Iingcali zenzululwazi ezisondeleyo kwiziCombululo ezihlala ixesha elide kwiNtsholongwane kaGawulayo, PrEP
Enye yezona thintelo eziphambili kwiimpembelelo zeziyobisi ze-HIV yinqanaba eliphezulu lokunamathela olufunekayo ukuze kufumaneke iinjongo zeklinikhi zonyango . Kweminye, umsebenzi wemihla ngemihla yokuthatha izidakamizwa ezidambisi-gciwane zingasondeka, ingakumbi xa ihamba nemibandela yempembelelo okanye esebenzayo engathintela ubomi-kunye nokunamathela- kubantu abane-HIV.
Eyona mininzi imicimbi, e-US namhlanje, ngaphezu kwe-20% yabantu abakwelapha unyango lwe-antiretroviral bayakwazi ukugcina umthwalo wentsholongwane engabonakaliyo , umlinganiselo wokuphumelela unyango.
Ukuphendula, izazinzulu sele ziqalise ukuhlola iziyobisi ezisebenza ixesha elide, kwakunye neenkqubo zonikezelo lweziyobisi, ekugqibeleni zivumele ukuba kubekho-nyanga zonke-okanye nokuba zenzeke ngekota nganye, nokuba zithathe unyango lwe- HIV okanye zikhusele.
Iidakamizwa eziPhezulu zoPhando
Ngo-2013, ama-antiretroviral ama-anti-antiretroviral amaxesha amabini aqaliswa kwi-7 ye-International AIDS Society (IAS) kwiNgqungquthela yaseKuala Lumpur. Izidakamizwa zophando zenziwe ziveliswe njengama-nanosuspensions engenayo, apho amakristal amancinci asebenzayo anqunyanyiswa kwinqwelo, avumela ukukhululwa okuthe ngcipheko nangokukhawuleza kwamachiza kule nkqubo.
Iyokuqala, i- cabotegravir (eyaziwa nangokuthi yi-GSK1265744) yile yeklasi yezilwanyana ezibizwa ngokuba yi- integrase inhibitors , ezivimbela i-enzyme ebizwa ngokuba yi-integrase ukuba i-HIV ifuna ukuphindaphinda. Okwesibini, i- TMC278-LA , isilungiso sexesha elide lesigqirha esilungileyo (ripilvirine) esetyenziswa ngoku kwi-anti-HIV.
Inani elithile leSigaba sesi-II sezilingo zonyango lubonise i-cabotegravir ekhutshwe nge-intramuscularly ixhomekeke kakuhle kunye ne- half half-life of between 21 to 50 days (xa kuthelekiswa namahora angama-40 emva komthamo owodwa, ngomlomo). Uphando olufanayo lubonise ukuba le nkunkuma iphinde iqinisekise ukuxinwa kweziyobisi ezixhasayo kumathambo angama-vaginal and vaginal, ebonisa ukuba inokulawulwa njengendlela esebenzayo, i-long-acting acting pre-exposure prophylaxis (PrEP) .
Ngokuthelekiswa, i-Phase I study yabonisa ukuba i-TMC278-LA yayinakho ukugcina iinjongo zeeplasma ezijoliswe kuzo ezivela kwiiveki ezi-12 ukuya ku-26. Esi sichazi saphinda sibonakalisa isithembiso njenge-PrEP, ngokugxininisa okubonakalayo kumathini angama-rectal xa kuthelekiswa nezicubu zesisu.
Uphando oluqhubekayo lucwangciswe ngenjongo yokwandisa uphando kwiSigaba II no-III zilingo.
Izilwanyana eziPhantsi kwe-Antiretroviral Implants
Izazinzulu kwi-Oak Crest Institute of Science ePasadena, eCalifornia zibike ukuphuhlisa ukuphakanyiswa okulinganayo okuza kunika iingcamango ezinonophelo zeyeza-antiretroviral xa zifakwe phantsi kwesikhumba.
Ngokufanayo kwindlela yokwenza izixhobo zokukhulelwa kwexesha elide, ifowuni yaboniswa kuphando lokuqala ukuba ikwazi ukukhulula ukukhutshwa kwezidakamizwa ze- tenofovir alafenamide (TAF) ukuya kwiintsuku ezingama-40.
