Ukungaphumeleli kwisimo esingaphandle kungaholela ekufeni kwabantu abangama-425,000
Ngexesha le-10 leminyaka edluleyo, amagunya eempilo zehlabathi jikelele enze igalelo elimangalisayo ekunikezeni izidakamizwa zokugcina ubomi kwi-HIV kubantu abahlala kwihlabathi jikelele. NgokweNkqubo yeZizwe eziManyeneyo kwi-HIV / AIDS (i-UNAIDS), malunga nabantu abayizigidi ezingama-21 bebekwe kwi- antiretroviral therapy ekupheleni konyaka ka-2017, ehambelana nokunyuka kwama-43 ekhulwini lokufa kwe-HIV ukususela ngo-2003.
Kodwa njengokuba i-UNAIDS kunye namanye amagosa ezempilo emhlabeni wonke ashukumisela ukuphela kobhubhane ngowe-2030, umonakalo ophazamisayo usongela ukuphazamisa loo migudu: ukunyuka kwe-HIV engaxhatshazwayo ngamachiza ngaphambili kwakucingelwa ukuba ayinqabile yizinzulu.
Le ngxaki ayichaphazeli kuphela amazwe anqamlekileyo (njengabaseAfrika abathwala umthwalo omkhulu kwiintsholongwane ze-HIV) kodwa kumazwe aphezulu angeniso apho amanqanaba okuxhatshazwa okudluliselwayo akhula .
Iimbangela ze-HIV-Ininzi-echasene ne-HIV
Ukuxhatshazwa kwamachiza amaninzi kuyinto ebonwayo kwezinye iimeko zonyango, njengesifo sofuba (TB) kunye nokutheleleka kwe-staphylococcal , apho umntu osulelekileyo angakwazi ukuphendula kwiindawo ezininzi zokwelapha iziyobisi. Kwezinye iimeko, ukuxhatshazwa kunokuba lukhulu kakhulu, njengokuba kukho i-TB engaphelelekiyo ye-TB (i-XDR TB) ebonwe kwiindawo ezisemzantsi Afrika, apho amaxabiso okufa aphezulu kwaye anonyango oluthile olunonyango.
Njengokuba kunjalo nezinye iindlela zokuchasana , ukuvela kwe-HIV engaxininiswa ngamachiza amaninzi kubangelwe ukuba umntu akakwazi ukuthabatha imithi yakhe rhoqo okanye njengoko iyalathwayo.
Xa kuthathwa ngokuchanekileyo, iziyobisi ziya kukhusela umsebenzi wentsholongwane kwinqanaba apho i- HIV ithathwa ngokuba "ayibonakaliyo. " Xa kuthathwe ngokungalunganga, imisebenzi yentsholongwane ingakwazi ukuqhubeka kumanqanaba apho ukuguqulwa kwamachiza okungenakukwazi ukukhula kuphela kodwa kukhula.
Ngokuhamba kwexesha, njengoko ukuhluleka kokwenziwa kwonyango kwenzeka kwaye umntu ufumaneke kumachiza amaninzi nangaphezulu, utshintsho olongezelelweyo luya kuphuhlisa, ukwakha enye enye elandelayo.
Ukuba loo mntu uchaphazela omnye, ukuxhatshazwa kwamachiza amaninzi kuya kudlulela, kusasazeka kubemi ngokusetyenziswa kwezonxeba okanye ukusetyenziswa kweziyobisi .
Isikali seNkqubela
Ngokwe-World Health Organisation (WHO), eyayihlolisisa idatha esuka kwiikliniki ezingama-12 000 kumazwe angama-59, umyinge wama-20 ekhulwini labantu abachazwe unyango lwe-antiretroviral behlile kunyango ngaphandle konyaka omnye. Kulabo bahlala besethatywayo, ubuninzi beepesenti ezingama-73 babedlala ngokungathandabuzekiyo, ngelixa phantse enye yeyesithathu yahluleka ukufezekisa umthwalo wentsholongwane engabonakaliyo ehambelana nokuphumelela unyango.
Eli nqanaba lomsebenzi wentsholongwane phakathi koluntu landisa amathuba okungaxhatshazwa kweziyobisi ezininzi, ngokukodwa kumazwe aphakamileyo aphezulu apho abaninzi abantu abathathu banesifo. Ukwandisa le meko zihlala zikhutshwa kwezidakamizwa, ezishiye izigulane zingenazo unyango kwaye zichaphazela malunga nama-36% eekliniki kwilizwe elikhulayo.
Kwimihlaba efana ne-US, amazinga aphezulu okusuleleka kwintsholongwane engafumanekiyo (iipesenti ezingama-20) kunye namazinga aphantsi okugcinwa kwezigulane (ama-40 ekhulwini) aguqulelwe kwizinga eliphantsi lokunciphisa i-virus (iipesenti ezingama-28).
"Impossible" Iingxaki ezininzi zokuMelana noMachiza Izizathu zokukhathazeka
Ucwaningo lwango-2016 oluvela kwiYunivesithi yaseLondon yase-London (u-UCL) lubonakalise inkxalabo ekhulayo phakathi kwabaososayensi abesaba ukuba ukuphuhliswa kokunyanzeliswa kweziyobisi ezininzi kunokuphelisa amaninzi amanqaku athatywayo kwi-global fight against HIV.
