Isicwangciso se-PrEP singasetyenziselwa ukuthintela umsebenzi we-HIV we-herpes?
I-Valtrex (valacyclovir) , i-Zovirax (i-acyclovir), kunye ne-Famvir (famciclovir) yile mithi emithathu esetyenziswa rhoqo ekuphatheni i- herpes yomzimba . Abantu abaye bafumana i-herpes ngokuphindaphindiweyo baya kubakhombisa ukuba basondele, ukuze ukuba i-characteristic tingling neentlungu zikhula, zingaqalisa iqela ngokukhawuleza kwaye zikhuphe okanye zinciphise ubunzima beqhekeza.
Njengoko umngcipheko wokudlulisa umbane uphezulu xa kukho izilonda ezibonakalayo, kubalulekile ukunqanda ukuphazamiseka ukugwema ukudlulisa intsholongwane kwabanye.
Kodwa, nangona kungekho zibonakaliso ezibonakalayo, ukuhanjiswa kungaqhubeka. Le ngenye yemiceli-mingeni ejongene nezibini xa omnye iqabane liphethe i-herpes kwaye enye ingenzi.
Kungenxa yesi sizathu sokuba amanye amaqabane angakhuselekanga athathe ukusebenzisa i-Valtrex ngaphambi kokulala ngesondo, ekholelwa ukuba ukwenza oko kunciphisa umngcipheko wokusuleleka. Yinto eqhelekileyo eyaziwa ngokuba yi- pre-exposure prophylaxis (PrEP ) apho isilwanyana sisetyenziselwa ukuthintela kunokuphatha isifo esithathelwanayo.
Ingumkhuba oqeshwe ngokubanzi ukukhusela i-HIV , kodwa ngaba imimiselo efanayo isebenza kwi-herpes?
Ukuqonda iProtelaxis Pre-Exposure
Nge-PrEP ye-HIV, ukusetyenziswa kwansuku zonke kweTruvada (tenofovir kunye ne-emtricitabine) kunokunciphisa umngcipheko womntu wokufumana i-HIV ngama-90 ekhulwini okanye ngaphezulu. Iyenjenjalo ngokugcina uxinzelelo oluphezulu lweTruvada egazini ukwenzela ukuba, ukuba i-HIV ivela, isichengisiso sinokuyithintela ngokukhawuleza kwisiza sokungcola.
Ukwenza isicwangciso sisebenze, nangona kunjalo, umntu kufuneka athathe isigxina ngokuqhubekayo, iintsuku ezisixhenxe ngeveki.
Kukho ubungqina, nangona kunjalo, ukuba amadoda alala namadoda angakwazi ukufumana ukhuselo oluninzi kunye namanani ambalwa nje ngeesonto ngalinye. Abesifazana, ngakwelinye icala, banokufuna ukulandelelana okukufutshane-ukufezekisa ukufikelela kumgangatho ofanayo wokukhusela. (Ucwaningo lweeLab lubonise ukuba le nkunkuma ifumaneka ngakumbi kwiisiski zamacangca kunezicubu zentsimbi, ichaza ukungalingani ekukhuseleni.)
Ukususela kwindawo yokujonga i-herpes, nangona kunjalo, bekukho uphando oluncinane malunga nokuxhamla kwangaphambili kwezidakamizwa ze-herpes. Oku kubangelwe, kwinqanaba, ukuba i-herpes ayinayo ingozi efanayo yokufa nokugula njenge-HIV. Kodwa ngaba oko kuphela kuchaza ukuba kutheni singakhange sijonge ngakumbi?
Iingxaki kwi-Herpes ngaphambi kokuVakalisa iProplaxis
Ekude ngo-2003, umenzi we-Valtrex wenza izifundo ukuba ahlole ukuba ukusetyenziswa kwansholongwane ngumlingane osulelekileyo uza kunika umkhuseleko kumntu ongakhuselekanga. Oko bafumene, ngokungaqinisekiyo kukuba, ngeenyanga ezili-8, i-dose ye-500 mg ye-Valtrex yanciphisa umngcipheko ngama-48 ekhulwini.
Okwangoku, nangona kunjalo, alukho uphando olunjalo luqhutyelwe ukuba lubone ukuba kuya kwenzeka ntoni ukuba imeko iqhutywe, kwaye iqabane elingatshintshi lithatha uValtrex esikhundleni sentsholongwane. Kwaye isizathu sokuba oku kulula: bekungekho mthethweni ukwenza njalo. Ukuba isiseko sasiyihluleka, umlingane osulelekileyo wayebekwa ngokungenasidingo kwingozi, kwaye oko bekuya kuphutha.
