Kurapa HIV / AIDS

Chirongwa cheHIV Kuchengetedzwa

Ikoko kunogona kuva pasina mubvunzo kuti mishonga inoshandiswa mukurapa HIV yakapfuura zvinoshamisa mumakore gumi adarika. Izvi ndezvechokwadi kana zvichienzaniswa nevakuru vemazana evanhu vemazana avo vaiva nehuwandu hwehuwandu hwehutano uye vainyanya kutarisana nekugadzirwa kwekutanga kwezvinodhaka zvinodhaka. Zvimwe zvingave zvisingacherechedzi ndeyekuti sainzi yakasvika kusvika kurei muna 1996, apo chirwere chekutanga chechirwere chechirwere chakashandura nzira chaiyo yehosha.

Kusati kwa1996, chiyero chekurarama kwehupenyu chechangobva kuine mukomana wemakore 20 muUnited States yaiva makore gumi nemana. Mazuva ano, zvizvarwa zvitsva zvinorapwa zvinokwanisa kuwana hupenyu hunoenzana nehuwandu hwevanhu pavanenge vachizvirumbidza zvishomanana zvido zvemishonga uye kupa sarudzo zvisinganzwisisiki sepiritsi imwe pazuva.

Asi, pasinei nekufambira mberi uku, vanopfuura hafu yevaAmerica vachirapa vanogona kuzadzisa zvinangwa zverapi, zvichida zvichienderana nekusawirirana kwekurapa kana kukanganiswa kwekuzvidira kwekurapa.

• Ndezvirimwa-Zvinodhaka Zvirwere Zvinotevera Frontier muHIV Kurapa here?

• 4 Mazano ekuita kuti utachiona hweHIV huwedzere kushandiswa

Kunyanya pamusoro pazvo zvakadaro ndeyekuti, kune mamiriyoni 1,2 evaAmerica vanorarama neHIV nhasi, chero ipi zvayo pakati pe20 kusvika ku25 muzana ichigere kuonekwa.

Pakupedzisira, kurapwa kweHIV kune zvinopfuura mapiritsi chete. Iko panyaya yekuziva kuti madhiragi anoshanda sei nekuziva izvo zvaunoda kuita semumwe munhu kuti aite zvakanakisisa migumisiro yakanaka, ingave iwe uchangobva kutapukirwa kana kutizve unoita nekutarisira.

Chii Chinonzi Antiretroviral Zvinodhaka?

Utachiona hweHIV hunoshandiswa se retrovirus , zvinoreva kuti inodzokorora mumashure mokuti mamwe mavairasi anopindura sei. Panzvimbo pekushandura maitiro ekuberekwa kubva kuDNA kusvika kuRNA sezvisikwa zvipenyu zvakawanda, HIV inonyora kodhi yayo kubva kuRNA kusvika kuDNA.

Nokutsanangura nzira iyo HIV inoshandura nayo, masayendisiti akashandisa mishonga inokwanisa kukanganisa matanho chaiwo muhutachiona hwehupenyu. Iyi mishonga, iyo yatinotaridzira semishonga inorwisa mabhakitiriya , inoshandiswa mumishonga yakafanana yekudzivisa kudzokorora kwemhepo kune imwe nzvimbo iyo inonzi isingaoneki.

Kunyange zvazvo zvakakosha zvikuru, zvinodhaka zvekare zvinotadza kupedza hutachiona asi zvinokanganisa kukwanisa kwayo kudzokorora. Nokuita kudaro, maitiro ezvirwere zvezvirwere zvezvirwere anoramba akasimba uye anogona kukwanisa kurwisa zvirwere (inozivikanwa sezvirwere zvinobatsira) izvo zvinogona kubuda kana kudzivirirwa kwezvirwere kusingagadziriswi.

Antiretrovirals Anoshanda Sei?

