Ukufunda ukuba unentsholongwane kaGawulayo kunokunyamezela. I- stigma echaphazelekayo negawulayo inokuba nzima, kwaye abantu abaninzi banzima ukuqhuba iindaba zokuthi banentsholongwane kaGawulayo. Nangona kunjalo, xa besenza, ngokuqhelekileyo enye yezinto zokuqala eziyicingayo yindlela yokukhetha unyango lwe-HIV. Oku kuqondakala ngokuthe ngqo kumagulane anonyango, kodwa ukhetho olufanelekileyo lwe-antiretroviral therapy (ipiriti) lunokuba lunzima kakhulu kwizigulane ezine-anti-drug resistant strain HIV.
Indlela Ukunyanzelwa Kwemithi Yonyango
Intsholongwane kaGawulayo iyatshintsha kwaye iguquke ngokukhawuleza. Ngaloo ndlela, unyango lwe-virus aluhlali lula. Kwiminyaka yokuqala ye-bhubhane , kwakukho iindlela ezimbalwa zokwenza unyango. Abantu babekwa kwisicuku esinye kuphela ngexesha, kwaye ukuchasana nala mayeza ngamanye amaxesha avelise ngokukhawuleza.
Njengoko izidakamizwa ezininzi zeHIV - kunye neeklasi zezilwanyana ze-HIV - zaphuhliswa, oogqirha batshintshela kwiirimimzi ezininzi ezibizwa ngokuba yi- antiretroviral okanye i-HAART. Ezi zijimeni zidla ngokubakho ubuncinane ezimbini zemithi yokulwa ne-antiretroviral kwiiklasi ezahlukeneyo zamachiza.
Kwiminyaka yakutshanje, nangona kunjalo, isigama sitshintshile. Ngoku oogqirha bahlala bethetha ngeCART - unyango lwe-antiretroviral. Nangona kunjalo, inqununu iyafana. Iklasi ngalinye lezonyango lisebenza ukuphazamisa inxalenye ehlukeneyo yokujikeleza kwintsholongwane yobomi, kwaye ngokudibanisa iziyobisi ezininzi kwenza kube nzima ukuba intsholongwane iguquke kwaye inganyangeki naluphi na unyango lwe-HIV.
Ukunciphisa ukuShatyiswa kweziMilutha
Ngenxa yenani elikhulayo lokunyango olutsha lwe-HIV, inani lokuchasana nezidakamizwa liye lahla ngokuhamba kwexesha. Ukutshintsha iifomula zonyango ukwenzela ukuba iipilisi zibe lula ukuyithatha, nokwandisa ukuthotyelwa, uye wanceda kakhulu. Ezi zinguqu, ngandlela-thile, zona ziboniswe kakuhle ngokuphuhliswa kwemirhumo eyodwa ye-HIV.
Ezi rejim ziqulethe ezintathu okanye ezine ezineyeza ezine kwipilisi enye ethathwa kanye ngosuku.
Oku kulula kakhulu kwizigulane ezininzi ukujongana nokucwangcisa inani elikhulu lamapilisi ngamaxesha ahlukeneyo ngosuku. Xa isifo sesigulane silawulwa kakuhle kwiyeza zabo zonyango, kwaye zigcina imithwalo engavonakaliyo yentsholongwane ngokuqhubekayo ngexesha elidlulileyo, akunakwenzeka ukuba ibe nefuthe elikhulu lokuxhatshazwa kweziyobisi.
Indlela iNtsholongwane KaGawulayo Yenza Ngayo Impendulo Ngenye Imithi
Abantu abanentsholongwane kaGawulayo banokupheliswa ngeentsholongwane ezingenakuxhatshazwa yi-HIV kwindlela ezimbini. Eyokuqala kukuba basenokusuleleka ukuba banesifo sengxaki enganyangekiyo. Okwesibini kukuba intsholongwane yabo inokumelana nomnye okanye amayeza amaninzi kwixesha. Ezinye izinto ezinokunyusa amathuba okuba ne-HIV ekukhuseleni iziyobisi zibandakanya:
- Ukungathobeli / ukungamkelekanga kakubi : Abantu abangazange bathathe iyeza zabo ngokuchanekileyo, njengoko kumiselweyo, banako ukuphuhlisa intsholongwane engagwenyanga. Oku kunjalo ngokukodwa kubantu abaneengxaki zokuthotyelwa kwixesha elide.