[Ngokungafani ne-tenofovir disoproxil fumarate (i-TDF), ebizwa ngokuthengiswa ngeViread kwaye iqulethwe kwiidakamizwa iTruvada ne- Atripla , i-TAF ithathwa njengelungu le-molecule eliphambili elikwazi ukufikelela kwiimeko ezincinci zokuxilongwa kweziyobisi kwimilinganiselo encinane kuneTDF .]
Nangona uphando olujoliswe kwi-APP ye-PrEP, kuphakanyiswa ukuba amanye ama-agent agents agcina asetyenziswa ukubonelela ngonyango lwe-antiretroviral (ipiriti) kubantu abaphila ne-HIV.
Uphando lwexesha elizayo luthemba ukuvula umnyango ekuphuhliseni izimpembelelo ezinokuhlala unyaka okanye ngaphezulu.
Izindleko ze-Intravaginal Microbicidal
Iingcali zenzululwazi ziye zazama ukubonelela abafazi abasengozini yokuzikhusela kwi-HIV, ingakumbi kwimimandla apho ukuxhotyiswa kwabasetyhini besondo kuphezulu. Zininzi zezicwangciso, mhlawumbi ngendlela ye-PrEP yomlomo okanye i- microbicides yomfazi , sele ihlulekile ekuphandeni ngenxa yokungahambi ngokubambelela kunye namazinga aphantsi okusetyenziswa kwezidakamizwa kwiisisu zomzimba , nakwabasetyhini abanezinga eliphezulu lokunamathela.
Ukujongana nale migaqo yokuqulunqa, amanqaku amacandelo ophando ahlola ukusetyenziswa kwamacangci angenanto engakwazi ukukhulula izidakamizwa ze-antiretroviral ukuya kwinyanga.
Isangqa, i-scaffold engaphelelekiyo ebandakanywe neziyobisi ezisebenzayo, yayiya kumvumela ukuba umfazi afake isixhobo esingabonakaliyo ngexesha lokusetyenziswa.
Iziphumo zakuqala ziye zabonisa ukubekezela kwendandatho engumngcipheko oqulethe i-drug- dapivirine (TMC120 ) yokuvavanya ngokuphumelela kwesilwanyana kwiphepha elingaphantsi kweentsapho zokubeleka ngeentsuku ezingama-33.
Izilingo ezimbini zeSigaba se-III, i-Ring Study kunye ne-ASPIRE, ziyaqhubeka ukuvavanya ukhuseleko lwendandatho kunye nokusebenza kwawo okukhuselekileyo okuqhubekayo phakathi kwamalungu angama-4 500 abafazi abane-HIV.
Imithombo:
Amaziko e-US for Control and Prevention (CDC) yeZifo. "I-CDC Fact Sheet | I-HIV e-United States: Amanyathelo okuNakekela." Atlanta, Georgia; epapashwe ngoJulayi 2012.
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.
Margolis, D .; Brinson, C; Eron, J; okqhubekayo. "744 kunye ne-rilpivirine njengonyango lwezonyango zomlomo ezimbini: i-LAI116482 (LATTE) iiveki ezingama-48." INgqungquthela ye-21 kwi-Retroviruses kunye neZifo eziHlangayo (i-CROI 2014); EBoston, eMassachusetts; Matshi 3-6, 2014; 91LB.
Gunawardana, M .; Remedios-Chan, M .; Miller, C; okqhubekayo. "I-Pharmokinetics ye-Tenofovir Alafenamide (GS-7340) Ukufakelwa kwangaphantsi kwe-HIV Prophylaxis." Amagciwane anesigciwane kunye ne-Chemotherarpy. Epreli 20, 2015; i-doi: 10.1128 / AAC.00656-15.
Nel, A; Smythe, S; Oselula, K .; okqhubekayo. "Ukhuseleko kunye ne-pharmacokinetics ye-dapivirine yokuhanjiswa kwi-matrix kunye ne-reservoir engxenyeni ye-HIV engena-HIV." Umbhalo Wokufumana I-Immune Deficiency Syndrome. 2009; 51 (4): 416-423.