Mazano kubva kuDhipatimendi reUnited Health uye Human Services
MunaMeyi 2014, Dhipatimendi reUnited Health and Human Services (DHHS) reUnited States rakarongedza mirayiridzo yehutachiona hweHIV, inokurudzira kushandiswa kwemishonga inorwisa mabhakitiriya (ART) kune vose vakuru vanorwara neHIV, pasinei nehuwandu hweCD4 kana chirwere chechirwere .
Zvinorayirirwa kare zvakadanwa kuWART pamadhadhi eCD4 pasi apa 500 masero / mL, ine ruremekedzo rukuru rweART pane mamwe madhora mazana mashanu / mL.
Chikonzero cheHIV Kuchengetedzwa paKutsvaga
Chisarudzo cheDHHS chinotsigirwa nouchapupu hwokuti kurapwa kwokutanga kunobatanidza nehuwandu hwezvibereko zvakanaka, ndezvi:
- kuderedzwa kwengozi yekufa uye zvirwere zvinosangana nehutachiona hweHIV.
- kuderedzwa kwengozi yekuparidzirwa kubva kuna amai kuenda kumwana.
- kuderedza mukana wekutapurirwa kubva kune munhu ane HIV.
Mashoko ekupedzisira anokurudzirwa anotsigirwa nouchapupu hwokuti kushandiswa kweART kunogona kuderedza zvakanyanya kuderedza kwehutachiwana hwevanhu vane HIV, chirongwa chinozivikanwa seChirango seKubvisa (TasP)
Yakave ichiratidzwa zvakare kuti vanhu vakapiwa chirongwa cheAIDS nokukurumidza vane 53% zvishoma kudarika yekuita zvirwere zvakakomba , zvose zvine hutachiona hweHIV uye zvisingawirirani, pane munhu ane HIV anorambidzwa.
Uyezve, kutanga kweAIDS hakusi kungova nemigumisiro yakanaka asi kwenguva refu. Maererano nevatsvakurudzi vane North American AIDS Cohort Kubatanidzwa Mukutsvakurudza nekugadzirisa (NA-ACCORD), munhu ane makore 20 ane HIV anei zvino anogona kutarisira kurarama mumakore ake ekutanga makumi manomwe kana akabatwa panguva yekuongororwa.
Kusiyana neizvi, kushandura ART kusvikira munhu weCD4 count akatsika pasi pemasero makumi maviri / mL anogona kuderedza mararamiro ehupenyu hwomunhu iyeye anenge avhareji yemakore gumi nemashanu.
Mazano ekurapa kwepakutanga kwevasiri vanhu vakuru
Nokuda kwekare zvisati zvarapwa ("kurapa naive") varwere, boka reUnited States rinowanzokurudzira imwe yematanhatu emishonga yemishonga sevanosarudza maitiro ekurapa kwekutanga:
- Triumeq (dolutegravir + abacavir + lamivudine), inotorwa kamwe zuva nezuva
- Tivicay (dolutegravir) + Truvada (tenofovir + emtricitabine), inotorwa kamwe zuva nezuva
- Stribild (elvitegravir + cobicistat + tenofovir + emtricitabine), inotorwa kamwe zuva nezuva
- Genvoya (elvitegravir + cobicistat + tenofovir AF + emtricitabine), inotorwa kamwe zuva nezuva
- Isentress (ratelgravir) + Truvada (tenofovir + emtricitabine), inotorwa kamwe zuva nezuva
- Prezista (darunavir) + Norvir (ritonavir) + Truvada (tenofovir + emtricitabine), inotorwa kamwe zuva nezuva
Chikonzero chikuru chechirongwa cheDHHS chakasarudzwa chinosanganisira mutoro wepirimen wepasi, nyore kurongedza nguva, kufambiswa kwemaitiro emagetsi, uye kukanganisa kunopesana nemishonga.
Sezvo mamwe mamiriro ezvinhu angaita kuti vamwe vasatora nzira dzakasarudzwa (dzakadai saTruvada mune varwere vane kupererwa kwepvo), DHHS inoratidzira nhanhatu dzemamwe maitiro ekurapa kwepakutanga sezvinotevera:
- Atripla (efavirenz + tenofovir + emtricitabine), inotorwa kamwe zuva nezuva
- Complera (rilpivirine + tenofovir + emtricitabine), inotorwa kamwe zuva nezuva
- Evotaz (atazanavir + cobicistat) + Truvada (tenofovir + emtricitabine), inotorwa kamwe zuva nezuva
- Reyataz (atazanavir) + Norvir (ritonavir) + Truvada (tenofovir + emtricitabine), inotorwa kamwe zuva nezuva
- Prezcobix (darunavir + cobicistat) OR Prezista (darunavir) + Norvir (ritonavir) inotorwa pamwe ne Epzicom (abacavir + lamivudine), kamwe kamwe
Sources:
Dhipatimendi reHutano neHuman Services (DHHS). "Mirayiridzo yeKushandiswa kweAntiretroviral Agents muHIV-1-Vakabatwa Vakuru Nevana Vari Kuyaruka." Rockville, Maryland.
Hogg, R .; Althoff, K .; Samji, H .; et al. Kuwedzera kwehutariro hwehupenyu pakati pevanhu vanotapukirwa neHIV muUnited States neCanada, 2000-2007. "7th International AIDS Society (IAS) Musangano wePathogenesis, Kurapa nekudzivirira Kuala Lumpur, Malaysia.June 30 -July 3, 2013; Abstract TUPE260.
Skarbinski, J .; Furlow-Parmley, C .; uye Frazie, E. "Mumiririri weZvenyika Anofunga nezveNhamba yeHIV + Vakuru Vakagamuchira Kuchengetwa Kwemishonga, Vakanyoreswa nezveVAR, uye Vakagadziriswa Viral Kuderedza-Kuchengetedzwa Kwemishonga Project, 2009 kusvika 2010-US." 19th Conference pamusoro peRevroviruses uye Mikana Yakasangana (CROI); Seattle, Washington; March 8, 2013; Nyaya yemusoro # 138.
Lasry, A; Rudzikinuro, S .; Wolitski, R .; et al. "Kuita zvepabonde nehutachiwana hwehutachiwana hwehutachiwana hwehutachiwana hwehutachiona hweHIV: kuongorora zvinogadziriswa zvekubatanidza maitiro ekudzivirira AIDS . June 14, 2014; 28 (10): 1521-1529.
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.