Ngendlela Uvavanyo olungaphumeleli Ngaphambi koPhando lwe-HIV
"Ukuphulukana" ligama elisetyenziswe rhoqo-abanye basenokuthi rhoqo rhoqo-xa bechaza intuthuko kwi-sciences ze-HIV. Kwaye nangona kunene inani labaguquleli bemidlalo kwiminyaka yamuva , igama lidla ngokubonisa ukuba sisondele ekunyangeni okanye kwisisombululo esiyiyo.
Oku kunokwenzeka xa uphando lungaqondwanga kakuhle okanye intatheli ehluleka ukubeka isayensi kwindawo efanelekileyo. Kwaye ihlazo, kunikwe ukuba oko kuthethwa rhoqo kubaluleke ngokwenene.
Ngokucacileyo, u-hype akukaze kube yinxalenye yengxelo yenzululwazi, into esiyifundile emva ngo-1984 xa uNobhala wezeMpilo kunye neNkonzo zoLuntu uMargaret Heckler wachaza ukuba siya kuba nesifo sokugonywa nge- HIV "kwiminyaka emibini."
Akunakucinga nje ngeengcamango ezifana nale ndlela yokuzithemba koluntu, zihlala zichaphazela ngqo kwimpilo yoluntu. Izifundo ezininzi zibonise ukuba umngcipheko womntu othile-ingakanani okanye encinci umntu uvakalelwa engozini-inokuchaphazelwa ngokuthe ngqo kumgangatho kunye nomthombo weendaba zokuzonwabisa ezifunayo.
Sazibonela ngo-2016 xa indoda e- HIV ephambi kwe-HIV (PrEP) yaxelwa ukuba ifumanekile ekubeni ichithe unyango losuku lokukhusela. Ukugqithisileyo kwimixholo, iingxelo ziphosakele ziphakamise ukuba "inqabile" ingxaki enganyangekiyo yayisasazela abantu, ibeka ukungathandabuzeki malunga nokuba i-PrEP yayisisicwangciso esilungileyo njengamagosa ezempilo ezivakalisiweyo.
Sijonge kwiintsuku ezintlanu, i-HIV "yintshukumo" yangoku ibe yinto kwaye ihlolisise into esiyifundeyo, kokubili okulungileyo kunye nokungalunganga, emva kwezi zithintelo.
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AIDSVAXNgomnyaka we-1995, ugonywa lwe-AIDSVAX lufumene igalelo elikhulu kumajelo eendaba xa iindaba eziqhekekileyo zenze ukuba i-response immune response in smallest, isifundo seSigaba II sevolontiya yabantu.
Oku kwabangela ukuba umenzi wezitofu, u-VaxGen, angenise isicelo sokuqhuba isilingo esikhulu seSigaba III ngaphakathi kwe-US-isicelo esagqitywa ekugqibeleni xa kuboniswa ukuba ininzi lamavolontiya ayesulelekile ngexesha lovavanyo lokuqala.
Ukungafuni, ubuholi be-VaxGen bhenxisa kuluntu lwenzululwazi lwamazwe ngamazwe kwaye ekugqibeleni lwaqhuba uvavanyo ngo-2002. Lelo vavanyo, i-alas, ayizange ikhuphe okanye iyanciphise intsholongwane phakathi kwabafundi abathatha inxaxheba.
Naphezu kweendaba, inkampani yakhupha ngokukhawuleza ikhutshwe i-press echaza ukuba isitofu sokugonya sibonakalisa ukusebenza ngempumelelo kubantu abathile (ikakhulukazi abamnyama nabase-Asia), kwaye kwaze kwaba khona ukubonisa ukuba umviwa ofanelekileyo unokufumaneka ngo-2005.
Ukususela ngeli xesha, i-AIDSVAX ihlolwe ngokubambisana nesinye isitofu, kwaye ngo-2009, i-regimen edibeneyo ikwazi ukufezekisa i-31 ekhulwini ukuphumelela ukukhusela i-HIV.
Ezi ziphumo zacetyiswa ngokukhawuleza "yimbali ephambili" yi-AIDS Vaccine Coalition. Oku kwakhokelela ekuphumeni kweengxelo ezibonisa ukuba izazinzulu zisesigqeba "sokunyanga okusebenzayo" kwi-HIV (oko kuthetha ukuba intsholongwane ilawulwa yicontsho kunokuba iipilisi).
Ezi ziphakamiso ziye zanyanzeliswa ngokukhawuleza ukususela ngaloo ndlela, kungabikho ubungqina obuncinane bokuxhasa amabango. Nangona kunjalo, isilingo esitsha seSigaba III saqala ngokunyanisekileyo eMzantsi Afrika ngo-2016, kwakhona sisebenzisa i-AIDSVAX kunye nesifo sokugonya esifanayo esasetyenziswa emva ko-2009.
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I-Mississippi BabyIintlobo "zokuphucula" ziye zafumana ingqwalaselo yabezindaba ukuba umntwana waseMississippi, umntwana ongenagama onganamagama oye wacingelwa ukuba waphiliswa yi-HIV ngo-2013.
