Chirongwa chinangwa chekudzorera mitero mumharaunda yakanyanya
Utachiona hweHIV seKuchengetedza (TasP) urongwa hunotungamirirwa nehutano hunofanirwa nevanhu vane hutachiona hwehutachiona husingagoni kuonekwa nehutachiwana husingaoneki .
Kunyange zvazvo TPP yakatanga kuonekwa senzira yekuderedza munhu pangozi apo pfungwa yacho yakatanga kubudiswa muna 2006, zvakaitika muna 2010 kuti humwe uchapupu hunobva kuHTPN 052 hutsva hwakaratidza kuti hunogona kushandiswa senzvimbo yekudzivirira vanhu.
Kutsvakurudza Kubuda Kunofungidzirwa Shanduri Yemutambo
The HTPN 052 trial-iyo yakadzidza kukanganiswa kwe antiretroviral therapy (ART) pamitambo yekufambisa muvasodiscordant murume nemudzimai vakaroorana-yakamira makore anoda kusvika mana pakutanga apo yakaratidzwa kuti vanhu vari kurapwa vaiva 96% zvishoma kudarika varwere vavo kupfuura vatori vasiri 't.
Migumisiro yekutongwa yakaita kuti vakawanda vafungidzire kana TasP inogonawo kunonoka, kana isingaregi zvachose, kupararira kweHIV kuburikidza nekuderedza iyo inonzi "inharaunda yehutachiona hwehutachiona." Mukufungidzira, nekuderedza kuwandisa kwehutachiwana hwehutachiwana mukati mehutachiwana, hutachiona hweHIV huchapedzisira husingawanzoitiki sokumisa chirwere ichi munzira.
Uchapupu Mukutsigira kweTapP
Kusati kwatangwa mishonga inotanga kushandiswa kwemishonga inorwisa mabhakitiriya, TasP yaifungidzirwa kusingaitiki nekuda kwehuwandu hwezvinodhaka zvezvinodhaka uye hutachiona hwehutachiona hwehutachiwana hunongopoteredza 80%, kunyange kune avo vane kunyatsoteerera.
Mufananidzo wacho wakachinja zvikuru mumakore achangopfuura, nekutangira kwemishonga inobatsira, inodhura. Kunyange munyika dzakakunda zvakadai seSouth Africa, kuwanikwa kwezvinhu zvakaderera zvinokosha (zvishoma nezvishoma $ 10 pamwedzi) zvakaisa pfungwa iyi iri pedyo nekusvika.
Kunyange zvazvo zvose izvi zvichitaura kuTapP sechikamu chinokosha chemunhu-based-prevention prevention strategy, zvinoreva here kuti zvingave pachizvarwa chevanhu?
Matambudziko Mukushandiswa
Kubva pakutanga, zvakajeka kuti paizova nezvipingamupinyi zvekugadzirisa zvinogona kukunda kana TasP yaive ichigoneka:
- Izvo zvinoda kutaridzika kukuru kwekuongororwa kweutachiwana nehutachiona, zvikurukuru munzvimbo dzisina kukodzera, dzakapararira. MuUnited States, vazhinji vevanhu vatanhatu vane HIV vanonyatsoziva nezvehutano hwavo. Mukupindura, US Prevention Services Task Force ikozvino inokurudzira kuongororwa kwekare kwevose veAmerica vane makore 15 kusvika ku65 sechikamu chekushanya kwechiremba wenguva dzose.
- Zvinoda kuwedzera kuwedzera kwevateereri varipo. Maererano neCenters for Disease Control and Prevention (CDC), 44% chete yevaAmerica vanorwara neHIV vanobatanidzwa kuchipatara. Kutsvakurudza kunoratidza kuti kutya kuzarura nekushayikwa kwehutachiwana hwehutachiwana hwehutachiwana hweHIV kune zvimwe zvikonzero zvekuti vazhinji vanononoka kurapwa kusvika pakuonekwa kwechirwere chechiratidzo.
- Izvo zvinoda nzira iyo yekuita kuti huwandu hwekuchengetwa kwevanhu hubudirire, hubudiriro hwahwo hwakasiyana zvikuru uye hwakaoma kufanotaura. Maererano neCDC, vanhu vane hutachiona hweHIV vari kurwara panguva ino, vanenge vanenge vana pavanenge vasingakwanisi kuchengetedza zvakakosha kuti vabudirire kukanganiswa kwemishonga yakakwana.
- Pakupedzisira, mari yekushandiswa inoonekwa sechipingamupinyi chikuru kunyanya sezvo hutachiona hweHIV huri kuramba hwakanyanya kuderedzwa.
