Kubata nePhenotyping Kunogona Kuziva, Uye Kunyatsofanotaura, HIV Drug Resistance
Kunyange kune vanhu vane hutano hwakanaka hwehutachiona, humwe huwandu hwehutachiona hweHIV hunotarisirwa kukura kwenguva yakareba nekuda kwekuchinja kwemuviri wehutachiona. Mune zvimwe zviitiko, kupikisa kunogona kukurumidza kukurumidza kana kusungirirwa kwekuteerera kunobvumira kuti vanhu vasingagoni kurarama neHIV varambe vachibudirira, zvichiita kuti pakupedzisira kupera kurapwa.
Kana kupererwa kwechipatara kuchiitika, kumwe kushandiswa kwezvinodhaka zvinodhaka kunofanira kusarudzwa kuitira kuti vadzivise hutachiwana hutsva hwehutachiona hwehutachiona.
Kuongorora kushandiswa kwemasvomhu kunobatsira kuita izvi kuburikidza nekucherechedza maitiro ekusagadzikana kwemasimba mumunhu "chirwere chetachiona," paanoziva kuti zvirwere izvi zvinokonzerwa sei nemishonga inogona kuvhiringidza mahara .
Zvidzidzo zviviri zvekutanga zvinoshandiswa pakuongorora maitiro ekudzivirira muhutachiwana hweHIV: hutachiona hweHIV hutachiona uye hutachiwana hweHIV hunotengesa .
Chii Chinonzi Genotype uye Phenotype?
Nenzira, jenotype inongova maitiro ekugadzirwa kwemhuka, asi phenotype ndiyo inoonekwa maitiro kana maitiro ezvo zvipenyu.
Genotypic assays (kana kuti genotyping) basa nekutsanangurira mirairo yakagara nhaka mukati memasero ekunyora mazita, kana kuti DNA. Phenotypic assays (kana phenotyping) inosimbisa kutaura kwemashoko aya pasi pesimba remamiriro ezvinhu akasiyana-siyana.
Nepo kushamwaridzana pakati pejenotype ne phenotype hakusi kwakakwana, genotyping inowanzova inofungidzira ye phenotype, kunyanya apo kuchinja kweiyo genetic code inotarisa kuchinjwa kwechimiro kana maitiro-sezvinowedzera kuwedzera kushandiswa kwemishonga.
Phenotyping, kune rumwe rutivi, inotsigira "pano-uye-ikozvino." Chinangwa chekuongorora kuitika kwehupenyu kune zvakananga kuchinja mune zvekuchengetedzwa kwezvakatipoteredza-zvakadai apo HIV inoratidzika kune mishonga yakasiyana uye / kana zvinodhaka.
Tsanangudzo yeHIV Genotyping
Utachiona hwe HIV hunowanzoshandiswa pakugadzirisa kuongororwa.
Chinangwa chekuedza ndekuona hutano husina kujeka munharaunda yegag-pol ye'virome '(kana kuti genetic code). Iyi ndiyo nzvimbo iyo reverse transcriptase, protease uye integrase enzymes-iyo inotorwa nemishonga yakawanda ye- antiretroviral -yakanyorwa neketani yeDNA.
Pakutanga kukurisa hutachiona hweHIV uchishandisa polymerase chain reaction (PCR) teknolojia, vashandi vebazi vanogona kuenzanisa (kana kuti "mapu") genetics yehutachiona vachishandisa mitambo yakasiyana-siyana yekuongorora.
Kutaura kuchinja-chinja (kana kuunganidzwa kwemashanduko) kunotsanangurwa nevanyanzvi vanoongorora hukama pakati pemararamiro akacherechedza uye hutachiona 'hunotarisirwa kutarisirwa kumishonga yakasiyana-siyana yemishonga inodhaka mahara. Nzvimbo dzepaIndaneti dzinogona kubatsira nekuenzanisa kuenzanisa kwekuenzanisa kune iyo ye " prototype -type" virusi (kureva, HIV inenge isina kusagadzikana mutations).
Tsanangudzo yezviedzo izvi inoshandiswa kugadzirisa kugadziriswa kwezvinodhaka, nehuwandu hukuru hwekuchinja kwemashoko kunopa mazinga akakwirira ekurwisa zvinodhaka .
