Kukundikana kumusana mamiriro ezvinhu kungaita kuti 425 000 vakafa
Munguva yemakore gumi akapfuura, vakuru vakuru vehutano vakaita sarudzo dzinoshamisa mukuendesa kwemishonga inoponesa upenyu hweHIV kune vanhu vanogara pasi pose. Maererano neUnited Nations Joint Program pamusoro peHIV / AIDS (UNAIDS), vanhu vanenge mamiriyoni makumi maviri nemashanu vakanga vaiswa pamishonga inorwisa mabhakitiriya pakupera kwegore ra2017, zvichienderana nekumhanya kudarika 43 muzana yehuwandu hwevanhu vane hutachiona hweHIV kubva muna 2003.
Asi kunyange sezvo UNAIDS nedzimwe zviremera zvehutano pasi rose zvichitsvaga kuguma kwechirwere ichi muna 2030, chiito chinotyisa chinotyisidzira kukanganisa kuedza kwakadaro: kuwedzera kwemishonga yakasiyana-siyana isina kukwanisa kushandisa HIV inofungidzirwa kuti inowanikwa nevasayendisiti.
Iyo dambudziko iri harisi kungobatsira nyika-dzisina kukwana nyika (kufanana neyeAfrica inotakura mutoro mukuru wezvirwere zveHIV) asi nyika dzine mari yakawanda iyo mitero yekudzivirira kupfurikidza iri kuwedzera.
Zvinokonzera Multi-Drug-Resistant HIV
Multi-drug resistance is a phenomenon seen in other conditions, like tuberculosis (TB) uye staphylococcal infections , umo munhu ane hutachiona anokundikana kutarisa kune zvakakwana zvakakura zvemishonga inorapa. Mune zvimwe zviitiko, kupikisa kunogona kuve kwakanyanya, zvakadai sechirwere chinotapukirwa neHIV (XDR TB) chinowanikwa mune zvikamu zvekumaodzanyemba kweAfrica, iyo inowanikwa nehutachiwana yakakosha uye inoshandiswa pakushandisa zvinodhaka zvishomanana.
Sezvimwe nemamwe marudzi ekurwisana , kubuda kwemishonga yakawandisa yemishonga inorwisa mishonga inokonzerwa nehutachiwana hunokonzerwa nekukwanisa kwemunhu kutora mishonga yake nguva dzose kana sekurairwa.
Kana inotorwa zvakanaka, zvinodhaka zvinoderedza hutachiona hwekuita kune imwe nzvimbo iyo HIV inonzi "isingaonekwi. " Kana ikatorwa zvisina kururama, basa rehutachiona rinogona kuramba richienda kumatanho apo kushandiswa kwemishonga kusingaiti kunongokura asi kunowedzera.
Nokufamba kwenguva, sezvo kusakirwa kwechirwere kunowanikwa uye munhu anoratidzwa mishonga inowedzera, zvimwe zvinogadziriswa zvinogona kukura, kuvaka imwe pane inotevera.
Kana munhu iyeye achizobatisa mumwe, zvinopesana nemishonga-zvinodhaka zvinopfuurira, zvinopararira mberi kusvika kuvanhu kuburikidza nehutano hwepabonde kana kushandisa injecting drug use .
Dambudziko reCrisis
Maererano neWorld Health Organization (WHO), iyo yakarondedzera dhiyabhorosi kubva kumakiriniki 12 000 munyika 59, avhareji ye20 muzana yevanhu vakapa antiretroviral therapy yakabuda kunze kwechirwere pasina gore rimwechete. Pakati peavo vakaramba vari kurapwa, vazhinji vanodarika 73 muzana vakaiswa musinganzwisisiki, asi inenge imwe yevatatu yakakundikana kuwana hutachiona husingaoneki hunoenderana nekubudirira kwehutano.
Iyi yehutachiona hwehutachiwana mukati mehuwandu inowedzera mikana yekurasika kwezvinodhaka, kunyanya munyika dzakawanda dzinopararira apo vazhinji vakawanda pakati pevanhu vashanu vanotapukirwa. Kunowedzera mamiriro acho ezvinhu nguva dzose zvinodhaka zvinodhaka, izvo zvinosiya varwere pasina mishonga uye zvinokanganisa zvinoda kusvika 36% zvemakiriniki munyika iri kusimukira.
Kunyange munyika dzakadai seU.S., huwandu hwakawanda hwehutachiona husingawanikwi (20 muzana) uye huwandu hwehutachiwana hwekuchengetedza varwere (40 muzana) hwakashandurwa kuhutano hwakaderera hwehutachiona hwehutachiona (28 muzana).
"Hazvigoneki" Multi-Drug Resist Resist Causes Concerns
Chidzidzo che 2016 kubva kuYunivhesiti yeLondon (UCL) chakasimbisa kuwedzera kunetseka pakati peasayendisiti vanotya kuti kukurudzirwa kwezvinodhaka zvinodhaka zvinogona kuchinja huwandu hwekuwana kunoitwa munyika yose kurwisana neHIV.
