Kwayoyin cuta na yau da kullum suna ci gaba da kasancewa babbar hanyar rashin lafiya da mutuwa a cikin mutanen da ke dauke da kwayar cutar HIV, yayin da yawancin cututtuka ko rikici ba a san su ba Daga cikin cututtuka masu kama da cututtuka wadanda ke da alaka da cutar HIV :
- Oral da esophageal candidiasis (thrush)
- Cryptococcosis (ciki har da cryptococcal meningitis)
- Histoplasmosis
- Coccidioidomycosis (Kwarin Fari)
Akwai wasu cututtuka da dama (ciki har da aspergillosis, penicillosis, da blastomycosis), da yawa a cikin mutane da CD4 suna ƙidaya fiye da 250 kwayoyin / mL.
Akwai wasu jami'o'in da aka saba amfani dasu don magance cututtuka na cutar HIV. Ana rarraba kwayoyi ta hanyar aikin su na musamman, kuma za'a iya rushe su cikin kungiyoyi hudu:
I. Hannun Antifigals na Polyene
Magungunan gyare-gyaren polyene suna aiki ta hanyar karya ka'idar mutuncin jikin mutum, wadda ta haifar da mutuwar cell. Kwayoyin da aka saba amfani da polyene wanda ake amfani dasu a cikin kwayar cutar HIV shine:
- Amphotericin B : An hade shi tare da jiyya na jiki (jiki duka) fungal cututtuka irin su cryptococcal meningitis. Lokacin da aka yi aiki a cikin intravenously, amphotericin B ana san cewa yana da mummunar tasiri, sau da yawa tare da wani mummunan dauki da take faruwa a jimawa bayan jima (misali, zazzaɓi, juyayi, rigina, tashin zuciya, vomiting, ciwon kai, da kuma tsoka). Saboda haka, gwamnatin intravenous na amphotericin B ana nunawa a cikin mummunar rigakafi ko marasa lafiya marasa lafiya. Ana yin amfani da shirye-shiryen maganganun don amfani a zaluntar takardun neman izini, wanda yake da lafiya don amfani tare da ƙananan ƙwayoyi.
- Nystatin : Ana gudanarwa ko dai ta hanyar magana ne ko kuma don kai tsaye ga maganganu na baki, jituwa, da kuma ƙirar fata. Za a iya amfani da Nystatin a matsayin kwayar cutar kwayar cutar (rigakafi) a cikin marasa lafiya HIV dauke da haɗari ga ƙwayar cuta (CD4 ƙidaya 100 kwayoyin / mL ko žasa). Nystatin yana samuwa a matsayin Allunan, mouthwash, pastilles, powders, creams, da ointments.
II. Azifile Antifungals
Wadannan masu amfani da azole suna katse kira na enzymes da ake buƙata don kula da mutuncin kirkirar jiki, don haka hana hana naman gwari na iya girma. Hanyoyin da ke tattare da juna sun hada da rash, ciwon kai, rashin hankali, tashin zuciya, vomiting, zawo, ciki ciki, da hanta enzymes.
- Diflucan (fluconazole) : Da ake tsammani daya daga cikin wadanda aka ba da izini a duniya, Diflucan yana amfani dashi don magance cututtukan marasa lafiya da na jiki, ciki har da rubutun fata, cryptococcosis, histoplasmosis, da coccidioidomycosis. Diflucan yana samuwa a cikin nau'i na kwamfutar hannu, a matsayin foda don maganin baki, ko a matsayin mafitaccen bayani don amfani da intravenous.
- Nizoral (ketoconazole) : Nizoral shine maganin maganin azole na farko, amma yawancin azoles sun kasance suna maye gurbin su wanda basu da mawuyacin hali kuma mafi girma. Ana samuwa a cikin nau'i na kwamfutar hannu, da kuma a aikace-aikace daban-daban don amfani akan cututtukan fungal marasa galihu, ciki har da rubutun ƙira.
- Sporanox (itraconazole) : An yi amfani dashi a kamuwa da kamuwa da kwayoyin cuta (kamar su masu zahiri ko cryptococcosis) yayin da sauran masu amfani da su ba su da tasiri ko rashin dacewa. Sporanox yana samuwa a cikin sutura ko asalin maganganun (la'akari da mahimmanci dangane da sha da kuma bioavailability). Ba a samarda shirye-shirye na intravenous ba a Amurka Saboda rashin shigar da shi a cikin ruwan sanyi, Sporanox ana amfani dashi ne kawai a layi na biyu lokacin da ake kula da meningitis cryptococcal.
Wasu azoles da ake amfani dashi a cikin maganin cututtuka masu bincike na masu bincike shine VFend (voriconazole) da Posanol (posaconazole).
III. Antimetabolite Antifungal
Akwai maganin antimetabolite daya kadai (Ancobon) da aka sani da suna da kayan haɓaka, wanda ya aikata ta hanyar haɓaka tare da RNA da DNA kira.
- Ancobon (flucytosine) : An yi amfani dashi don magance matsalolin masanan da cryptococcosis, Ana amfani da Ancobon tare da fluconazole da / ko amphotericin B kamar yadda ake ci gaba da juriya na kowa lokacin amfani da shi kadai. Haɗuwa da amphotericin B da Ancobon sun tabbatar da cewa sun kasance masu dacewa wajen kula da meningitis cryptococcal. Ancobon yana samuwa a cikin nau'i nau'i. Hanyoyin lalacewa na iya haɗawa da rashin haƙuri da ɓarna mai ɓarna (ciki har da anemia). Rash, ciwon kai, rikice-rikice, hallucination, sedation, da kuma hawan hanta aiki da aka ruwaito.
IV. Echinocandins
Anyi amfani da sababbin jarabobi wanda ake kira echinocandins a wajen kula da masu yin nazari da aspergillosis. Echinocandins aiki ne ta hanyar hana yin amfani da wasu polysaccharides a cikin fursunonin fungal cell. Yayin da yake magana, echinocandins yana ba da mummunar guba da ƙwayoyi masu magungunan miyagun ƙwayoyi, ko da yake a halin yanzu an ba da izini ga marasa lafiya tare da rashin haƙuri ga wasu magungunan gargajiya na gargajiya. Dukkanin uku ana gudanar da su a cikin intravenously, tare da irin wannan aminci, inganci, da juriya.
- Eraxis (anidulafungin)
- Cancidas (caspofungin)
- Mycamine (micafungin)
Sources:
Marty, F. da Mylonakis, E. "Antifungal yayi amfani da cutar HIV." Kwararre bayani Pharmacotherapy. Fabrairu, 2002; 3 (2): 91-102.
Mei, H .; Kok, L ;; Shariff, M .; et al. "Antifungal Amfani da Ingancin Ciwo A Ciwon Masarautar HIV: Daidaita Ƙarfin lafiya da Tsaro." Wutar yanar gizo na yanar gizo. 2011; 2 (12): WMC002674.
Cibiyar Kula da Lafiya ta Duniya (NIH). "Sharuɗɗa don Rigakafin da magance cututtuka da dama a cikin kwayar cutar HIV-Cutar da ke da yara da matasa." Bethesda, Maryland; sabunta Satumba 27, 2013.