Shin kwayar cutar HIV ko HIV ne ke kula da mai laifi?
Cibiyar bincike ta yanzu ta nuna cewa mutane da ke dauke da kwayar cutar HIV suna da kashi 50 cikin 100 na iya samun ciwon zuciya fiye da yawan jama'a. Nazarin shekaru shida da aka gudanar a matsayin wani ɓangare na Tsohon Kwalejin Tsohon Kwango (VACS) ya nuna cewa kashi 41 cikin 100 na mummunar cututtuka na murya (MIs) ya faru a cikin mutanen da ke dauke da kwayar cutar HIV.
Yayin da aka kwatanta yawan kujerun MI zuwa rukuni ( duba ƙasa ), masu binciken sun tabbatar da cewa MI yana da haɗari "mai mahimmanci kuma mafi girma" a tsakanin masu mahalarta HIV kuma suna karuwa a tsawon lokaci, ba tare da la'akari da cin zarafi ba, cututtuka marasa lafiya, ko wasu cututtuka na zuciya dalilai.
Yawan Infarctions Na Iyalanci (MIs) Dubu Shekaru 1000-Mutane
| Matsayin Ranar | Masu tsohuwar cutar HIV | Magungunan cutar HIV |
| 40-49 | 2.0 halaye | 1.5 lokuta |
| 50-59 | 3.9 lokuta | 2.2 lokuta |
| 60-69 | 5.0 lokuta | 3.3 lokuta |
Lambobin suna daidai da bincike na baya wanda ya nuna kusan yawan sau biyu a cikin MI a tsakanin mutanen da ke dauke da cutar HIV, da kuma karuwa sau biyu a marasa lafiya da kwayar cutar HIV da ƙwayar cuta ta C.
Ta Yaya cutar HIV ta ba da gudummawar haɗari?
Duk da yake abubuwan da ke haifar da waɗannan ƙananan ba su da cikakkun bayani, shaida mai zurfi ta nuna cewa HIV kanta tana iya zama alhakin, mai yiwuwa ne saboda amsawar ƙoshin ƙwayar cutar ta hanyar ciwon HIV.
Nazarin na 2012 daga asibitin asibitin Faransanci akan HIV (FHDH) ya tabbatar da cewa cutar HIV, da kuma yanayin rashin lafiyar marasa lafiya, sune dalilai masu mahimmanci don haɗarin haɗari. Bugu da ƙari, ana ganin rashin lafiyar wani mai fama da zuciya na zuciya don karawa a cikin ƙungiyar kai tsaye da ragewa a cikin ƙididdigar CD4 kuma yana ƙaruwa cikin nauyin hoto .
Malin CD4 nadir mai haƙuri (mafi ƙasƙanci mafi mahimmanci CD4 ya auku) an dauke shi babban mai taimako.
Abin da duk wannan yana nuna shi ne cewa kamuwa da cutar kanjamau na dindindin yana sa mutum ya kasance ƙarƙashin nauyin kumburi mai ci gaba, wanda zai iya rinjayar cutar da zuciya a jikin tantanin salula da kwayoyin halitta.
Binciken da aka gudanar a Jami'ar California, San Francisco ya bayyana dangantaka tsakanin CD4 da kiwon lafiya, inda marasa lafiya da CD4 masu ƙananan yawa (ko kuma babu wani maganin cutar HIV ) sun shawo kan matsalolin da suke da mahimmanci a lokacin da aka kwatanta da marasa lafiya wadanda ke da ƙwarewar CD4, jiyya da wuri, da kuma kulawa da kyamarar hoto.
Shin kwayar cutar kwayar cutar HIV ta haifar da matsalolin zuciya?
Yayinda wasu rahotanni na maganin rigakafi, musamman Ziagen (abacavir), an bayar da rahoto don kara yawan hadarin zuciya, bincike na yau da kullum yana da rabuwa a kan batun. Yawanci, ana iya ganin haɗarin ya fi girma a tsakanin waɗanda ke da wata cuta ta zuciya da ta rigaya ko wadanda ke da alamun haɗari na zuciya guda biyar ko fiye (kamar shan taba, da ciwon sukari ko hawan cholesterol).
Duk da yake wasu bincike sun nuna cewa kwayoyin cutar mai cutar HIV (PI) sun kara yawan haɗarin MI, mutane da yawa sun yarda cewa duk wani haɗari mai hadari zai iya haɗuwa da wakilin mutum maimakon dukkanin kwayoyi. Darussan nan biyu sun kammala cewa uku daga cikin wadanda ake zargi PI-Reyataz (atazanavir), Viracept (nelfinavir), da Invirase (saquinavir) - babu wata ƙungiyar da ke dauke da MI.