Antiretroviral therapy inoshanda nekudzivirira HIV kuti irege kudzokorora pamatanho makuru muhupenyu hwavo , inotsanangurwa zvakajeka se:

1. Kusungirirwa-danho iyo HIV inosungiririra kune imwe sero
2. Kusanganiswa-danho iyo HIV inoputira kumagetsi uye ichiisa maruva ayo mujeri
3. Kudzokorora kushandura-iyo danho iyo virusi RNA inyoreswa kuDNA
4. Kushamwaridzana-danho apo DNA yeHIV inosanganiswa mumusana wejeri rekuchengetedza (iko kushandisa integrase enzyme), zvichikurumidza kuvhara magetsi

1. Kudhindwa-chiitiko apo HIV inoshandisa iyo mishonga kuti iite zvivako zvezvivharo zvitsva
2. Gungano-chiitiko apo chirwere chemajeri chakasangana uye chinotamira kune chepamusoro memusasa
3. Kubhadharira nekutsvaga-chiitiko apo hutachiona hwechokwadi hunoputika kubva mumusero wechipfuva uchishandisa protease enzyme kuumba virusi yakakwana

Nokushandisa kusanganiswa kwemishonga (iyo inhibisa zvikamu zviviri kana kupfuura zvehupenyu hwehupenyu), hutachiona hweHIV huri kupera zvachose, uye hutachiona hutachiona hutachiona hunogona kupukunyuka uye hunofamba pachena muropa.

Makirasi eAntiretroviral Zvinodhaka

Iko kune zvikamu zvishanu zvemishonga inorwisa mabhakitiriya, imwe neimwe yakarongedzwa nechetatu rehupenyu hunoita kuti:

1. Fusion inhibitors
2. Nucleoside reverse transcriptase inhibitors
3. Kwete-nucleoside reverse transcriptase inhibitors
4. Integrase inhibitors
5. Protease inhibitors

Pazvikamu izvi zvishanu, pane 39 mishonga yakasiyana-siyana yemishonga inorambidzwa nemishonga inobvumirwa neU.S. Food and Drug Administration, kusanganisira 12 kusanganiswa kwemazai (FDC) ane madzimai maviri kana kupfuura.

Nei Chirwere Chinobatana Chinoshanda

HIV inowanzoumbwa nehutachiona hwehutachiona hukuru (hunonzi "chirwere chemhuka") pamwe chete ne plethora yekuchinja kwehutachiona , mumwe nomumwe ane mazita akasiyana-siyana ekunyora mazita uye maitiro. Kurapa kwekusanganiswa kunoshandiswa kudzvinyirira sezvizhinji zvezvimwe zvinoshandiswa sezvinobvira kune imwe nzvimbo apo mutachiona wehutachiona hwevanhu hunofungidzirwa kusingaoneki .

Kana yakashandiswa pamwe chete, zvinodhaka zvinodhaka zvinoshanda sechimwe chinhu che "biochemical" team. Kana chirwere A, somuenzaniso, hachikwanise kudzvinyirira kushandiswa nekusimudzira chikwata muhupenyu hwehupenyu, zvino chirwere B uye C vanogona kupedzisa basa nekurwisa imwe nhanho yakasiyana.

Kuongorora kushandiswa kwemajeni kunoshandiswa navanachiremba kubatsira kubatsira mhando uye zviyero zvekuchinja kwezvinhu zviripo mukati mehutachiona hwehutachiwana hwevanhu. Kubva pamigumisiro yechirongwa, kurapa kunogona kugadziriswa kuitira kuti mishonga yakanyorwa irege kugadzirisa chete kukwana kwehutachiona hwakakwana asiwo kukunda chero mishonga inopesana nemishonga inogona kuvapo mukati mehutachiona hwevanhu.

Nguva Yokutanga Antiretroviral Therapy

MunaMeyi 2014, Dhipatimendi reUnited Health and Human Services (DHHS) reUnited States rakarongedza mirayiridzo yehutachiona hweHIV, iyo inokurudzira kushandiswa kwemishonga kune vose vakuru vanowanikwa vane HIV, pasinei nehuwandu hweCD4 kana chikamu chechirwere .

