela wakho. Qinisekisa, futhi, ukufaka udokotela wakho we-HIV kunoma yikuphi ukubonisana okungenzeka ube nakho nabahlinzayo bezimonyo mayelana nokubhekana nokubonakala komzimba we-lipodystrophy.
Umthombo:
Izikhungo Zempilo Zikazwelonke (NIH). "Imiphumela emibi yeMithi Ye-HIV: I-HIV ne-Lipodystrophy." AIDSInfo. I-Rockville, e-Maryland; ibuyekezwe ngoJanuwari 1, 2016.