Kuphando lwabo, izazinzulu ze-UCL zenze uphando olulindelekileyo lwezigulane ezingama-712 ezafumana unyango lwe-antiretroviral phakathi kweminyaka ka-2003 no-2013 kwaye zahluleka kwiyeza lokuqala.
Kulezi zigulana ezili-115 (16%) zinomdla we-HIV kunye ne-antimidine analog resistance, uhlobo olunxulumene nezidakamizwa zokuzalwa njenge-AZT kunye ne-3TC. Okumangalisa kukuba, i-80% yezi zi gulane nazo zazingamelana ne-tenofovir, isizukulwana esitsha sonyango esibhalwe ngokubanzi kwihlabathi jikelele.
Oku kwakumangalisa abaninzi kwiindawo zophando, abaye bacinga ukuba lolu hlobo lwenzululwazi yamanqabana alunqabile, ukuba akunakwenzeka.
Ngethuba bekude kwaziwa ngexesha elithile ukuba izinga lokunqandwa kwe-tenofovir liye landa-ukusuka kwi-20% eYurophu nase-US ukuya kuma-50 ekhulwini kwiindawo zaseAfrika-abaninzi bekholelwa ukuba ezi zimbini iintlobo zenguqu ezinokuthi zingabikho.
Ukuba umendo uyaqhubeka, uninzi ummangali, imiphumo ingaba enkulu. Ezinye izifundo zicebise ukuba ukuxhatshazwa kwe-HIV engaxhatshazwa ngamachiza kungabangela abaninzi abantu abafana nokufa kwabantu abangama-425,000 kunye no-300 000 ukusulelwa kwintsholongwane kwiminyaka emihlanu ezayo.
Okwangoku, ngaphezulu kweepesenti ezili-10 zabantu abaqala unyango lwe-HIV kumbindi nakumazantsi Afrika abanqabile kwiziyobisi zokuqala, ngelixa iipesenti ezingama-40 ziya kufumana ukuchasana okufanayo kumgca wesibini kunye nolwazi olulandelayo lwezonyango. Ukuhlanganiswa kwe-tenofovir kunye ne-thymidine ukuxhatshazwa kwe-analog kwandisa kuphela umbandela ngokunciphisa ubuzwe bomntu kungekuphela kuphela kweyeza okanye ezimbini, kodwa zonke iiklasi zamachiza.
Ukuguqula umendo
Nangona ukwandiswa kwe-HIV-thintelo-ngokuhambelanayo neCandelo leZizwe eziManyeneyo kwi-90-90-90 isicwangciso- kubalulekile ekupheliseni ubhubhane, ngokubaluleka ngokulinganayo imfuno yethu yokutshala kwezobuchwepheshe kunye nokuchonga izisombululo zokunqoba izithintelo ezichanekileyo kwisistim ngasinye ukubambelela. Isilumkiso sikhankanywe ngamagosa kwi-WHO, echaza ukuba ngaphandle kweendlela zokuqinisekisa ukugcinwa kwesigulane ekunyamekelweni, ukwandiswa ngokukhawuleza kweenkqubo zonyango akusayi kuze kubekho ulwahlulo.
Ithemba, okwangoku, unyanzeliswa kwisicingo sokulinga esibizwa ngokuba yi-ibalizumab, esinikezwe isimo sokuphulukana ne-US Food and Drug Administration ngo-2015. Isidakamizwa esiyi-injection sivimbela i-HIV ukungena kwiseli kwaye iboniswe ukuba inqobe amaninzi amaninzi- iintlobo ezixhatshazelisayo kwizilingo zabantu. Ngoxa ingekavunyelwanga ngokusemthethweni yi-FDA, isimo sokuqhubela phambili sihamba ngokukhawuleza ukuvunyelwa ukusuka naphakathi kwinyanga ezintandathu ukuya kunyaka.
Olunye uphando luye lwaphakamisa ukuba uhlobo olutsha lwe- tenofovir (olubizwa ngokuba yi-tenofovir AF) lunokwazi ukunqoba ukuchasana oluhambelana nefomu "elidala" leziyobisi (ebizwa ngokuba yi-tenofovir DF).
Ukususela kumbono ngamnye, ukuthintela kusekho okubalulekileyo ekukhuseleni ukusasazeka kokuqhutyelwa kwamachiza amaninzi. Ifuna zombini amazinga aphakamileyo okunyanzeliswa koluntu kubantu abaphila ne-HIV kunye neendlela zokunciphisa iingozi zokukhusela kokubili ukuthengwa nokuhanjiswa kwegciwane elingenakunyango.
> Imithombo:
> Gregson, J .; Kaleebu, P .; Marconi, V; okqhubekayo. "Ukuxhatshazwa kwegciwane lesandulela-ngculaza-1 ukuchasana kwezidakamizwa kwi-thymidine efana nokuhluleka kwe-tenofovir yokuqala-line kunye ne-cytosine-analogue kunye nevirapine okanye i-efavirenz kwi-Afrika engezantsi kwe-Sahara: i-retrospective study-center study." Izifo ezithathelwanayo zeLancet. Novemba 30, 2016; S1473-3099 (16) 30469-8.
> Iqela leSifundo seTenoRes. "I-epidemiology yehlabathi jikelele yokuchasana neziyobisi emva kokungaphumeleli kwe-WHO iphakanyise iirimimeni zokuqala zentsholongwane kaGawulayo-1: isifundo seqela eliphindaphindiweyo." Izifo ezithathelwanayo zeLancet. NgoJanuwari 28, 2016; papashwa kwi-intanethi.