Uzalwe ngumama onentsholongwane kaGawulayo, umntwana waphathwa ngekhondo elibi lokulwa ne-antiretroviral emva kweeyure ezingama-30 emva kokuziswa. Xa umntwana eneminyaka eyi-18 ubudala, unina ngokukhawuleza washiya ukunakekelwa waza washiya umntwana ngaphandle kwonyango kwiinyanga ezingaphezu kweenyanga.
Xa umama nomntwana ekugqibeleni babuya, oogqirha bamangaliswa ukubona ukuba umntwana wayengenayo intsholongwane ebonakalayo kwigazi okanye kwiisampuli zamathambo. Oku kwakhokelela ekucingweni kwezilwanyana ukuba unyango olwenziwe ngexesha losulelo luyakwazi ukuyeka ukusuleleka kwindlela.
Ngokugqithiseleyo kwakukho iinkolelo, ukuba iindwendwe zeendaba zilandelwa ngokukhawuleza, zithi abanye abantwana baye bafumana umphumo ofanayo ngenxa yonyango lokuthunyelwa kweposi. (Okumangalisayo kukuba, ngokungafani nomntwana we-Mississippi, akukho namnye kulaba bantwana oye waphathwa unyango ngenxa yezizathu zokuziphatha.)
NgoJulayi 2014, ekuphakameni kwe-media hype, oogqirha babike ukuba intsholongwane, ngokuqinisekileyo, yabuya (ivuselelwe) kwintsana yaseMississippi. Oku kubonisa ukuba intsholongwane ayizange ichitheke njengokuba abanye babekholelwa kodwa befihliwe kwiindawo zokugcina izixhobo zamaselula ezilungele ukuvela kwakhona ekungabikho kolwaphulo oluqhubekayo.
Izifundo zokuqhubela phambili kuphando lwe-HIV olukhuselekileyo kwiintsana ezisandul 'ukuzalwa ziye zahlehliswa.
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Ukuxela ukunyangwa kweBell BerlinUTimothy Ray Brown, aka "Isigulane saseBellin," uthathwa njengomntu kuphela oye waphiliswa yi-HIV. Emva kokuqala ukutshintshwa kwe-stem cell cell ukuhlola okuvela kumntu owayenqabile ngokusesikweni kwi-HIV, uBrown waphuma ngo-2008 kungekho bungqina bentsholongwane kwigazi okanye kwiisampuli zamathambo.
Iindaba zokunyanga kukaBrown zakhokelela kwizifundo ezalandelayo zithemba ukuphendula iziphumo kwabanye. Konke ukuya kutshatyalaliswa.
Phakathi kwabo, amadoda amabini eBoston athi "aphilisiwe" ngo-2013 aphindaphindiwe ngonyaka omnye emva kokugqithiselwa. Abanye baye bacebisa ukuba le nkqubo yokugqibela "yayinokugqithisa" kuneBrown kwaye ingabangela isizathu sokuba intsholongwane ayizange isuswe ngokupheleleyo kwiinkqubo zazo.
Akunjalo ukuba ukuguqulwa kweeseli zentsholongwane kwakucatshangwa njengesicwangciso esilungileyo sokunyanga i-HIV. Nangona imeko yembali ye-Berlin isigulane esineziguli, le nkqubo ngokwayo ithathwa njengeyona yindleko kakhulu kwaye inobungozi ukuphumeza ngaphandle kwezona zonyango ezigqithiseleyo.
Ngenxalenye yakhe, uBrown uyaqhubeka ehlala engabonakaliyo kunye nonyango, nangona kusekho ingxoxo malunga nokuba inyantsholongwane ipheliswe ngokupheleleyo okanye ilawulwa kuphela yenkqubo yokufakelwa.
Uphando olungakumbi luyathemba ukuchonga iindlela ezithile zokunyanga kweBrown, ngokufanelekileyo ukuphuhlisa izixhobo ezingasetyenziselwa kwisikhulu esiphezulu sabantu.
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I-HIV Microbicide SetbacksI-HIV microbicides yenza ingqiqo. Cinga ngento: Ukuba unganenkxalabo malunga nokufumana i-HIV kumlingani wesini, konke okufuneka uyenze ukubeka i-gel okanye ukhilimu wokubulala i-HIV kumnxeba. Ngaba kunzima kangakanani?
Kodwa emva kweminyaka engaphezu kwe-15 yophando olunzulu, asikaze sibone umviwa okwazi ukunika uhlobo lokukhusela olufunekayo ukufezekisa ezi njongo.
Olunye uvavanyo, i-CAPRISA 004, lwaye lwabanjiswa "ukuqhubela phambili" ngo-2010 xa kuboniswe ukuba i-gel equkethe i-1% yexinaniso ye-drug tenofovir inokunciphisa umngcipheko wokungena komngcipheko kwabasetyhini ngamaphesenti angama-39. Kulabo basebenzise i-gel rhoqo, ukuphumelela kunokufikelela phezulu kuma-54 ekhulwini.
