Utshintsho luyinto engaphezu kweSemantics nje
I-ART yisigama esasetyenziswa kakhulu namhlanje ukuchaza intsholongwane kaGawulayo. Ngaphambi koko, oogqirha kunye nososayensi baya kusebenzisa iCART (intsebenziswano ye-antiretroviral therapy), nangaphambili kweso sigama esibizwa ngokuba yi- HAART esetyenziselwa ukuchaza "unyango olushushu lwe-antiretroviral."
Utshintsho kwiminyaka lubonakalisa okungaphezulu nje kwefashoni, kodwa inzame yangempela yamagosa ezempilo karhulumente ukuhlaziya indlela esinxibelelana ngayo nokusebenza kwe-HIV unyango kuluntu.
Asisayizama ukunceda abasebenzisi ukuba izidakamizwa "zisebenza ngamandla" kuba zinyani ngaphezu koko. Namhlanje bavumela ukuqhelekileyo, umgangatho wobomi, ngoxa iindawo ezintsha zepilisi ezitsha zenza ukusetyenziswa kwegama elithi "inhlanganisela" konke okungaphezulu.
Ukuqonda i-ART
Kungakhathaliseki ukuba isichazamazwi sisetyenziswe njani, eli gama lithetha ukusetyenziswa kwezidakamizwa ezintathu okanye ngaphezulu kwee- antiretroviral , zithathwe ngokwazo okanye zidibaniselwano zezilingo ezichanekileyo. Injongo yonyango kukuba kuqinisekiswe ukunyanzelwa kwe- HIV kuthiwa "amanqanaba angabonakaliyo" -thi intsholongwane ayigxothwanga ngokupheleleyo, kodwa iphantsi nje kwamanqanaba okuvavanywa kwamalinge okuvavanya ngoku.
Ngokuchasene nesichengisi esisodwa okanye iyeza-machiza ezimbini, ukudibanisa izidakamizwa ezintathu okanye ngaphezulu ziyaziwayo ngokukhawuleza ukukhusela iintlobo ezahlukeneyo ze- HIV ezinokumelana nazo ezinokuthi zibe khona kwi-viral population. Okubalulekileyo, ukuba esinye isilwanyana asikwazi ukunqanda ukuguqulwa komthamo othile, abanye baya kukwazi ukwenza njalo.
Amanqanaba aphezulu okunamathela adingekayo ukuze kugcinwe amanqanaba okusetyenziswa kweziyobisi egazini. Ukuba la manqanaba awela phantsi komngcipheko wokwelapha, iintlobo ezixhatshazelwayo zinikezelwa ithuba lokukhula . Eyona mikhulu inabantu abachasayo, ukusetyenziswa kakubi kweziyobisi kuya kuphelisa ukuphindaphinda kwe-HIV-ekugqibeleni okukhokelela ekuguquleni kwintsholongwane kunye nokungaphumeleli kwonyango .
Ukususela ngo-2009, itekethi yekota ixhomekeke kwi-HAART eyaziwayo, ngokukodwa kubaphandi kunye neekliniki. Nangona iigama ziguquguqukayo, i-HAART yayininzi ingathatyathwa ngokwaneleyo ekuchazeni ukuphumelela okusebenzayo kwonyango.
Ekugqibeleni, i-ART yayicatshulwa ngokufanelekileyo, kuba kunokwenzeka ukuba unyango oluhlangeneyo luya kutshintsha kwiminyaka ezayo. Uphando lwangoku luphanda ukusetyenziswa kwezinto ezibini zokulwa ne-antiretroviral, ezifana ne-ripilvirine kunye ne-dolutegravir, ekulawulweni kwezifo ezingapheliyo ze-HIV.
Iiklasi ze-ART
Kukho iiklasi ezintlanu ze-antiretroviral izidakamizwa , ngasinye sivimbela isigaba esithile kumjikelezo wobomi be-HIV :
- Inhibitors yokungena
- Nucleoside reverse transcriptase inhibitors
- I-non-nucleoside reverse transcriptase inhibitors
- Integrase inhibitors
- Protease inhibitors
Ezinye iiklasi ze-antiretrovirals ziphandwa, ngelixa izidakamizwa zitsho zitsha zijolise ekuphuculeni ukunyamezela, ukunciphisa imiphumo emibi kunye nokwenza lula ukulandelelana kwabo bafumana unyango.
Kule nto iphelile, inani elinyukayo lezonyango ezihlangeneyo (FDC) zikhoyo, ngokudibanisa ezimbini okanye ezininzi izilwanyana kwiipilisi enye okanye i-tablet. Abanye, kuquka i- Atripla ((i-tenofovir + emtricitabine + efavirenz), i- Triumeq (abacavir + lamivudine + dolutegravir) kunye neStriobraz (tenofovir + emtricitabine + elvitegravir + cobicistat) inikezela ngeendlela ezilodwa zokulungelelanisa, ukulandelana kwansuku zonke.
Ikusasa le-ART
Ngokuqhubela phambili kwi-HIV, i-ART isetyenziswa njengendlela yokubuyisela amanqanaba okusuleleka kwiintsholongwane eziphezulu kubantu abane-HIV. Isicwangciso, esaziwa ngokuba nguTyango njengoThintelo (TasP) , siye saboniswa ukunciphisa umngcipheko wokudlulisa i-HIV ngokunciphisa intsholongwane ye-HIV. umsebenzi kumanqanaba angabonakaliyo. Ngokwenza njalo, umngcipheko wokudluliselwa kwephepha uncitshiswe ngo-96%.
Ngokuqinisekisa ukusabalala kweziyobisi, i-ART inokunciphisa oko kuthiwa "umthamo wentsholongwane yomphakathi" (umthwalo wentsholongwane yommandla ngaphakathi koluntu) ukuya kumanqanaba apho amathuba okudluliselwa kwegazi aphezulu kakhulu, nangona kuncinci, anciphise.
Oososayensi ngoku bahlola ukuphuhliswa kwee -antiretroviral agents ezihlala ixesha elide , ezinye zazo zingadinga inyanga zonke okanye iinyanga zenyanga.
Imithombo:
UDelaney, M. "Imbali ye-HAART - ibali eliyinyaniso yendlela yokwenza uphando lwezonyango ezininzi lwaphuhliswa ngayo unyango lwe-HIV." Retrovirology. Disemba 21, 2006; 3 (iSiza 1): S6.
Skarbinski, J .; I-Furlow-Parmley, iC .; kunye ne-Frazie, E. "Iimali zokuBaluleka koLuntu lweNtsholongwane kaGawulayo + Abadala abakufumene unyango lwezoNyango, abaye babhalwa ngo-ART, kunye neProjekthi yokuLawulwa kweNyango yeNtsholongwane, ku-2009 ukuya ku-2010." INgqungquthela ye-19 kwi-Retroviruses kunye neeNtsholongwane eziKhuselekileyo (CROI); Seattle, Washington; Matshi 8, 2013; engumlomo # 138.
Spreen, W; Margolis, D .; kunye nePottage, J .; "Izidambisi ze-antiretrovirals ezinokuthatha ixesha elide kwi-HIV kunye nokukhusela." Iingcamango zangoku kwi-HIV kunye noGawulayo. Novemba 2013; 8 (6): 565-571.