Utano Huri nani, Lower Transmission Risk Pakati Pezvipo
Musi waSeptember 30, 2015, World Health Organization (WHO) yakarongedza mirayiridzo yehutachiona hweHIV munyika yese yekukurudzira kushandiswa kwemaantiretroviral therapy (ART) munguva yekuongorora.
Kusvikira munguva pfupi yapfuura, pakanga paine nhaurirano iri kuenderera mberi pakati pevadzidzisi vemagadziro nevatsvakurudzi vekuti chirongwa cheART chinofanira kutangwa nokukurumidza kana kunonoka kusvikira nguva yakadai sechirwere chemuviri chichiwira pasi pechimwe chiyero chemuviri (sekuenzaniswa neCD4 munhu wacho).
Vatsigiri veAIDS vanokurumidza vakatarisa kune dhiyabhorosi yakaratidza kuti kupindira kwepakutanga kwakaderedza kukanganisa kwenguva yakareba HIV inogona kukonzera masimba evanhu-kukuvadza kunogona kuwedzera kuwedzera njodzi yezvirwere zvemazuva mazhinji. Vatsoropodzi vakanyevera kuti pakanga pasina humwe huripo hwokuti kutanga ma ART pane yezvino inoridzirwa chikumbaridzo (CD4 chiverengero pasi pe 500 masero / mL) chaive nechinonyanya kukosha pane zvinokonzerwa nechirwere kana hupenyu hwemurwere.
Kuchinja kwehurongwa hwe WHO kunowedzera huwandu hwehuwandu huwandu hwevanhu vanoda ART, kubva kune mamiriyoni gumi nemashanu kusvika kuhuwandu hweHIV hwemamiriyoni 37.
Kutanga Kudzidza Kuchinja Global Global Policy
Musi waMay 27, 2015, masayendisiti paNational Institute of Allergies and Infectious Disease (NIAID) pakupedzisira akaisa mharokiti refu kwenguva refu yokuzorora nekugumisa Strategic Timing yeAnterretroviral Treatment (START) kudzidza kupfuura gore rapfuura nekuda kwekunatswa-kucheka uchapupu hwokuti kurapwa kwekuongororwa, pasinei neCD4 count, kwakabatsira chaizvo varwere vane HIV.
Chidzidzo icho chakanyoresa varume nevakadzi vanokwana 4 685 vane HIV vane makore gumi nemana nemakore, vaifanira kugumisa pakupera kwegore ra2016, asi rakapera nguva isati yasvika kana zvigumisiro zvenguva pfupi zvakaratidza kupera kwe 53% kwehuwandu hwezvirwere zvakakomba pakati pavo avo vaibatwa pakarepo vachitsinhanisa avo vane avo vakanonoka ART.
Zvitsva zvaive zvisingagumi pane zvidzidzo zvekudzidza, kana varwere vaibva kunyika dzakakwirira, dzepasi kana dzepakati.
Mukupindura, masayendisiti nevanoita mitemo vakabudisa mushumo wepamutemo musi waJuly 19, 2015, vakaonekwa seVancouver Consensus, iyo yakadana kuti pakarepo kuumbwa kweART mune varwere vose. Mukutaura kwavo, boka racho rakarondedzera zvikonzero izvo ART inorwara kuongororwa yakagadziriswa kune zviitiko zviri nani kuvarwere vane HIV.
Kutanga Kurapa Kunogadzirisa Kukanganisa Kwemazuva Ekupedzisira Kumanikidzwa
Pakazosvika chirongwa che START, vatsvakurudzi vazhinji vakanga vakangwarira nezvekurapa HIV pakuongororwa sehutachiwana hwehutachiona hwevarwere vakatanga ART pane zvinyorwa zveCD4 zvema 350 masero / mL zvaive zvakatarisa upenyu hwakafanana sehuwandu hwevanhu. Sei, vakakakavadzana, tinofanira kuisa pangozi kusarudzwa kusingatarisirwi kurapwa patinotanga pamatunhu akakwirira eCD4 tisingabatsiri mamwe maitiro maererano nekuwedzera kwehupenyu?