Kutsanangura HIV Kuita Phenoytyping
Hupenotyping yeHIV inotarisa kukura kweHIV munhu muhupo hwemishonga, zvino inofanidza kuti kukura kwekudzivirira, utachiona hwechikara mune mimwe mishonga.
Sezvakaita genotypic testay, zviratidzo zve phenotypic zvinowedzera nzvimbo yegag-pol yemagenome eHIV.
Ichi chikamu che genetic code "inonamatirwa" pane imwe nyuchi dzomusango dzinoshandisa recombinant DNA teknolojia . Chirwere chinokonzerwa nehutachiona hunoshandiswa kuparadzira masero emammalian in vitro (mubasa).
Muenzaniso wehutachiona hunowanikwa kune huwandu huri kuwedzera hwemishonga yakasiyana-siyana yemishonga inorwisa mahara kusvika 50% uye 90% kuwedzerwa kwehutachiona hunobudirira. Iko kuwedzera kunobva kwaenzaniswa nemigumisiro kubva kuhutungamiri, senzara-shanduko.
Nhengo dze "hupfumi" dzinoshandura dzinopa huwandu hunotarisa hunoshandiswa nemishonga inogadziriswa. Chimwe chechina chinoshandura chinongoreva kuti kanomwe chiyero chechirwere chaidiwa kuti zvive nehutachiona hwekuparadzanisa zvichienzanisa neyechikara.
Iyo yakawanda iyo yakakosha, iyo inonyanya kutengesa utachiona kune imwe mishonga.
Aya maitiro anobva aiswa mukati memakirini emakiriniki nepamusoro-makiriniki akasiyana, nepamusoro-soro kugovera kumazinga akakwirira ekumanikidzwa kwemishonga. (Ona muenzaniso mushumo .)
Rini Rudzi Rwokuramba Kurwisana Rwakaitwa?
MuUnited States, maitiro ekurwisa kushandiswa kwemaitiro anowanzoitwa pamushonga waaiive nevarwere kuti vaone kana vane "vakawana" mishonga yekudzivirira. Zvidzidzo muUnited States zvinoratidza kuti pakati pe6% uye 16% yehutachiona hunotapurirwa hucharamba huchida rimwe remishonga inorwisa mabhakitiriya, asi inenge 5% icharamba ichidzivirirwa kune imwe boka rechirwere.
Kuongorora maitiro ekugadzirisa muviri kunoshandiswawo kana kusagadziriswa kwezvinodhaka kuchifungidzirwa kune vanhu vari kurapa. Kuedzwa kunoitwa apo murwere achitora chirwere chisina kukwana kana mukati memavhiki mana ekuregererwa kwehutano kana hutachiona hwepamusoro hukuru kupfuura mazana mashanu / mL. Genotypic kuedza kunowanzosarudzwa mune izvi mamiriro ezvinhu sezvavanodhura mari shoma, vane nguva yekukurumidza kuchinja, uye kupa hukuru hukuru hwekuona mishonga yepachirwere-yega uye yekusagadzikana utachiona.
Kubatanidzwa kwe phenotypic uye genotypic yokuyera inowanzodiwa kune vanhu vane maitiro akaoma, akawanda-kushandiswa kwemishonga, kunyanya kune avo vanobudiswa kune protease inhibitors .
Sources:
World Health Organization (WHO). "Utachiona hweHIV Hwokurwisana Chikamu Sheet." Geneva, Switzerland; April 11, 2011.
Kim, D.; Ziebell, R .; Saduvala, N .; et al. "Nzira inotapurirwa HIV-1 kushandiswa kwemishonga yeARV-kushandiswa kwakasiyana-siyana: 10 nzvimbo dzeutachiona hweHIV, US, 2007-2010." Musangano we20 wezveRevroviruses uye Zvirwere Zvisingaoneki. Atlanta, Georgia; March 6, 2013; Chirevo chemuviri 149.
National Institutes of Health (NIH). "Nhungamiro Yekushandisa Antiretroviral Agents muHIV-1-Vakabatwa Vakuru Nevana Vari Kuyaruka." Bethesda, Maryland; Gunyana 11, 2013.