Iingcebiso ezivela kwiSebe lezeMpilo leNkonzo yaseMzantsi Afrika
NgoMeyi 2014, iSebe lezeMpilo neSebe lezeMpilo lase-United States lihlaziye izikhokelo zalo zonyango lwe-HIV, likhuthaza ukuphunyezwa kweyeza-antiretroviral (ART) kuzo zonke abantu abadala abaxilongwa nge-HIV, kungakhathaliseki ukuba yi- CD4 counters okanye isigaba sesifo .
Iziphakamiso ezadlulelwa ngaphambili kwi-ART kwi-CD4 zibalwa ngaphantsi kweeseli ezili-500 / mL, kunye nesincophiso esilinganiselweyo se-ART ekubaleni ngaphezu kweeseli ezili-500 / mL.
Isizathu sonyango lweNtsholongwane kaGawulayo kwi-Diagnosis
Isigqibo se-DHHS sisekelwa ngobungqina bokuba unyango lokuqala ludibene nenani leziphumo ezilungileyo, oku:
- ukunciphisa umngcipheko wokufa kunye nezifo ezihambelana nokukhula kwesifo se-HIV.
- ukunciphisa umngcipheko wokusasazeka kumama ukuya kumntwana.
- ukunciphisa umngcipheko wokusasazeka kumntu osuleleka ngu-HIV.
Iziphakamiso zokugqibela zixhaswa bubungqina bokuba ukusetyenziswa kwe-ART kunokunciphisa kakhulu ukuphazamiseka komntu onentsholongwane kaGawulayo, isicwangciso esaziwa ngokuba yiNyango njengoThintelo (i-TasP)
Kuye kwabonakaliswa kwakhona ukuba abantu abanikezelwa ngama-ART angama- 53% amathuba okuba bahlakulele isifo esibi , bobabili abanxulumene negciwane lesandulela ngculaza kunye nabangenxulumene nalo, kunomntu onikwe i-ART.
Ngaphezu koko, ii-ART zakuqala azigcini nje kwiziphumo ezingcono kodwa zide zide ubomi. Ngokwabaphandi abane-North American AIDS Cohort Ukubambisana koPhando kunye noDawulo (NA-AGAWORD), umntu oneminyaka engama-20 ubudala onentsholongwane kaGawulayo unokulindela ukuba aphile kwiminyaka yakhe engama-70 ubudala xa ephathwa ngexesha lokuxilongwa.
Ngokwahlukileyo, ukuchasisa i-ART ade idibansi ye-CD4 yomntu ehla ngaphantsi kweeseli ezingama-200 / mL inokunciphisa ukulinda komntu wobomi kwiminyaka eyi-15.
Iingcebiso zoPhando lweNgcaciso lwaBokuqala kwiiNkcazo eziPhezulu
Ngaphambili kungaphathwa kakubi ("unyango olungenangqondo") izigulane, iphaneli yase-US ngoku iphakamisa enye yeerimenim yezilwanyana njengezikhetho ezikhethiweyo zonyango lokuqala:
- I-Triumeq (dolutegravir + abacavir + lamivudine), ithathwa kanye ngosuku
- I-Tivicay (dolutegravir) + iTruvada (tenofovir + emtricitabine), ithathwa kanye ngosuku
- Stribild (elvitegravir + cobicistat + tenofovir + emtricitabine), ithathwa kanye ngosuku
- UGenvoya (elvitegravir + cobicistat + tenofovir AF + emtricitabine), ithathwa kanye
- Isentress (ratelgravir) + iTruvada (tenofovir + emtricitabine), ithathwa kanye
- I-Prezista (darunavir) + i- Norvir (ritonavir) + iTruvada (i-tenofovir + emtricitabine), ithathwa kanye ngosuku
Isizathu esiyintloko kwisimo esikhethiweyo se-DHHS sibandakanya umthwalo ophantsi weepilisi, i-shedding schedule, iphrofayili yempembelelo encinci, kunye nomqobo ophezulu wokuchasana neziyobisi.
Ekubeni iimeko ezithile zingabandakanyeli abathile ekuthathethweni iindlela ezikhethiweyo (ezifana neTruvada kwizigulane ezinokukhubazeka kweengqondo), i-DHHS iluhlu lwee-regimens ezi-6 zonyango lokuqala njengolu hlobo:
- I-Atripla (efavirenz + tenofovir + emtricitabine), ithathwa kanye ngosuku
- I-Complera (rilpivirine + tenofovir + emtricitabine), ithathwa kanye ngosuku
- I-Evotaz (atazanavir + cobicistat) + iTruvada (tenofovir + emtricitabine), ithathwa kanye ngosuku
- Reyataz (atazanavir) + Norvir (ritonavir) + iTruvada (tenofovir + emtricitabine), ithathwa kanye rhoqo
- I-Prezcobix (i-darunavir + cobicistat) OKANYE i- Prezista (darunavir) + no- Norvir (ritonavir) ethathwe ngokubambisana no- Epzicom (abacavir + lamivudine), kanye
- I-Prezcobix (darunavir + cobicistat) + iTruvada (tenofovir + emtricitabine), kanye rhoqo
Imithombo:
ISebe lezeMpilo kunye neNkonzo zoLuntu (DHHS). "Izikhokelo zokusetyenziswa kwee-Antiretroviral Agents kwi-HIV-1-abadala nabachaphazelekayo." Rockville, Maryland.
Hogg, R .; Althoff, K .; Samji, H .; okqhubekayo. Ukunyuka kwexesha lokuphila phakathi kwabantu abano-HIV kwi-United States naseKhanada, 2000-2007. "I-7 ye-International AIDS Society (IAS) Inkomfa yePathogenesis, unyango kunye nokuthintela kwi-Kuala Lumpur, eMalaysia ngoJuni 30-Julayi 3, 2013; Abstract TUPE260.
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.
Lasry, A; Isihlengo, iS .; Wolitski, R .; okqhubekayo. "Intsholongwane kaGawulayo yengozi phakathi kwezibini ezisebenzayo: ukuvavanya iziphumo zokudibanisa amaqhinga okuthintela." AIDS . NgoJuni 14, 2014; 28 (10): 1521-1529.
Kitahata, M .; Gange, S .; Abraham, A., et al. "Impembelelo yonyango lokuqala lwe-antiretroviral ye-HIV kwindlela yokuphila." I-New England Journal of Medicine. Aprili 30, 2009; 360 (18): 1815-1826.