Pamusoro pekufa kwega moga, izvo zvingaratidzika kunge zvakakosha. Mukureva zvekurwara, zvisinei, chokwadi chinotaura zvakasiyana.
Munguva yehutachiona chero ipi zvayo, muviri unotarisana nekuputira kupindura muhupo hwehutachiona hwehutachiona hwakadai seHIV. Kana ikasatenderwa, kuenderera mberi, kuputika kunoramba kuchikonzera kunogona kukonzera kusakanganiswa kusingagoneki kumasero nematumbu emuviri.
Nemhaka yokuti chirwere cheHIV chirwere chisingagumi, kunyange kupfuurira, kukwidziridzwa kwepamusoro-soro kunogona kukonzera kusakara kwenguva refu kwemasero-inozivikanwa senescence isati yasvika kana kuti "kuputira" -iyo nhoroondo dzepamusoro yezvirwere zvepfungwa uye kanzira kune vanhu vane HIV, kazhinji 10- Makore gumi nemashanu apfuura pane vamwe vasina kutapukirwa.
Kunyange kune vanhu vane maitiro ekurwisa HIV-vanozivikanwa se "vatungamiri vehurumende" -kukanganiswa kwekusingaperi kusaguma kunowedzera kubudirira kwehurombo uye huwandu hwezvirwere kana uchienzaniswa nevanhu vari paAIDS vane hutachiwana hwakakwana .
Zvichinyatsojeka, nokuisa munhu paAIDS pamatanho ekutanga ehutachiona , iwe unomuponesa munhu iyeye kusakosha kwekuvhiringidza kunobatanidza nechirwere chisina kutenderwa.
Kuteerera kunongobvumira kuvhiringidza kupfuurira, kusingabvumirwi, kune chero ipi zvayo kubva pakati pemakore mashanu kusvika ku10.
Zvitsva Zvinodhaka Zvipi Zvokupa Chinyorwa Chinokosha, Kukurudzira Kuvandudzwa
Zvizhinji zvezvinetso zvine chokuita nekugara kwenguva refu kwemishonga zvakatangwa pane zvakaitika zvakaonekwa nezera rekare remishonga inorwisa maitiro , apo kupararira kwekushandiswa kwaiwanzoguma nekukanganisa kusingatarisirwi kwomurwere.
Zvinodhaka zvakadai se stavudine, somuenzaniso, zvakaonekwa zvichiita kuti zvikwereti zvakanyanya zvezvinodhaka zvezvinodhaka zvirwere muvarwere, zvichibva pamakumbo anonzi lipodystophy (kuongororwa kusinganzwisisiki kwemafuta emuviri) kuuropathy (kukuvara kunorwadza kumasero emagetsi) kune lactic acidosis (inogona kutyisa upenyu kuvaka-up ya lactic acid).
Saizvozvowo, dzakawanda zvepakutanga ma antiretroviral vakange vasina huwandu hwemagadzirirwo emishonga. Kushandiswa kweevirapine mune monotherapy, somuenzaniso-miitiro shoma pfupi muna 2002 kudzivirira kutapurirwa kweamai kusvika kune vana- inosvika mumatunhu akakwirira ekurwisana nevirapine, dzimwe nguva mushure mekuita imwe chete.
Izvi zvinokonzerwa nekuderedzwa kwemishonga mitsva, izvo zvinongoratidzira mazamu emapato mapfupi asi madiki madzimai mapiritsi uye "kukanganwirwa" kukuru (kureva kukwanisa kuchengetedza maitiro ekurapa mishonga kunyange kana miviri isipo).
Uyezve, kutya kwekutapukiswa kwemishonga -kupera kwekurwisana kubva kune mumwe munhu kuenda kune inotevera-kwakanyanyisa kubviswa, nemashoko aripo kubva kuWorld Health Organisation anoratidza kuwedzera kwehutachiona hwehutachiwana hunenge 7% munyika dzepasi-kusvika kune imwe nyika ( inenge hafu yakaonekwa muUnited States neEurope).
