Kukho izidakamizwa ezisetyenziselwa unyango lwe-HIV ezinokunyusa uxinzelelo lwe-plasma yee- antiretroviral ezithile (ii-ARVs) xa zisetyenziswe ngonyango. Eyaziwa ngokuba yizona "zikhuseleko," izidakamizwa zivumela oogqirha ukuba banciphise umlinganiselo kunye nokuphindaphindiweyo kwe-ARV yomlindi xa behlisa isiphumo semiphumela yecala echaphazelekayo.
Izifo ezikhuselekileyo ze-HIV, ezaziwa ngokuba ngabaphuculisi be-pharmacokinetic, akufanele zidideke kunye namavithamini okanye izongezo eziphathwe njenge-"boosters immune," ezingenalo iipropati ezaziwayo zokukhusela okanye ukulwa nosulelo lwe-HIV.
Ukuqaliswa kwe-HIV Boosters
Xa i-HIV protease inhibitors (i-PIs) yafunyanwa kuqala phakathi ne-1990, enye yeengxaki eziphambili kubaphenyi yijubane elikhawulezayo apho izidakamizwa zaxilongwa ngayo isibindi kwaye zacinywa kwigazi. Ngenxa yoko, ii-PIs zifunwa kabini-ukuya kwi-triple-day dosing. Akuzange nje kuphela ukuba ama-dosage aphezulu akwandisa umngcipheko wezobisi ezinobungozi, umthwalo ophezulu weepilisi wenza ukunqongophala kunzima kunabo bonke (kunye nokuphuhliswa kokuchasene konke okungakumbi).
Ngo-1996, i-Norvir (ritonavir) yonyango ivunyiwe ukuba isebenziswe kwi-HIV yi-US Food and Drug Administration (FDA). Ngelixa iichiza laziwa ngokuba nempahla ye-anti-virus, ngokukhawuleza kwafumanisa ukuba, nangona kwimiqathango ephantsi kakhulu, inokuvimbela loo nzyzyme (CYP3A4) ifunekayo ukulungelelanisa i-PIs.
Ukufumanisa kwangoko kwathintela indlela i-PIs ebekwe ngayo. Namhlanje, i-Norvir ayinakudla ngokusetyenziswa kwisenzo sayo sokubulala unqulo, kodwa kunoko ukwandisa ukusebenza kwe-PI yabakhonzi, ngelixa kunciphisa imiphumo emibi echaphazelekayo.
Isiza lisiqalo se-dose edibeneyo ye-PI, i-Kaletra (lopinavir + ritonavir).
(Nceda uqaphele - iNorvir inokuphazamisa iingcamango zeeplasma zezinye iziyobisi ongazithathayo, ngamanye amaxesha zibangele ukusebenzisana okukhulu. Nceda ucebise ugqirha wakho malunga nayiphi na imichiza enokuyisebenzisa xa i-Norvir okanye iKaletra imiselwe.)
Ikamva le-HIV
Kwiminyaka yakutshanje, kuye kwagxininiswa kakhulu ukuphuhliswa kwamanye amaxhoba e-HIV. Kucingwa ukuba amanxeba afanayo angeke akhulise kuphela ukuphumelela kwee-PIs, kodwa enze okufanayo kwezinye iiklasi ze-ARVs-ezinokubangela ukudibanisa, ukuhlawulelwa kwamanye amaxesha, ngelixa ukuvumela "ukuxolelwa" okukhulu kufuneka kuhlwehlwe okanye ikhefu lonyango kwenzeka.
Ngo-2012, iminyaka eli-16 epheleleyo emva kokungeniswa kukaNorvir, isilwanyana sesibini se-booster sagqitywa yi-FDA. I-Tybost (i-cobicistat) , icandelo le-dose edibeneyo ye-drug Stribild (elvitegravir + cobicistat + tenofovir + emtricitabine) , iboniswa ukuvimbela zombini i-enzyme ye-CYP3A4 kunye namaprotheni athile amathumbu awaziwayo ekuphazamiseni ukungena kweziyobisi.
Nangona ingenayo iipropathi ze-anti-virus, i-Tybost inako ukwandisa ukuphumelela kwe-elvitegravir, i-HIV integrase inhibitor, ngelixa iphumelele kwiziphumo ezifanayo kunye ne-PIs Reyataz (atazanavir) ne-Prezista (darunavir) kunye ne-nucleotide analogue iViread (tenofovir).
Ekuqaleni kuka-2015, i-FDA yavuma ezimbini, i-dose edibeneyo yokudibanisa iziyobisi ezibandakanya iTybost, kuquka u- Evotaz (atazanvir + cobicistat) kunye ne- Prezcobix (darunavir + cobicistat) .
Ezinye iziphuzo zokuhlola ziphantsi kophando, kubandakanywa ne-CYP3A4 inhibitor entsha eyenziwa yi-Sequoia Pharmaceuticals.
Imithombo:
Isiko seSizwe soMbane kunye nezifo ezithatheleneyo (iNIAID). "Ezimbini ezintsha zeprotease inhibitors ezivunywe yi-FDA. Ukutya kunye noLawulo lweMithi. "I- NIAID AIDS Agenda. EBethesda, eMaryn; Matshi 1996; 4-5.
US Administration and Drug Administration (FDA). "I-FDA ivumela iPilisi entsha yokuhlanganiswa kweNtsholongwane kaGawulayo yezinye izigulane." ISiliva Spring, eMaldin; ukukhutshwa kogcino kukhutshwa ngo-Agasti 27, 2012.
Gallant, J .; Koenig, E .; Andrade-Villanueva, J .; okqhubekayo. "I-Cobicistat Versus Ritonavir njenge-Pharmacoenhancer ye-Atazanavir Plus Emtricitabine / iTenofovir Disoproxil I-Fumarate kwi-Treatment-I-HIV ine-HIV eneNtsholongwane yokuGula i-1-Iimpembelelo ezichaphazelekayo: Iveki 48 Iziphumo." I- Journal of Infectious Diseases. Julayi 1, 2013, 208 (1): 32-39 .
Bristol-Myers Squibb. "I-Evotaz (Atazanvir + cobicistat) - UKUZIPHILA KWEZIXHUMA." ENew York, eNew York.
Bristol-Myers Squibb. "PREZCOBIX - UKUZIPHATHA KWEENKCUKACHA." ENew York, eNew York.