• Ikoko Subdermal Implants Inogona Kuva Icho Chine Frontier Mukudzivirira kweHIV

• Daklinza (daclatasvir) Hepatitis C Zvinodhaka Mishonga

Munguva yakapfuura, kurapwa kwakakurudzirwa chete apo CD4 yakawanda yevanhu yakaderera pasi pechikumbaridzo chemasero mazana mashanu / mL.

Chisarudzo cheDHHS chakatsigirwa nouchapupu hwokuti kurapwa kwekutanga kunobatanidza nehuwandu hwezvibereko zvakanaka, ndezvi:

• Kuderedzwa kwengozi yezvirwere zvakabatana neutachiona hweHIV
• Kupera mukana wekuparidzirwa kubva kuna amai kusvika kumwana
• Kuderedzwa kwengozi yekutapurirwa kweHIV

Mashoko ekupedzisira aya anotsigirwa nehupupuriro hwekuti antiretroviral therapy inogona kuderedza zvakanyanya kupererwa kwevanhu vanogara neHIV, chirongwa chinozivikanwa seArape as Prevention (kana TasP) . Yakaratidzwawo kuti vanhu vanogoverwa nehutachiona hweHIV pakutanga ndivo makumi mashanu kubva muzana kubva muzana vanogona kuwedzera zvirwere zvakakomba , zvose zveHIV- uye zvisina hutachiona hweHIV.

Kusiyana neizvi, kurerutsa kurapwa kusvikira munhu aine CD4 count inoderera pasi pe2002 (danho rezvirwere rinozivikanwa seAIDS ) rinogona kuderedza mararamiro ehupenyu hwomunhu iyeye anenge avhareji yemakore gumi nemashanu.

Ndezvipi Zvinodhaka Ndinofanira Kutanga Nazvo?

Kunyange zvazvo mazano ekurapa acharamba achichinja uye achichinja nekubudiswa kwemishonga mitsva kana kuti svesayenzi, sangano rezvino remainzi rinokurudzira kushandiswa kwechizvarwa chitsva integrase inhibitors uye nucleoside analogues mumutambo wekutanga.

Chinangwa chekutanga chekurapa ndeyekupa mishonga iyo ichapa iyo yakajeka dosing nguva, zvishoma zvishoma migumisiro, uye yakaipisisa dambudziko rekugadzirwa kwezvinodhaka zvinodhaka. Nhasi, dzakawanda zvezvinodhaka zvinoshandiswa zvinowanikwa mune imwe mapiritsi, kamwe chete kuumbwa kwezuva nezuva, iyo inogona kuwedzera zvakanyanya kukwanisa kwevanhu kuchengetedza maitiro ekuteerera izvo zvinokosha pakubudirira kwekurapa.

Izvi zvinonyanya kukosha sezvo sangano rezvino rekutsvakurudza rinoratidza kuti vanhu vari kurapwa vanoda kuchengetedza kupfuura makumi mapfumbamwe ekutengesa kwepamusoro kuitira kuti vawane zvinangwa zvakakwana zverapi.

Dzidza zvakawanda nezvemazano ekurapa iye zvino akataurwa neDhipatimendi reMishonga yeUtano neHuman Services kuvanhu vakuru vanorarama neHIV.

Chii Chinoitika Kana Kurapwa Kunokundikana?

Kana zvakatorwa sezvinorayirwa, mishonga yako inotapukirwa nehutachiona inofanirwa kuramba yakabatana zvachose kwemakore mashanu, gumi, kana gumi nemashanu. Izvi zvinogona kusiyana nemunhu kumunhu, hongu, zvichienderana nemhando dzehutachiona hutachiwana hutachiwana. Asi kazhinji kutaura, nguva yehutano hwehutano inobatanidzwa zvakananga nehuwandu hwekuteerera munhu anokwanisa kubudirira.

Kukundikana kuchengetedza chirwere chetachiona kunoita kuti utachiona udzoke zvakasununguka, kupa mishonga isingagadzirisi mishonga inokwanisa kubudirira uye inova yakasiyana zvikuru . Kana izvi zvikaitika, kurapwa kuchava kuderera uye kuderera nekupedzisira kusamira kushanda zvachose. Izvi zvinozivikanwa sehutano husakundikana .