Kwaye, ngokusekelwe kulokho esikuziyo malunga neziyobisi, kuya kusenokungaphumeleli. Ukuze i-herpes PrEP isebenze, isicatshulwa sidinga ukuba sihlale egazini kumanqanaba aphezulu ngokukhawuleza ukubonelela ikhuselo lokukhusela, kwaye yilapho imodeli iyakunqumla khona.
Imathematika elula. I-Valacyclovir, i-acyclovir, kunye ne-famciclovir nganye ine-half-life-drug ye-2.5 ukuya kwi-3.3 iiyure kunye ne-intracellular half-life of 10, nto leyo ithetha ukuba iyaxoshwa emzimbeni ngokukhawuleza. Ngo-Truvada, isiqhelo se-half-life is 17 iiyure kunye ne-intracellular half-life engaphezu kwama-60. I-HIV PrEP isebenze ngenxa yokuba uxinzelelo lweziyobisi luhlala luzinzile ixesha elide phakathi kwamanani.
Ukuze i-Valtrex yenze okufanayo, umntu kufuneka athathe amanani amaninzi imihla ngemihla. Akukuphela nje oku kungabalulekanga, akunakufunwa ukuba iikhondom zinikezela ukhuselo olumalunga neengcambu zomzimba.
Njengethuluzi lokuthintela, iikhondom zide zingaphelelekanga , kodwa zilula ukunamathela kunokusebenzisa iziyobisi imihla ngemihla.
I-HIV PrEP njengeHerpes PrEP?
Kuyathakazelisa, izazinzulu zifumanisa ukuba, ngaphakathi kwakha ubudlelwane obuzibopheleleyo, abantu abathatha i-HIV PrEP babengama-33 ekhulwini amathuba okufumana i-herpes yofuzo kumlingane ogulayo kunokungabikho.
Nangona kunjalo, ukufezekisa le ngenelo, loo mntu uya kufuneka ukuba alondoloze ukunyanzeliswa kweziyobisi ezisondeleyo, umsebenzi obunzima kunokuba ubonakala . Njengesisombululo esinokuthintela i-herpes, kungakhathaliseki ukuba ne-HIV, kuya kuba yinto engenakunikwa ingozi yemiphumo emibi yexesha elide (kuquka ukukhubazeka kweengtso kunye nokulahleka kwemfuyo).
Ngale nto engqondweni, indlela engcono yokuphepha i-herpes yomzimba isisiseko kunye nesebenzayo:
- Sebenzisa iikhondom ngokuqhelekileyo ukuba zikhona izilonda okanye akunjalo.
- Nciphisa inani lakho leqabane lesini.
- Gweba isondo xa kukho naziphi izilonda ezibonakalayo okanye izilonda ezijikeleza izidalwa zomzimba, i-anus, okanye umlomo.
> Imithombo:
> Bonnar, P. "Ukwelashwa kwe-valacyclovir yokunciphisa ukunciphisa i-herpe transmission: Umgaqo-nkqubo wezempilo olungileyo?" McGill J Med. 2009; 12 (1): 39-46. PMCID: PMC2687913.
> Celum, C; UMorrow R .: Donnell, D. et al. "I-tenofovir yemihla ngemihla kunye ne-emtricitabine-tenofovir preexposure prophylaxis inciphisa uhlobo lwegciwane lohlobo lwe-herpes simplex 2 ekufunyaneni phakathi kwe-HIV-1 nabasetyhini abangabandakanywanga: ukuhlalutya kwamagqabantshintshi enzame." Ann Intern Med . 2014; 161 (1): 11-9. INGXELO: 10.7326 / M13-2471.
> Heinine, W. and Kashuba, A. "Ukukhusela i-HIV nge-Oral Preexposure Prophylaxis." I-Cold Spring Harb Perspect Med. 2012; 2 (3): a007419. INGXELO: 10.1101 / cshperspect.a007419.
> Magaret, A .; Mujugira, A .; Hughes, J. et al. Usetyenziso lweComm Usetyenziso lwe-HSV-2 Ingozi yokuThumela kwi-HIV-1, i-HSV-2--Cordant Couples. " Iiklinikhi ezingenayo. 2016; 62 (4): 456-61. INGXELO 10.1093 / cid / i-civ88.
> Marcus, J .; Glidden, D .; McMahan, V. kunye al. "I-emtricitabine yomlomo / i-tenofovir yesandulela ngandlela-thile i-prophylaxis kunye ne-herpes simplex yintsholongwane ye-2 phakathi kwabantu abalala ngesondo." PLoS One. 2014; 9 (3): e91513. INGXELO: 10.1371 / iphephandaba.pone.0091513.