Kodwa kungekudala emva konyaka, iiNational Institutes of Health zayeka ukuvavanya okukhulu kwi-Afrika nase-Indiya xa kuboniswa ukuba enye i-gelbicidal gel ayinayo inzuzo yokukhusela xa ifaniswa ne-tobo version.
Abaphandi baye bafumana izizathu zeziphumo, kubandakanywa ukuxhaphaka okukhulu kwezifo ezithathelwana ngesondo phakathi kwabafundi abathathi-nxaxheba kunye nomthwalo ophezulu wentsholongwane ye-HIV phakathi kwabantu abane-HIV.
Ekugqibeleni, iqhinga-eliye labonwa njengesinyathelo esibalulekileyo ekuxhotyeni abasetyhini kunye namantombazana abasengozini-laphelela ngenxa yento enye umphandi akakwazanga ukuyiqwalasela: ukuziphatha kwabantu.
Ngokutsho kohlalutyo lwangemva kwesilingo, abafazi (ingakumbi abasetyhini abasetyhini) behlulekile ukusebenzisa i-gel njengoko kumiselweyo, ngokuphindaphindiweyo ngenxa yokungamkelwa kwamalungu entsapho okanye ukwesaba ukufumanisa ngabafazi okanye abalingani bobulili.
Uphando olusandul 'ukusetyenziswa kwimizuzu emininzi ye- microbial intravaginal ebonisa ukukhuseleka ngokulinganayo ngokubanzi, ngelixa lihluleka ukubonelela naluphi na ukhuseleko olunokuthi lube nolutsha oluneminyaka engama-18 ukuya kwe-21 ubudala.
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I-Danish Kick-Kill CureKwimizekelo yezithembiso ze-HIV ezithe zawa mfutshane, abambalwa banomdla wokubaluleka okunjengekaDyunivesithi yase-Aarhus xa kwakhankanywe ngo-2013 ukuba kulindeleke ukuba unyango luphele "kwiinyanga."
Kwiiyure ezimbalwa zesibhengezo, amajelo ashicilelekileyo, apapasha iingxelo ukuba iqela laseDanish alizange likwazi ukucima i-HIV kwiindawo zokungcwatshiswa kwamaseli (ezibizwa ngokuba ziindawo zokugcina izilwanyana ) kodwa zakwazi ukunciphisa intsholongwane. Isicwangciso, esaziwa ngokugqithiseleyo ngokuthi "ukukhaba," sithatha ingcamango yoluntu olutyunjwe ngokuphumelela emva kweengxelo zeendaba malunga nosana lwe-Mississippi.
Nangona uphando lwama-Aarhus luyilo, isinyathelo esithembisayo sokufikelela "ukubulala ukukhaba," kwahluleka ukuqonda into ebangela ukuba azikhumbule: asinakukwazi nokuba zinkulu kangakanani lezi ziqhumane.
Kungekudala ngaphambi kokuba iindaba zifikile ukuba isifundo se-Aarhus siphumelele kakhulu kwisithembiso sawo, sifinyelele ekusebenziseni okuthobekileyo kwintsholongwane engapheliyo kodwa akukho ndawo kufuphi namanqanaba afanelekileyo ukwenza "umsebenzi wokukhaba."
Ukongezelela, akukho nto ibonisa ukuba nayiphina i-arhente, nokuba imithi okanye i-immunological, inokuphelisa ngokupheleleyo i-HIV xa ikhutshwe kwi-cellular hiding sanctuary yayo.
Uphando olongezelelweyo luqhutyelwa ukuba lubone ukuba udibaniso lwamachiza kunye / okanye izithuthi zogonywa zingaphucula kwezi ziphumo zakuqala.
> Imithombo:
> I-Rerks-Ngarm, iS .; Pitisutithurm, P .; Nitayaphan, S; okqhubekayo. "Ukugonywa nge-ALVAC kunye ne-AIDSVAX ukukhusela i-HIV-1 Infection eThailand." I-New England Journal of Medicine. Disemba 3, 2009; 361: 2209-2220.
> Ledford, H. "Intsholongwane kaGawulayo idibanisa i-Hope of 'Mississippi Baby'. Uhlobo; papashwe ngoJulayi 10, 2014.
> I-Hutter, G. "Ukutshintshwa kweseli yesitshixo kwizicwangciso zokuphilisa i-HIV / AIDS." Uphando lwe-AIDS kunye noTyhulwa. NgoSeptemba 13, 2016; 30:13.
> Amacandelo oPhando loPhando lwe-AIDS eMzantsi Afrika (CAPRISA). Uvavanyo olutsha lwe-tenofovir gel alubonakali miphumo ekukhuseleni i-HIV: Okuphantsi kunokuba kulindeleke ukuba ukusebenzisa i-gel impembelelo yeziphumo zesilingo. " Ukukhululwa kweMedia Februwari 24, 2015.
> United Press International (UPI). "Ukunyangwa kwe-HIV kulindeleke 'ngaphakathi kweenyanga,' izazinzulu zaseDanish zithi." Kukhishwe ngoMeyi 1, 2013.