Panguva ino, vanachiremba vachada kuita zviratidzo zvekusagadzikana kwema genetic kuti vaone kuti yakawanda sei kusagadzikana kwezvinodhaka. Mune zvimwe zviitiko, kupikisa kunogona kukanganisa imwe chete kana maviri mishonga; mune dzimwe, zvidzidzo zvose zvingashandurwa zvisina maturo. Kurapa kuchazodikanwa kuongororwa kuitira kukunda zviri nani nyaya idzi paunenge uchitaura zvinetso zvekunamatira izvo zvingave zvakakonzera kukanganisa kurapwa munzvimbo yekutanga.

Dzidza zvakawanda pamusoro pezano uye mazano ekuchengetedza zvakakwana kutarisana nehutano hweHIV.

Sei Hatingakwanisi Kutora Antitretrovirals Kuchengetedza HIV?

Kunyange zvazvo ma-antiretroviral akakwanisa kudzivisa kudzokorora kwemhepo, vanonyanya kuita saizvozvo nehutachiona huchifamba pachena mumvura yemuviri.

Mukati mehutachiona hwevanhu, hutachiona hwehutachiona, hunonzi provirus , hunokwanisa kuvharira mumasero uye masukisi emuviri unozivikanwa sevadavhuna anonzi latent . Panzvimbo pane kudzokorora uye kubuda kubva mumasero ane utachiona, zvinoita kuti HIV iparadzanise uye inopindirana pamwe chete nemusasa wechirwere, isingazivikanwi nemajoni ezvirwere. Inogona kuramba iri mumamiriro ezvinhu kwemakore uye kunyange makumi emakore, kungoitazve kubuda apo kana kurapwa kuchimiswa kana kuratidzika kusina kubudirira.

Kusvikira masayendisiti akwanisa "kukanda" utachiona kunze kwezvivako izvi zvakavanzika, kukwanisa kwepi zvayo mujeri kubvisa zvachose HIV hazvibviri, kana zvisingaitiki.

_Sources:

_{Dhipatimendi reHutano neHuman Services (DHHS). " Mirayiridzo yeKushandiswa kweAntiretroviral Agents muHIV-1-Vakabatwa Vakuru Nevana Vechidiki." Rockville, Maryland; yakagadziriswa July 14, 2016.}

_{Hogg, R .; Althoff, K .; Samji, H .; et al. "Kuvhara Gari: Kuwedzerwa mune tarisiro yehupenyu pakati pevanhu vanobatwa neHIV muUnited States neCanada, 2000-2007." 7th International AIDS Society (IAS) Musangano wePathogenesis, Treatment uye Prevention. Kuala Lumpur, Malaysia. June 30-July 3, 2013; Abstract TUPE260.}

_{Skarbinski, J .; Furlow-Parmley, C .; uye Frazie, E. "Mumiririri weZvenyika Anofungidzira Nhamba yeHIV + Vakuru Vakagamuchira Kuchengetwa Kwemishonga, Vakanyoreswa nezveVAR, uye Vakagadziriswa Viral Kuderedza - Chirongwa Chekuona Kurapa, 2009 kusvika 2010-US." 19th Conference pamusoro peRevroviruses uye Mikana Yakasangana (CROI); Seattle, Washington; March 8, 2013; Nyaya yemusoro # 138.}

_{Kitahata, M .; Gange, S .; Abhurahama, A., uye al. "Migumisiro yepakutanga kuenzaniswa nehutachiona hwehutachiona hweHIV mukurarama." New England Journal of Medicine. April 30, 2009; 360 (18): 1815-1826.}

_{Sax, P .; Meyers, J .; Mugavero, M., et al. "Kuenderana neAntiretroviral Treatment uye Correlation neKuisa Njodzi Yezvipatara pakati pevatengesi veHIV vanochengeterwa HIV muUnited States." Tenth International Congress pamusoro peDrug Therapy muHIV Infection. November 8, 2010; Glasgow; Mharidzo yehurukuro # 0113.}