Dukkanin kwayar cutar HIV da HIV da aka hada da kwayar cutar da aka hada da kwayar cutar ta nuna cewa haɓaka ƙari
Misalin ciwon sukari na iri 2 yana da alaka da cutar HIV ta dadewa, wanda aka danganta shi a baya don yin amfani da wasu kwayoyi masu maganin rigakafi (ARVs) -a mahimmanci magungunan protease-proteins kamar Crixivan (indinavir) da cikakken ƙarfi Norvir (ritonavir) .
Duk da yake ba cikakke ba ne game da yadda ARV ke taimakawa, mun san shi ne cewa ciwon sukari yana fuskantar hadarin mutum mai dauke da kwayar cutar HIV shine mafi yawan lokuta ne akan wasu abubuwan da suka taimaka, ciki har da:
- Tsufa (yawanci 40 da sama)
- Tarihin iyali
- Kiba
- Hepatitis B (HBV) da kuma ciwon hauka C (HCV)
- Hawan jini
- High cholesterol
- Hawan ciki a yanzu
- Ƙasar (Asian, Afirka ta Afirka, Hispanic)
Amma a cikin 'yan shekarun nan, bincike ya nuna cewa ciwon kumburi da ke haɗuwa da kamuwa da dogon lokaci da magungunan cutar da ake amfani dasu don magance cutar HIV ya iya haɓaka yawan ciwon sukari.
Ciwon sukari da kuma HIV-Associated Chronic Kumburi
Ko da lokacin da kwayar cutar HIV ta dade ko kuma an kawar da shi ta hanyar maganin rigakafi (ART) , kasancewa da cutar ta latsa ta haifar da mummunar amsawa kamar yadda tsarin jiki na jiki ya bar a cikin babbar jijjiga.
A lokacin da ake ciwo da kumburi na kwayar cutar HIV, wasu alamomin ƙwayoyin ƙwayoyin ƙwayoyin cuta-waɗanda ake kira C-reactive protein (CRP) da interleukin-6 (IL-6) - sun sani sun kara. Binciken da aka yi kwanan nan ya nuna cewa tasowa a cikin wadannan alamomi yana kara yawan yiwuwar ciwon sukari a cikin mutane a kan ART.
Masana kimiyya tare da ƙungiyar binciken SMART da ESPIRIT masu kula da cutar sun bincika cutar da ciwon sukari tsakanin marasa lafiya 3,695 masu cutar HIV a kan ART fiye da shekaru 4.6. Matsakaicin adadin CD4 a tsakanin mai halarta an dauke shi a 523 cell / ml.
Bisa ga bayanai, marasa lafiya da CRP da IL-6 sun fi dacewa su ci gaba da ciwon sukari na iri 2, tare da sau biyu na CRP da IL-6 daga tushen da zai haifar da haɗari 20% da 33%.
Dukkanin sun shaidawa, mutane 137 suka ci gaba da ciwon sukari a yayin gwajin da aka samu a cikin 8,18 a kowace shekara mai haƙuri.
Yayin da aka gamsu da wasu al'amuran gargajiya don ci gaba da ciwon sukari a tsakanin mahalarta nazarin-ciki har da halayen magungunan jiki (BMI), tsofaffi, farfadowa da ciwon hepatitis da magungunan kwayoyi - hujjar cewa koda ƙananan kumburi zai iya taimakawa a matsayin muhimmi , samar da tsarin da zai iya gano mutanen da ke cikin haɗari ga ciwon sukari na 2 da kuma tabbatar da haɗin gwiwar da ta dace kafin zuwan ART.
Ciwon sukari da aka lakafta don amfani da kwayar cutar ƙwayoyi?
Daya daga cikin kwakwalwa na hana ciwon sukari a cikin mutanen da ke dauke da kwayar cutar HIV shine tasirin kwayoyin magunguna akan ci gaban cututtuka. Ana amfani da kwayoyi, waɗanda ake amfani da su a kan tsaunuka (musamman LDL cholesterol), suna da muhimmanci a guje wa cutar cututtukan zuciya a cikin jama'a inda akwai yiwuwar ciwon zuciya ta kusan kusan ninki biyu na yawan jama'a.
Duk da haka, sababbin binciken da aka gudanar daga binciken Harkokin Jakadancin HIV (HOPS) ya nuna cewa yin amfani da kwayar cututtuka a cikin mutanen da ke dauke da kwayar cutar HIV zai iya ƙara yawan ciwon sukari ta hanyar kashi 10% tare da kowace shekara ta amfani.
Sakamakon binciken shekaru 10, wanda ya biyo bayan masu fama da kwayar cutar HIV 4,962 daga shekara ta 2002 zuwa 2011, yayi la'akari da irin cututtukan cututtuka 2 na mutanen da aka ba da magunguna (590) tare da wadanda basu kasance ba (4,372).
Daidaita samfurin na shekaru, jima'i, kabilanci, amfani da ARV da BMI, masu binciken sun iya cewa ƙananan ciwon sukari ya karu da ƙarfin tsinkayar statin.
Duk da haka, sun kasance da sauri a lura cewa ƙarar suna haɗaka da tsufa da kuma BMI mafi girma, kazalika da tsere / kabilanci (tare da kashi 50 cikin dari a cikin ƙananan baƙi da kuma ƙwararru a cikin yan asalinsa). Ba abin mamaki bane, ƙananan ƙwayoyin cuta ne aka ruwaito daga marasa lafiya, yayin da tasirin wadanda suka hana masu kare protease sun kasance marasa daraja.
Daga shawarar da aka ba da shawara, masu bincike na HOPS sun ba da shawara cewa "ba za a kauce masa ba" idan aka nuna musu asibiti "saboda nuna" amfani da cututtukan cututtukan zuciya na zuciya. "
Saboda haka, yayin da kwayoyin magungunan kwayoyi sun kasance masu mahimmanci a matsayin hanyar haifar da lipids a cikin mutanen da ke dauke da kwayar cutar HIV, ba za a yi amfani dasu ba. Don rage haɗarin haɗari yana buƙatar buƙataccen tsari, ciki har da rage yawan abincin mai daɗaɗɗa , motsa jiki na yau da kullum , shan taba , da kuma farawa da samfurin ART tare da haɗakarwa mafi kyau don tabbatar da maganin cututtukan hoto (don ragewa da mummunar amsawar cutar ta HIV).
Sources:
Betené A Dooko, C .; De Wit, S .; Neuhaus, J; et al. "Interleukin-6, Tsarancin Sensitivity C-Reactive Protein, da kuma Ci Gaban Ciwon sukari na 2 Daga cikin Magungunan Kwayoyin lafiya na HIV dauke da maganin cutar." Rajistar Jirgin Ƙunƙasar Ƙaƙwalwar Lalacewa. Disamba 15, 2014; 67 (5): 538-546.
Lichtenstein K .; Debes, R. Wood, K. et al. "Amfani da ciwon sukari yana hade da ciwon ciwon sukari a cikin marasa lafiya a cikin Nazarin Harkokin Kwayoyin cutar HIV." Taro na 20 game da Magungunan Rubuce-Ruka da Hanyoyin Ciki (CROI). Maris 3-6, 2013; Atlanta, Jojiya; m 767.
Freiberg, M .; Canza, C. Kuller, L; et al. "Ciwon HIV da kuma hadarin mummunar infarction m." Journal of the American Medical Association (JAMA) Medicine na cikin gida. Afrilu 22, 2013; 173 (8): 614-622.