Akwai shakka game da ko wasu PIs, irin su Kaletra (lopinavir) da Crixivan (Invirase), suna ba da taimako tun lokacin da ake amfani da PIs ba a la'akari da shi kadai ba saboda matakan da suka kamu da cutar kututtukan da aka gani a cikin kwayar cutar HIV da ciwon zuciya.
Duk da haka, yanayin rikitarwa na bincike-tare da wasu goyan baya da sauransu watsar da ikirarin-ya bar dakin yin taka tsantsan lokacin zabar dabarun miyagun ƙwayoyi masu dacewa ga marasa lafiya da cututtukan zuciya da aka sani. Har ila yau yana nuna muhimmancin yin nazari na zuciya na kullum a duk marasa lafiya da ke dauke da cutar HIV, tare da taimakawa wajen rage irin waɗannan abubuwa masu haɗari irin su shan taba , abinci, da hauhawar jini.
Yin maganin cututtukan zuciya a cikin mutanen da ke dauke da kwayar cutar HIV
A cikin kwayar cutar HIV da ke dauke da cututtuka na zuciya da cututtuka wanda ya nuna cutar, ana ba da shawarar sosai ga likitan kwakwalwa. Dole ne a yi la'akari da yadda za a fara ko gyaggyarawa don haɗawa da magungunan antiretroviral wanda ba tare da tasiri akan matakan lipid.
Bugu da ƙari, za a kula da nunawa ga dukan masu cutar HIV da ke cikin kulawa don gane cikakken ƙwayar cutar ta mutum, ciki har da irin gwajin kamar:
- bayanin martabar azumi (ciki har da LDL cholesterol, HDL cholesterol, da triglycerides)
- nuna ciwon sukari (kafin farawar farfadowa, tare da saka idanu na yau da kullum)
- ma'aunin lantarki (ECG) don marasa lafiya da cututtukan cututtukan zuciya na zuciya
- yawan saka idanuwan jini
- rikice-rikice masu rikitarwa a marasa lafiya da cututtukan zuciya na zuciya don rage shan taba, kiba, da kuma sauran hadari
Duk da yake babu wasu kwayoyin rigakafi na cutar kanjamau da aka yi amfani da kwayar cutar ta HIV, an bada shawarar dabarun gargajiya na gargajiya - ba kawai ga marasa lafiya da ciwon zuciya da aka sani ba amma a matsayin cikakkiyar tsarin kulawa na tsawon lokaci a duk masu cutar HIV. Dole ne a karfafa girmamawa don tabbatar da:
- motsa jiki na yau da kullum, ciki har da wasan motsa jiki
- rage yawan amfani da fatattun fat
- Kwayar cutar shan taba ta HIV
- rage yawan shan barasa zuwa raka'a uku a kowace rana ko žasa
- Mafi kyau duka biyayyar maganin antiretroviral
Sources:
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.
Freiberg, M .; Canza, C. Skanderton, M .; et al. "Hasarin cututtukan zuciya na cututtukan zuciya a tsakanin tsoffin soji da tare da HIV da cutar hepatitis C." Yanayi: Kwayar cutar da jijiyoyin jini da sakamakon. Yuli 2011; 4 (4): 425-432.
Lang, S .; Mary-Krause, M., Simon, A., et al. "Shirye-shiryen kwayar cutar HIV da matsananciyar matsayi sune masu hangen nesa masu zaman kansu na hadarin ƙananan ƙananan ƙwayoyin cuta a cikin kwayar cutar HIV." Cututtuka na cututtuka na asibiti. Agusta 2013; 5 (4): 600-607.
Hsue, P .; Lo, J. Franklin, A; et al. "Ƙara yawan ci gaban atherosclerotic a marasa lafiya da kwayar cutar HIV: Rawar da ke tattare da halayen gargajiya da na rigakafi." Taro na goma game da cututtuka da raunuka (CROI 2003); Boston, Massachusetts; Fabrairu 10-14, 2003; m 139.
Monforte, A .; Reiss, P .; Ryom. L ;; et al. "Atazanavir ba a hade da haɗarin cutar kwayar cuta- ko kuma cututtuka na cerebrovascular." AIDS. Janairu 28, 2013; 27 (3): 407-415.