Ukukhusela i-HIV kuye kwatshintsha ngokuphawulekayo phakathi kwexesha elishumi elidlulileyo. Asisayi kuphinda sibone iikhondom okanye ukuyeka ukuzibandakanya kwiindlela eziphambili zokukhusela i-HIV. Namhlanje kukho uluhlu olubanzi olubanzi lweendlela eziza kusebenzisana kunye nokunciphisa umngcipheko we-HIV ukuya kumazinga athathekayo.
Oyintloko phakathi kwezi zinto kuye kwaba yi- pre-exposure prophylaxis (PrEP) , ipilisi yosuku olulodwa oluya kunciphisa umngcipheko we-HIV ngama-92 ekhulwini.
Xa isetyenziswe kunye nomlingani we -HIV kwi-antiretroviral therapy , umngcipheko unako ukuyeka ngakumbi-ngaphezulu kwama-99 ekhulwini ngamanqaku athile.
Nangona kunjalo, naphezu kobuchule bokungqina, kukho imingeni enkulu ekuphunyezweni kwe-PrEP. Ukongeza kwinto yokuthatha izidakamizwa zansuku zonke, asiqinisekanga nokuba kukunamathela kangakanani ukufezekisa inzuzo epheleleyo yokukhusela. Ezinye izifundo zicebise ukuba i-gay kunye nabesilisa abangabesilisa abafazi banokufuna kuphela amanani amabini ukuya kwethathu ngeveki, ngelixa abafazi besenokufuna ukubambelela ngokukhawuleza ukufikelela kwiziphumo ezifanayo.
Ukuphuhlisa isixhobo, ngoko ke, esinokubonelela ngokukhuseleka kwexesha elipheleleyo kuthathwa njengeyona nto ibaluleke kakhulu phakathi kwezesayensi kunye namagosa ezempilo ngokufanayo.
NgoJanuwari 2017, iSiseko soYilwayo kunye noMelinda Gates sabeka i-gauntlet yocwaningo ngokunikela i-Intarcia Therapeutics i-Intarcia Therapeutics, i-Boston-based based biopharmaceutical firm, ukuvelisa isixhobo esinokufakwa phantsi kwesikhumba ukukhusela i-HIV ngelixa.
Umnikelo ngokufanelekileyo ubeka izimpembelelo ezingaphantsi kwindlela yokuphucula ukuphucula, kunye namanye amachiza athatha ixesha elide ephononongwa ngokubaluleka nokukhusela i-HIV.
Indlela yokuFakela phantsi kweSigqeba esiya kusebenza ngayo
Isixhobo se-Intarcia asiyiyo yokuqala ifowuni yokusebenzisa ubuchwepheshe be-subdermal ukuhambisa umlinganiselo othe ngqo weyeza zokukhusela.
Izifakelo zokukhulelwa , ubuninzi bobukhulu beemidlalo, zisetyenziselwe ukususela ngo-1983 ukukhusela ukukhulelwa kwabasetyhini, ngeendlela ezinokutsha ukukwazi ukuzinikela kwiminyaka emithathu yokukhusela okuqhubekayo.
Iimveliso ezinokuthi zitshintshwe ziye zaphandwa ukuze zisebenzise ngohlobo lwe-2 lweswekile, unyango lomhlaza, unyango lwesifo sofuba, kunye neengxaki ze-schizophrenic.
Kwintsimi ye-HIV, enye yezimpembelelo zokuqala ezenziwe phantsi yi-Pasadena esekelwe kwi-Oak Crest Institute of Science. Uphando lwezilwanyana zakuqala lubonise ukuba idivayisi, xa ifakwe phantsi kwesikhumba se-forearm, yakwazi ukuhambisa i-dose eqhubekayo ye-tenofovir alafenamide (TAF) ukuya kwiintsuku ezingama-40 kungekho miphumo ebonakalayo.
Uphando luqhubeka ukwandisa kwezo ziphumo, ngenjongo yokudala ifowuni inakho ukubonelela ngokukhawuleza kokusasazwa kwimizuzu ukuya kwiinyanga ezili-12.
Ngexesha elifanayo kwindlela, i-Intarcia ifowuni (ebizwa ngokuba yi-ITCA 650) inikeza inkqubo ekhethekileyo "ye-mini-pump" efanelekileyo ekuqiniseni i-dosing kwiinyanga ezintandathu. Amanzi avela kwi-extracellular fluid engena kwelinye icala kwisistim nge-memmane ene-semi-permmeable, eyandula kwaye iqhuba ipiston ye-osmotic. I-ITCA 650 ibonakala iyinto ehamba phambili ngaphezu kwezixhobo zangaphambilini kwaye sele iphumelele kwiziphumo ezintle kwizilingo zesifo sikashukela.
Ukuba iziphumo ezifanayo zifezekiswe kwi-HIV, isixhobo singavunyelwa ngaphakathi kwithuba elincinane, elifutshane. Ngelixa i-Intarcia engasayi kuthatha isigqibo sokuba yiyiphi i-antiretroviral drug to work, abaninzi bakholelwa ukuba i- Truvada (esele iqwalaselwe umgangatho we-PrEP ngomlomo) iya kuba ngumviwa onikezelwe ukuba ilungelo layo lobunikazi lizakuphela ngo-2018.
