Kune zvinodhaka zvinoshandiswa mukurapa kweHIV izvo zvinogona kuwedzera kukanganiswa kweplasma yevamwe antiretroviral agents (ARVs) apo inoshandiswa muhutano hubatanidzwa. Zvinowanzozivikanwa se "kukurudzira," mishonga inobvumira vanachiremba kuderedza kuyerwa uye kuwandisa kwevarindi vemishonga yeAIDS nekuderedza zvingave nemigumisiro yechirwere.
Kuwedzera kweHIV, iyo inonziwo pharmacokinetic enhancers, haifaniri kunge yakanganiswa nemavithamini kana kuwedzererwa kunotengeswa se "mafungiro ekudzivirira zvirwere," izvo zvisingazivikanwi zvipi zvekudzivirira kana kurwisana neHIV.
Kutanga kweHIV Boosters
Apo HIV protease inhibitors (PIs) yakatanga kuwanikwa pakati pemakore ekuma1990, imwe yezvinetso zvakanyanya kune vatsvakurudzi ndeyokukurumidzira kwakakurumidza iyo mishonga yakagadziriswa muropa uye yakabviswa kubva muropa. Somugumisiro, PIs inodiwa kaviri- kusvika katatu-zuva rimwe nerimwe. Haisi kungoita kuti madhiyo akakwirira awedzere njodzi yezvinodhaka zvezvinodhaka, iyo piritsi yepamusoro yakagadzirisa zvakanyanya kuoma (uye kukura kwekumanikidza zvachose).
Muna 1996, chirwere cheNirvir (ritonavir) chakabvumirwa kushandiswa muHIV neU.S. Food and Drug Administration (FDA). Kunyange zvazvo chirwere ichi chakanga chichizivikanwa kuti chiine maitiro antiviral, yakakurumidza kuonekwa kuti, kunyange panguva yakaderera zvikuru, inogona kudzivisa iyo enzyme chaiyo (CYP3A4) inoda kudimburira PIs.
Kuwanikwa kwacho kwakangoerekana kwakagadzirisa nzira iyo maPIs airehwa. Nhasi, Norvir haisati yashandiswa pakuita maitiro ekuraira maitiro, asi pane kuwedzera kushanda kwevashandi vePI, nekuderedza migumisiro yakaipa ine chokuita nerapi.
Mushonga wachowo chikamu chechimiro chakasanganiswa chibatanidza PI, Kaletra (lopinavir + ritonavir).
(Ndapota cherechedzai - Norvir inogona kupindira nehuwandu hweplasma yemimwe mishonga inogona kunge iri kutora, dzimwe nguva inokonzera kukanganisa kukurukurirana kwakanyanya.Nokumbira kurudzira chiremba wako pamusoro pemishonga inogadzirisa yauri kushandisa kana Norvir kana Kaletra inorayirwa.)
Ramangwana reHIV Rinokurudzira
Mumakore achangobva kupfuura, pane zvave zvakanyanya kuiswa zvakakonzerwa nekugadziridzwa kwehumwe huwandu hweHIV. Zvinofungidzirwa kuti avo vanofananidza vangave vasingangowedzera kuwedzera kwehutano hwePIs, asi vanoita zvakafanana kune mamwe makirasi emaARV-zvingangoita kuti vabatane, kamwechete-zuva nezuva, asi vachibvumira "kukanganwirwa" kwakanyanya kunofanirwa kuregererwa kana kupera murapi zvinoitika.
Muna 2012, makore makumi matanhatu nemashure mushure mekutangwa kwaNorvir, wechipiri mushonga wemishonga yakagamuchirwa neDFA. Tybost (cobicistat) , chikamu chechigadziriswa-dose pamwe mushonga wechirwere Stribild (elvitegravir + cobicistat + tenofovir + emtricitabine) , inoratidzirwa kuvhara zvose enzyme yeYP3A4 uye mamwe mapuroteni emuviri anozivikanwa kuti anopindira nekugadzirwa kwemishonga.
Kunyange zvazvo isina zvirwere zvehutachiwana zvayo, Tybost inokwanisa kuwedzera kushanda kwaElvitegravir, ine HIV integrase inhibitor, asi ichibudirira nemigumisiro yakafanana nePIs Reyataz (atazanavir) uye Prezista (darunavir) uye nucleotide analogue Viread (tenofovir).
Mukutanga kwegore ra2015, FDA yakagamuchira mbiri, yakagadzikana inosanganiswa mishonga inosanganisira Tybost, kusanganisira Evotaz (atazanvir + cobicistat) uye Prezcobix (darunavir + cobicistat) .
Zvimwe zviitiko zvekuedza zviri pasi pekutsvakurudza, kusanganisira inoverengeka CYP3A4 inhibitor inokurudzirwa naSequoia Pharmaceuticals.
Sources:
National Institute of Allergies and Infectious Diseases (NIAID). "Iviri itsva protease inhibitors inotenderwa neCDA. Zvokudya uye Drug Administration. " NIAID AIDS Agenda. Bethesda, Maryland; March 1996; 4-5.
US Food and Drug Administration (FDA). "FDA inobvumira Piritsi Inotakura Kurapa kweHIV kune Vamwe Varwere." Silver Spring, Maryland; nyaya yekubudiswa yakabudiswa musi waAugust 27, 2012.
Gallant, J .; Koenig, E ;; Andrade-Villanueva, J .; et al. "Cobicistat Versus Ritonavir semu Pharmacoenhancer weAtazanavir Plus Emtricitabine / Tenofovir Disoproxil Fumarate Mukurapa-Nayo HIV HIV 1 Chirwere chevatachiona 1: Vhiki 48 Zvabuda." Journal of Infectious Diseases. July 1, 2013, 208 (1): 32-39 .
Bristol-Myers Squibb. "Evotaz (Atazanvir + cobicistat) - FULL PRESCRIBING INFORMATION." New York, New York.
Bristol-Myers Squibb. "PREZCOBIX - FULL PRESCRIBING INFORMATION." New York, New York.