- Ukungabi nempendulo kwonyango lokuqala: Ukuba unyango lokuqala alukho ukunyanzeliswa kwe- virus ngaphakathi kweenyanga ezili-12, ngoko kunokwenzeka ukuba intsholongwane yakho, okanye iyenzeka, inganyangekiyo. Oku kubaluleke kakhulu kwizicwangciso eziphantsi kwezondlo apho abantu baphathwa khona ngokuqala nge-nonnucleoside reverse-transcriptase inhibitor (NNRTI) esekelwe kwiimpawu zonyango. Nangona kunjalo, kubalulekile ukwazi ukuba ukungabikho kwempendulo akuthethi ukuba i-first line yeyeza yenza ukuba intsholongwane yakho ingakwazi ukumelana nayo. Ukungabikho kwempendulo kaninzi kubonisa ukuba oogqirha basebenzise ukuphanda ukuba ngaba unesifo se-anti-drug resistant strain.
- Unonophelo olusisigxina : Oku kwenzeka xa oogqirha bengasetyenziswanga ngokuphambili kwintsholongwane kaGawulayo, okanye ngesizathu esithile, unyango olungcono alufumaneki. Kukho ukulandelelana okuthe ngqo kwonyango olucetyiswayo ukunciphisa amathuba okungaxhatshazwa kweziyobisi. Oku akubandakanyi nje ukudibanisa iiklasi zamachiza ngokuchanekileyo kodwa ukhethe izidakamizwa ezithile kwiklasini ezingenakunokubangela ukuchasana okanye ukwabelana ngamanqanaba okunyanzelisa.
- Ukungabikho kokumelana noxinzelelo : Xa kunokwenzeka, oogqirha kufuneka baqaphele rhoqo umthwalo wentsholongwane yesigulane ngenxa yeempawu zokukhula. Oku kuvumela oogqirha ukuba batshintshe iziyobisi ngokukhawuleza ukuba bajonge ezo ziza kusebenza ngempumelelo. Nangona kunjalo, kwezinye iindawo, ukunyamekela ukunyanzelisa akufumaneki, okanye izigulane azikwazi okanye zikulungele ukuhlolwa rhoqo. Ngokuqhelekileyo, ukungabikho kokunyamekela kokumelana nokuchaswa ngumzekelo wendlela oogqirha abaza kukhankanya ngayo ukumelana nokuchasana, kungekhona isizathu.
Ukufumanisa i-HIV-resistant HIV
Ezinye iintlobo zokuchasisa iziyobisi zingabonwa nge-genome virtual sequencing. Kuye kwafumanisa inani lokutshintshwa kwezidakamizwa, kwaye ukuguqulwa kwamanyathelo kuye kwaxhunyezwa ekunciphiseni ukwenziwa kobisi lwezilwanyana okanye iindidi zamachiza. Ulwazi olutshintsho olukhoyo kwi-genome yentsholongwane luza kunceda oogqirha bakhethe i-regimen yesigulane esifanelekileyo kwisigulane. Nangona kunjalo, ukuhlolwa kwe-genome ye-HIV-gama ayisoloko isisigxina somsebenzi wekliniki.
Imithombo:
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I-Hosseinipour MC, iGupta RK, UVan Zyl G, uEron JJ, uNachega JB. Ukuxhatshazwa kweNtsholongwane kaGawulayo kwi-anti-antiretroviral line-first-and-second-line kwizixhobo ezicwangcisiweyo. J Disfect Dis. 2013 Juni 15; 207 Isibonelelo 2: S49-56.
IKostrikis LG, i-Hezka J, i-Antoniadou ZA, i-Kousiappa I, u-Mamais I, i-Skoura L, i-Pilalas D, i-Metallidis, i-Nicolaidis P, i-Malisiovas N. I-Cellular HIV-1 Amanqanaba e-DNA Alinganayo phakathi kweeNyango eziHloniphekileyo kunye neeDrand Resistant Strains kwiNew diagnostic and antiretroviral Izigulane. UGawulayo I-Hum Retroviruses. 2013 Septemba 12. [Epub phambi kokuprinta]
Siliciano JD, uSiliciano RF. Iimpawu zamva kwi-HIV-1 yokunganyanga kweziyobisi. I-Curr Opin Virol. 2013 Septemba 7.