Kutheni i-Implementation Subdermal Kubaluleke kangaka
Ngelixa abaninzi abantu bathatha iPEP ngomlomo banako ukugcina amanqanaba aphezulu okubambelela, ukusetyenziswa kwabo phakathi kwamaqela aphezulu kakhulu kunokuthi bahluke kakhulu. Ngokomphando owenziwe kwiNgqungquthela ye-AIDS yamazwe ngama-21 eThekwini, abantu abasengozini enkulu ye-HIV abanqabile ukuba abo bathatha iPEPEP.
Oku kubandakanya amaAfrika aseMerika, abamele iipesenti ezingama-44 zentsholongwane zonyaka zonyaka kuphela kodwa iipesenti ezilishumi zeemfuno ze-PrEP.
Nangona amaxabiso amaninzi adlala indima kule ntlukwano, ukunyanyiswa kunye nokudalulwa kwanokubangela inxaxheba, ngokukodwa phakathi kwabasetyhini kunye nabafazi base-Afrika baseMerika abanama- 50 engama - 50 engozini yokuphila kwe-HIV . Kweminye yale madoda, nayiphi na uhlobo lwe-HIV unyango (nokuba lonyango lokukhusela) lufana nesibhengezo esicacileyo sokuqhelaniswa kwabo ngokwesondo.
Ukunikezelwa kwezi zinto, ingaba isixhobo sokukhusela esingabonakaliyo sinqobe le nkxalabo?
Umbuzo obangelwa ngabaphathi bezempilo behlabathi jikelele, abaye bazama ukukhusela i-HIV kubantu abasengozini, ikakhulukazi abasetyhini kunye namantombazana akhululelwe amandla. Nangona kunjalo, ezininzi izicwangciso ezicetywayo, ngelixa likhulu kumaphepha, ziye zahluleka okanye zawa zingalindelekanga. Phakathi kwabo:
- I-VOICE kunye ne-FEM-PrEP iimvavanyo, izifundo ezimbini zokuqala ze-PrEP ezingazange zithintele ukusuleleka kwintsholongwane yabasetyhini baseAfrika, ngenxa yokubambelela ngokuthe ngqo kwonyango.
- Izilingo ze-ASPIRE kunye ne-RING, ezibonelela ngamacangca angaphathekanga ngokubhekiselele kumabhinqa angama-5 000 aseAfrika. Kuzo zombini iimeko, izixhobo zifezekiswe ukunciphisa ukuthotywa kwe-HIV (iipesenti ezingama-27 kunye nama-37 ekhulwini, ngokulandelanayo). Ngaphezu koko, abo basengozini enkulu (abaneminyaka eyi-18 no-24) babengenaso nzuzo yokukhusela.
Kulo mva ongaphantsi kwee-subdermal implants kubonisa isithembiso esikhulu. Abafanelekanga kuphela ukuba bakwazi ukuveliswa ngentengo ephantsi kuneendlela zokwelapha zomlomo, bavumela abafazi nabanye ukuba bazikhusele ngokwamkeleka okufutshane. Ngokungafani namacangci angqongqo kunye nezinye iimveliso ze-microbicidal , azikwazi ukusetyenziswa kakubi okanye zisuswe kalula. (Enye yeepsides kuphela yinto enokuba yinkqubo yokumisela iyakufuneka yenziwe phantsi kwe-anesthetic yendawo.)
Nangona kuya kuba seminyaka ngaphambi kokuba nayiphi na ifowuni ivunyelwe unyango okanye ukukhusela i-HIV, uphando olusenokwenzeka luhlala lusuthembisa. Kule nto, i-Gates Foundation ithembise i-$ 90 yezigidi ngezibonelelo eziphambili ekuqinisekiseni ukuba isithembiso sesigxina se-HIV sisisigxina.
> Imithombo:
> Bancroft, a. "I-Intarcia ifumana i-$ 140m yeSango seSiseko seSiseko se-HIV Tech." Kwi-Pharma Technologist. Ipapashwe ngoJanuwari 4, 2017.
> Montanya, J. "Incwadi ye-Incretin-Based Based Therapies ngohlobo lwe-2 lweswekile." NgoJuni 8, 2016; Linker Link; iphe. 77-92.
> Du Toit, L .; Pillay, V .; kunye noDanckwerts, M. "Isifo sesifo sofuba I-Chemotherapy: iindlela ezikhoyo zokuhambisa iziyobisi." Ukuhlonipha. Res. Septemba 2006; 7 (1): 118.
> Gunawardana, M .; Remedios-Chan, M .; Miller, C; okqhubekayo. "I-Pharmacokinetics ye-Long-acting Tenofovir Alafenamide (GS-7340) Izimpembelelo ezingaphantsi kwe-HIV Prophylaxis." Amagciwane anesigciwane kunye ne-Chemotherapy. Ngo-Apreli 15, 2015; 4 (2): 186-190.