Uchapupu Mukutsigira kuTapP
Guta reSan Francisco ringangodaro riri chinhu chapedyo kune uchapupu hwechirevo cheTapP. Nevarume nevarume vanoita zvepabonde vanenge makumi mapfumbamwe kubva muzana zvevanhu vane hutachiwana hweguta racho, kushandiswa kwakasimba, kupindira kwakarongeka kwakaguma nehuwandu hwematambudziko asina kuwanikwa. Kupararira kwakawanda kweART kwakakonzera zvakananga kuti 33 muzana inodonha muhutachiwana hutsva kubva muna 2006 kusvika muna 2008. Muna 2010, kuiswa kwehupenyu hwepasi rose pakucherechedza zvakaguma kwakaguma nekuwedzera kwemazana matanhatu muhuwandu hwevanhu vanogona kuchengetedza kuzora kwoutachiona kwakakwana .
Asi vazhinji vanobvumirana kuti San Francisco ine humwe hunoita humwe humwe hune simba kune vamwe vanhu vane HIV. Icho chiripo chisina kukwana uchapupu hunotsigira kana TasP inoderedza hutachiwana hwehutachiwana mumutambo mumwechete kune imwe nzvimbo.
Zvechokwadi, chidzidzo che2015 kubva kuYunivhesiti yeNorth Carolina chakaratidza kuti kunyatsogadzirisa nyika kweTPP kunogona kuderera mune dzimwe nzvimbo dzinokosha. Kuongorora, kwakatarisa 4 916 serodiscordant mazano mumusangano weHenan weChina kubva muna 2006 kusvika muna 2012, akadzidza zvakakosha zveART maererano nehutachiona hwehuwandu mune huwandu umo kushandiswa kwekondomu kusingagumi kwaive yakakwirira (63 muzana) uye kuwandisa kwezvirwere zvepabonde uye Kuita zvepabonde kwepabonde kwakanga kwakaderera zvikuru (0.04 uye 0.07 muzana, zvichienderana).
Maererano nekudzidza, 80 muzana yevamwe vane HIV, avo vose vakanga vachangobva kutorwa pakutanga kwekutongwa, vakanga vagoiswa paAIDS muna 2012. Panguva iyoyo, kudonha kwehutachiona hutsva kwakabatana nehuwandu hwekuderedza dambudziko rekukomba 48 muzana.
Uyezve, sezvo chidzidzo ichi chichienderera mberi uye vamwe vane hutachiwana hweHIV vakagadzirirwa paART, maitirwo akaonekwa akaregerera mberi. Kubva muna 2009 kusvika muna 2012, kushandiswa kweAIDS kwakashandurwa kwakaderedza hutachiwana hweHIV nevanenge 67 muzana, inenge katatu zvakaonekwa kubva muna 2006 kusvika muna 2009 apo yaingova 32 muzana chete.
Shoko Rinobva
Sezvinokumanikidza sezvinoitika izvi, zvakakosha kuziva kuti, pamunhu mumwe oga, TasP haina kumbobvira yakarongwa sangano rega-roga, kunyange pakati pevanhu vakazvipira, sarodiscordant couples. Zvaisati zvambofanirwa kutora makondomu kana kupa mvumo yekusununguka yekusiya zvepabonde zvakachengeteka zvepabonde.
Nezvo izvo zvichitaurirwa, zvinangwa zverongwa huri kuramba hwakasimba. Izvi zvinonyanya kuitika kune vakaroorana vanoda kuva nevana kana vanhu vari pangozi yakakura yehutachiona . Mumamiriro ezvinhu akadaro, pre-exposure prophylaxis (PrEP) inogonawo kurongerwa kuti dzirambe dzichidzivirira munhu asina HIV. Kana yakashandiswa pamwe chete, TasP uye PrEP inogona kuderedza njodzi yehutachiwana kusvika pedyo-kusakanganiswa kwezinga.
Nguva dzose kurukurai izvi zvingasarudzwa nachiremba wenyu musati matanga pane imwe nzira yakadaro.
> Sources:
> Cohen, M .; Chen, Y ;; McCauley, M .; et al. "Kuchengetedzwa kweHIV-1 utachiona nehutano hwekare hwehutachiona hweHIV." New England Journal of Medicine. August 11, 2011; 365 (6): 493-505.
> Gill, V .; Lima, V .; Zhang, W .; et al. "Kuvandudzwa kweZvirevo zveVirological muBritain Columbia Zvinopindirana neAchiri Kuwedzera kweHIV Type 1 Drug Resistance Detection." Clinical Infectious Diseases. January 1, 2010; 50 (1): 98-110.
> US Centers for Disease Control and Prevention (CDC). "Zviratidzo Zvinokosha: Kudzivirira Utachiona kuburikidza nekuchengetedza uye kurapwa - United States." Kuipa uye Kufa Kwemavhiki Gwaro (MMWR). December 2, 2011; 60 (47): 1618-1623.
> Charlebois, B .; Das, M .; Porco, T ;; uye Havlir, D. "Migumisiro yeArged Antiretroviral Treatment Strategies pamusoro peAIDS Kurwisana pakati pevarume vanoita zvepabonde nevarume muSan Francisco." Clinical Infectious Diseases. April 15, 2011; 52 (8): 1046-1049.
> 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].