Mukutsvakurudza kwavo, masayendisiti eUCL akaita chirongwa chekutsvakurudza kwevanomwe 712 varwere vakanga vagamuchira antiretroviral therapy pakati pemakore 2003 na2013 uye vakakundikana pamushonga wekutanga.
Pakati idzi, 115 varwere (16%) vaiva nehutachiwana hweHIV ne-thymidine analog resistance, rudzi rwakabatana nezera rekare remishonga seAIDS uye 3TC. Zvinoshamisa kuti 80 muzana yevarwere ava vairamba vachirwisana neTenofovir, chizvarwa chitsva chakakonzerwa zvikuru munyika yose.
Izvi zvakashamisa kune vazhinji vari munharaunda yekutsvakurudza, avo vaifunga kuti rudzi urwu rwemishonga-zvinodhaka kusakosha, kana zvisingaiti.
Kunyange zvazvo yakanga yave ichizivikanwa kwenguva yakati kuti mukana wekutengesa tenofovir yakanga ichinge ichikura-kubva ku20% muEurope uye neU.S. kusvika kune makumi mashanu muzana muzvikamu zveAfrica-vakawanda vaitenda kuti idzi mbiri dzekusagadzikana kwekuchinja dzisingagoni kubatana.
Kana chiitiko chichienderera mberi, sezvo vakawanda vanofungidzira, migumisiro inogona kuva yakakura. Zvimwe zvidzidzo zvakaratidza kuti mishonga inopesana nemishonga yeHIV inogona kukonzera vazhinji vanopfuura 425 000 vakafa uye 300 000 mitsva inopera mumakore mashanu anotevera.
Pari zvino, vanopfuura 10 kubva muzana yevanhu vanotanga HIV kurapwa mukati uye kumaodzanyemba kweAfrica vanopesana nemishonga yekutanga, asi 40 muzana vachange vachirwisana nenzira yechipiri uye inotevera mishonga yemishonga. Kubatanidzwa kweTenofovir uye thymidine anogamisi yekudzivirira kunowedzera kukonzera nekudzivirira kushushikana kwevanhu kwete chete kana mishonga mbiri, asi mapoka ose emishonga.
Kudzorera Mutambo
Kunyange zvazvo kuwedzera kwehutachiona hweHIV-maererano neUnited Nations '90-90-90 hurongwa -hunokosha pakugumisa denda racho, zvakakoshawo ndezvekuda kwedu kudyara mumagetsi uye kutsvaga zvingagadziriswa kukunda zvipingamupinyi zvakarongeka kune mumwe munhu anotsvaga zvinodhaka kutevera. Icho chiyeuchidzo chakakumbirwa nevatungamiri veW WHO, vanoti hakuna nzira yekuita kuti murwere agadzirire kuchengetedza, kukurumidza kukurumidza kwezvirongwa zvezvinodhaka hakuzombogone kuva nehosha.
Tariro, panguva iyi, iri kuvharirwa mune zvinodhaka zvinonzi ibalizumab, iyo yakapiwa kugadziriswa kwehutano neU.S. Food and Drug Administration muna 2015. Mishonga inopindwa muropa inodzivirira HIV kupinda muchitokisi uye yakaratidzwa kukunda dzakawanda-zvinodhaka- zvinetso zvinopikisa mumatambudziko evanhu. Kunyange zvazvo isati yave yakabvumirwa zviri pamutemo neDFA, kuchinja kwemaitiro kunowanzokurumidza-kunogamuchirwa kubvumidzwa kubva chero ipi zvayo kubva pamwedzi mitanhatu kusvika pagore.
Imwe tsvakurudzo yakaratidzawo kuti chimiro chitsva che tenofovir (chinonzi tenofovir AF) inogona kukwanisa kukunda kusangana kwakasanganiswa ne "yakwegura" maitiro echirwere (chinonzi tenofovir DF).
Kubva pane mumwe munhu maonero, kudzivirira kunoramba kuripo kwekudzivirira kupararira kwekuwedzera kwemishonga. Inoda kuti zvikwata zvepamusoro zvekurapa kwevanhu vanorarama nehutachiona hweHIV uye zvirongwa zvakakwana zvekudzivirira hutachiona hudzivirire zvose zvekuwana uye kutapurirwa kwemishonga inopesana nemishonga.
> Sources:
> Gregson, J .; Kaleebu, P .; Marconi, V .; et al. "Mhirizhonga yeHIV-1 kusagadzikana kwezvinodhaka kune thymidine zvakafanana nekusakundikana kwetenefovir yekutanga kutanga pamwe neytosine analogue uye nevirapine kana efavirenz muSouth Africa yeSahara: chidzidzo chekuongorora masangano akawanda." Lancet Infectious Diseases. November 30, 2016; S1473-3099 (16) 30469-8.
> TenoRes Yokudzidza Gulu. "Global epidemiology yekushungurudzwa kwezvinodhaka mushure mekukundikana kweWIV kwakaronga mitambo yekutanga yehutachiona hweHIV-1: unyanzvi hwekudzivirira hutachiwana hwekudzidzisa." Lancet Infectious Diseases. Musi waJanuary 28, 2016; rakabudiswa paIndaneti.