Masayendisiti Edge Ava Pedyo Nezviraramiro Zvenguva Isingaperi zveAIDS, PrEP
Chimwe chezvipingamupinyi zvakakosha kuburikidza nehutachiona hweHIV ndeyepamusoro yekuteerera kunodiwa kuwana zvirongwa zvekliniki dzehutano . Kune vamwe, basa roga rega rekutora antiretroviral zvinodhaka zvinogona kukurira, kunyanya kana zvichiendeswa nenyaya dzepfungwa kana dzinoshanda dzingakanganisa hupenyu- nekuteerera-kune vanhu vane HIV.
Saka zvakanyanya ndezvenyaya idzi, muUnited States nhasi, vanopfuura 20% yevanhu vane antiretroviral therapy vanokwanisa kuchengetedza simba risingaoneki rehutachiwana , chiyero chekurapa kubudirira.
Mukupindura, masayendisiti ava kutanga kutsvaga zvinodhaka zvinoshandiswa kwenguva yakareba, pamwe chete nemishonga yekushandisa zvinodhaka, izvo zvingaguma zvichibvumira kamwechete-mwedzi-kamwe kana kunyange kamwe chete-mwedzi-dosing, kana kutora utachiona hweHIV kana kuti hudzivirire.
Zvenguva refu Dzakaongorora Mishonga Inodhaka
Muna 2013, maviri maitiro ekuita antiretroviral agents akaiswa pamusangano wegore rechinomwe weAIDS AIDS Society (IAS) Musangano muKuala Lumpur. Mishonga yekutsvakurudza yakave yakagadzirwa seinosayable nanosuspensions, umo makirasi maduku emishonga anoshingaira anosimwa mumvura, zvichibvumira kusunungurwa nekudzivirirwa kwemishonga muchirongwa.
Chekutanga, cabotegravir (inozivikanwawo se GSK1265744) ndeyekirasi remishonga inonzi integrase inhibitors , iyo inovhara enzyme inonzi integrase iyo HIV inoda kuwedzera. Chechipiri, TMC278-LA , ndeyekuita kwenguva refu kwechirwere Edurant (ripilvirine) ikozvino inoshandiswa muHIV therapy.
Chiverengero cheChikamu II chezvipatara zvinoratidza kuti cabotegravir inowanikwa intramuscularly inowanzochengetedzwa nehafu inoreva upenyu huri pakati pemasikati makumi maviri nemakumi mashanu (zvichifananidzwa nemaawa makumi mana zvichienderana nehana imwe chete, yemuromo). Ongororo dzakafanana dzakaratidza kuti mishonga iyi yakaitawo kuti mishonga inogadziriswa yezvipembenene ichichengetedze mumakemikari nemadzimai, zvichireva kuti inogona kushandiswa senzira inoshanda, yakareba-inoshanda ye pre-exposure prophylaxis (PrEP) .
Nokuenzanisa, chidzidzo chePekutanga I chakaratidza kuti TMC278-LA yakakwanisa kuchengetedza chinangwa che plasma chemishonga kubva kumavhiki 12-26. Mushonga uyu wakaratidzawo chivimbiso sePrEP, nekuisa kwakasimba kwezvinhu zvakaratidzwa mumakemikari akafanana kana achienzaniswa nemadzimai emuviri.
Ongororo inoenderera mberi yakarongedzwa nechinangwa chekuwedzera tsvakurudzo kusvika kuChikamu II uye III kuongororwa kwemakiriniki.
Subdermal Antiretroviral Implants
Masayendisiti e Oak Crest Institute of Science muPasadena, California anozivisa kugadzira kushandiswa kwemasvostik-sized implant iyo inogona kuratidza kuwedzera kwakanyanya kwema antiretroviral mishonga kana ichiiswa pasi peganda.
Saizvozvowo mukugadzirwa kwekuita kwenguva refu yekuita zvekudzivirira pamuviri, chigadzirwa chacho chakaratidzwa mukutsvakurudza kwekutanga kuitira kukwanisa kusunungurwa kwakasununguka, kwakasununguka kwezvinodhaka tenofovir alafenamide (TAF) kwemazuva makumi mana.