Munyika dzakapfuma zvakanyanya, kushandiswa kwemishonga inoparadzirwa kunowanzoenderana nezera rekare remishonga yakaiswa kune avo vanogaramo makore gumi nemaviri apfuura kupfuura munyika dzakawanda dziri kusimukira.
Zvidzidzo zvakafanana zvakaratidza kuti hutachiona hweHIV mune nyika dzisina mari , iyo inokonzerwa nehutachiona inozivikanwa kuti inowanikwa, yakaderera zvikuru, zvichida zvikuru, kuti kunyangwe vanhu vashomanana vakanga vaiswa kurapwa vachienzaniswa neAmerica neEurope.
Kurapa Kuzivikanwa Kunogona Kuderedza Kupararira kweHIV
Kurapa seKudzivirira (TasP) inzira inodzivirira iyo inotarisira kuderedza izvo zvinonzi "hutachiona hwemahara" nekuisa boka revanhu paART. Mukuita kudaro, mikana yekutapurirwa kweHIV inonyanya kuderedzwa sezvo vanhu vakawanda vachikwanisa kuchengetedza zvakakwana kushandiswa kwehutachiwana .
Nzira yacho inonyanya kutsigirwa neuchapupu hunobva kuSan Francisco, guta rakaona kudonha kwe30-33% mune hutachiona hweHIV kubva muna 2006-2008 nekuda kwekupararira kwema antiretrovirals. Kubva pamigumisiro iyi, vakuru vakuru veguta vakataura chirongwa cheART pane chirwere chekuongorora mukutanga kwegore ra2010.
Saizvozvowo, chidzidzo che2015 kubva kunharaunda yeHenan yeChina chakaratidza kuti njodzi yekuparidzirwa mumadzimai e-serodiscordant (kureva, munhu ane HIV neavo vane HIV isina kunaka) yakaderedzwa ne 67% kubva muna 2006-2009 sekusvika 80% Vachidimbu vane HIV vane hutano vakaiswa paART.
Mukuita kwehutano hwepasi rose hweART pahutano hwehutano, vazhinji vehutano vanofunga kuti kubudirira kwakafanana kunogona kuitwa kunyange muhuwandu hwehuwandu hwevanhu vanoita seSouth Africa, uko hutsva hwehutachiona huri kuramba huchikwira kunze pasinei nekuwedzera kweART.
Pasinei nokuti zviremera zvepasi rose zvinogona kuzadzisa zvinangwa izvo zvakapiwa zvipo zvekubhadhara mari kubva kune dzimwe nyika G8 dzakabudirira ndeimwe nyaya yacho zvachose. Nevanhu vanopfuura mamiriyoni makumi matatu vane utachiona hweHIV nhasi-uye vane mamiriyoni gumi nematanhatu paAIDS-dambudziko guru rinogona kunge richiwedzera kurapwa munyika umo hutano hwehutano hwakawanda husiri chokwadi, zvakanakisisa.
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Hasse, B,; Ledergerber, B ;; Egger, M., et al. "Kukwegura uye (Kwete-asina hutachiona hweHIV) Kurwisana nevanhu vane HIV: Chidzidzo cheSwitzerland Cohort (SHCS)." 18th Conference pamusoro peRevroviruses uye Mikana Dzakasangana (CROI). Boston, Massachusetts; February 27-March 2, 2011; abstract 792.
Pantazis, N .; Porter, K .; Costagliola, D .; et al. "Muongorori Wenguva Yakaitwa Mukuratidza Zviratidzo zveHIV-1 Virulence uye Transmissibility: Chidzidzo cheAn Observational Cohort." The Lancet HIV. December 2015; 1 (3): e119-126.
Smith, K .; Westreich, D .; Liu, H ;; et al. "Kurapwa Kuchengetedza Utachiona hweHIV muVerodiscordant Couples muHenan, China, 2006 kusvika 2012." Clinical Infectious Diseases. March 13, 2015; pii: civ200. [Epub mberi kwekudhinda].
Human Sciences Resource Council (HSRC). " South Africa National Prevalence HIV , Kutevedzera uye Maitiro Ekuongorora, 2012." Pretoria, South Africa; yakabudiswa musi waDecember 1, 2012.