Masayendisiti neVatori vePurogiramu Vanobvumidza Kutanga Kuratidzira kweHIV Kurapa Kwevose
Kune nguva yakareba yakakakavadzana pakati pemagadziro anoita vashandi, vatsvakurudzi, uye makiriniki zvakafanana kana kutanga kutapurirwa kweHIV panguva yekufungidzirwa kunogona kubatsira kune murwere, zvose maererano nehutano huri nani kwenguva refu uye kudzivirirwa kweHIV-uye kwete -HIV-zvirwere zvinobatanidzwa.
Chimwe chiitiko chinoshamisa chakabudiswa neNew England Journal of Medicine musi waJuly 20, 2015 chakaita kuti nhaurirano ipfuure nokugumisa kuti kurapa nokukurumidza hakungogadziri mukana wehutano nekufa ne 57% asi zvakadaro zvisinei nokuti munhu wezera, rudzi, zvepabonde, utachiona hwehutachiona , nzvimbo yenyika, mamiriro ehupfumi kana maitiro emuviri wekuzvidzivirira (zvichienzaniswa neinoti CD4 count).
Pamberi pekudzidza, antiretroviral therapy (ART) yakakurudzirwa apo CD4 yakaverengwa yeumwe munhu pasi pechimwe chikumbaridzo (kazhinji pasi pemamiriyoni mashanu / mL kana, mune dzimwe nyika, pasi pe 350 mendi / mL).
Kutsvakurudza kutsva-kunonzi Strategic Timing yeAntiretroviral Therapy (START) kuedza-yakagadzirirwa kuziva kana kurapwa pamatunhu akakwirira eCD4 kunogona kupa zvirwere zvoutano zviri nani pasina kuwedzera dambudziko remurwere wehutano hwepfungwa, hwepvo kana zvimwe zvirwere zvisingawaniki neHIV.
Tanga kudzidza Kudzidza uye Zvigadzirwa
Mhedzisiro yekutanga yekutongwa kwekutanga, yakapiwa muSangano reHIV reAIDS ra2015 muVancouver naDkt. Jens Lundgren weCopenhagen HIV Programme, yakatarisira zvikuru mushure mekunge yaziviswa muna May kuti chidzidzo chacho chizogadziriswa nguva isati yakwana nekuda kwehuwandu hweuchapupu yaro inobatsira.
Kudzidza, kwakatangwa muna 2009, kwakatora 4 685 varume nevadzimai vane HIV vane zvikamu makumi maviri neshanu kubva munyika makumi maviri nemaviri munyika 35, avo vose vaiva nehuwandu hweCCD4 dzemasero mazana mashanu / mL. Zera remakore raive makore makumi matatu, asi 27% yevatori vechikamu vaiva vakadzi.
Varwere vakabva vagoverwa mumapoka maviri: imwe iyo ART yakatanga pakarepo uye imwe iyo iyo ART yakadzoserwa kusvikira iyo CD4 count yemunhu yakaderera pasi pe 350 masero / mL kana kuve nekurwara kwehutachiona hwehutachiona hweHIV kana rufu.
Nenguva yekudzidzira kwekugadziriswa, zviitiko zvakakomba zveAIDS zvine hutano zvakasimbiswa pakati pechipfuva chakasimudzwa chechidzidzo chacho, kanenge kachina kupfuura izvo zvakaonekwa pakati pevarwere vakapiwa chirongwa cheAIDS (14). Saizvozvowo, kwaiva nechokuita kaviri pane dzakawanda zvisingaiti zvekare nezveAIDS (29) kupfuura zvakaonekwa munguva pfupi (ARM).
Tuberculosis, lymphoma uye Kaposi sarcoma (KS) zviitiko zvitatu zvakakonzerwa neAIDS zvakaratidzwa muvadzidzi vanenge vachidzidza, uye 62% yezvizvi zvinowanikwa muvanhu vemuAfrica. Zviitiko zvakakomba zvisingaitiki zveAIDS zvakanyanya kunyanya, kenza , chirwere chemwoyo (CVD) uye rufu.
Neboka, huzhinji hwezviitiko zvinotambudza zvakaonekwa kune vakwegura vakura, izvo zvingaratidzika sezviri kupiwa zvakapiwa mazinga akakwirira ekenza neCVD pakati pevanhu vakwegura vakawanda. Zvinoshamisa kuti kusvuta kwakange kusingaoneki kuchinja migumisiro, zvichiratidza kuti maPirisi epamberi aive akafanana nekubatsira kune vanoputa kupfuura kune vasiri vasvuta.
Zvichida kutsvaga kusina kujairika, zvisinei, kuti zviitiko zvinotambudza zvaisati zvaitika kwete pakati pevarwere vane nhamba yeCD4 shoma, sezvaizotarisirwa, asi pakati pevaya vane ma CD4 akawandisa . Kunyange zvazvo vatsvakurudzi vakanga vasina kukwanisa kutsanangura zvakakwana mhinduro yacho, zvakawanikwa zvakarongedza zvidzidzo zvepakutanga izvo zvakaratidza kuti CD4 inongororwa chete inogona kunge isina kupa mufananidzo wakazara wehutachiona hwemunhu.
Muhurukuro yake, Dr. Lundgren akakumbira kutsvakurudza kune nzira itsva yekudzivirira zvirwere zvekuzvidzivirira kwezvirwere kuti anzwisise nzira dzezviitiko izvi zvisati zvamboitika zvine chokuita neAIDS uye zvisingaiti nezveAIDS.
START Kutaridzirwa Mukadzi Anotsanangura Mukurumbira weAIDS
Dare START yakatanga kuwana kukosha muna 2011 apo imwe yedzidzo, iyo HPTN 052, yakaratidza kuti kutora chirongwa cheART kunopedza ngozi yekutumira hutachiona kubva kune munhu ane hutachiona hwehutachiwana kune mumwe munhu asina hutano hwepabonde-chirongwa chinowanzozivikanwa seChirango seKuchengetedza, kana kuti TASP .
Mukuona kwemigumisiro iyi miviri, vatungamiri paGungano reIAS ra2015 vakabudisa izvo zvinonzi Vancouver Consensus statement, vachizivisa kuti "(vose) vanhu vanorarama neHIV vanofanira kuva nekuwana ma antiretroviral pavanorwara."
Kunyange zvazvo vatungamiri vakabvuma zvipingamupinyi zvakasiyana-siyana zvekushandiswa-kwete zvishoma zvinosanganisira pfupi, gore negore re $ 8-10 mabhiriyoni kuwedzera mune mari kubva kune vanobvumirana nenyika uye nyika dzinopa-vanosimbisa zano rinokwanisa "kugumisa" denda sezvatinoziva naro kare sa2030.
Mukutaura pamusoro pematambudziko ekutanga, Kate Thomson we Global Fund akazivisa kuti chirongwa chakaratidza "kujekesa nguva" mukurwisana kwenyika yose neHIV, imwe iyo ichiri kutarisa mamiriyoni maviri ekutapukirwa mitsva uye kufa kwemamiriyoni 1.2 gore roga roga.
Sources:
Iyo INSIGHT START Chidzidzo Chekudzidza. "Kutanga kweAntiretroviral Therapy muAt Early Asymptomatic HIV Infection." New England Journal of Medicine. July 20, 2015; DOI: 10.1056 / NEJMoa1506816.