[Kusiyana neTenofovir disoproxil fumarate (TDF), inowanzoshambadzirwa kuViread uye iri mumishonga inonzi Truvada neAtripla , TAF inonzi inofanirwa kunyanya kukanganisa mishonga pamishonga yakanyanya kudarika TDF.]
Nekutsvaga kutsvakurudza ikozvino kuisa pachigadzirwa chePrEP, zvinonzi vamwe vashandi venguva refu vanogona kushandiswa kupa hutano hwema antiretroviral therapy (chirwere) kuvanhu vanogara neHIV.
Ongororo yeramangwana inotarisira kuzarura mukova wekuvandudzwa kwemaplandi anokwanisa kupera kusvikira gore kana kupfuura.
Intravaginal Microbicidal Rings
Masayendisiti vave vachiedza kwenguva yakareba kupa vakadzi vari pangozi nzira dzekuzvidzivirirwa kubva kuHIV, zvikurukuru munzvimbo dzinowanikwa simba rekuita zvepabonde zvevakadzi. Nzira dzakawanda dzezvirongwa izvi, zvichienderana nenzira yePPRP kana kuti yemadzimai emadzimai , yakakundikana mukutsvakurudza nekuda kwekushaiwa kwekuteerera pamwe nehuwandu hunokonzerwa nehutachiona hwehutachiwana mumadzimai , pamwe nevakadzi vane hurefu hwekuteerera.
Kugadzirisa izvi, mamwe mapoka ekutsvakurudza ari kutsvaga kushandiswa kwezvindori zvepravaginal izvo zvinogona kusunungura antiretroviral zvinodhaka kusvikira mwedzi panguva.
Nhete, iyo isina kukwana elastomer scaffold yakaiswa nemishonga inoshandiswa, inobvumira mukadzi kuvhara chigadzirwa chisingaoneki kwenguva yekushandiswa.
Mitsva yekutanga yakaratidza kushivirira kwechindori chinonzi intravaginal chine kuedza kwemishonga dapivirine (TMC120 ) nekubudirira kwechirwere kumucheto wechidiki wepabonde kwemazuva makumi matatu nemaviri.
Muchikamu chechipiri chePeople III trials, Ring Ring uye ASPIRE, vari kuongorora kuvhara kwekete pamwe nekushanda kwayo kwenguva refu kwekuchengetedza mukati meboka revakadzi 4 500 vasina HIV.
Sources:
US Centers for Disease Control and Prevention (CDC). "CDC Fact Sheet | HIV muUnited States: Matanho Ekutarisira." Atlanta, Georgia; yakabudiswa muna July 2012.
Spreen, W; Margolis, D .; uye Pottage, J .; "Kuita kwenguva yakareba antiretroviral inopindwa nehutachiona hweHIV uye kudzivirira." Mune maonero aripo pamusoro peHIV neAIDS. November 2013; 8 (6): 565-571.
Margolis, D .; Brinson, C; Eron, J .; et al. "744 uye rilpivirine semishonga miviri yekurapa muromo: LAI116482 (LATTE) vhiki 48 migumisiro." Musangano weChipiri pamusoro peRevroviruses uye Mikana Inopesana (CROI 2014); Boston, Massachusetts; March 3-6, 2014; abstract 91LB.
Gunawardana, M .; Remedios-Chan, M .; Miller, C .; et al. "Pharmokinetics ye Long-Acting Tenofovir Alafenamide (GS-7340) Kushandiswa Kwechirongwa cheHIV Prophylaxis." Antimicrobial Agents uye Chemotherarpy. April 20, 2015; doi: 10.1128 / AAC.00656-15.
Nel, A; Smythe, S ;; Muduku, K .; et al. "Kuchengetedza uye pharmacokinetics ye dapivirine kubva kune matrix uye gadziro mukati mezvinyorwa zvindori kune vakadzi vasina HIV." Nyaya Yokuwana Immune Deficiency Syndrome. 2009; 51 (4): 416-423.