I-Genetic, iCliniki kunye Nezinto Ezizimeleyo Zidlala Ingxenye Ekukhetheni Ngokuhlakanipha
Ngokuzisa izidakamizwa ezitsha , ukukhetha unyango olufanelekileyo lwe-HIV lusetyenziswa ngokulula njengokukhetha enye imihla ngemihla, yonke i-tablet enye kunye nenye imihla ngemihla, ithebhulethi yonke. Kwaye kwizigulane ezininzi ezisandul 'ukuguqulwa, kunzima nje ngokuba-efuna ubuncinci ngaphezu kokuvavanywa kwegazi kunye nokuhlaziywa ngokugqithisileyo kwimbali yonyango ukuqinisekisa ukuba iziphi izidakamizwa ziza kusebenza kakuhle kuwe.
Nangona kunjalo, ukwenza okulungileyo akusoloko kulungele. Nangona isisombululo sonke-esisodwa njenge- Atripla , i- Complera okanye i- Genvoya inokwenza ubomi bube lula kwiinkalo zokubambelela , i-genetic, iikliniki okanye nokuba zizinto ezithile zibonisa ukuba ezinye iindlela zonyango.
Ekugqibeleni injongo yonyango oluchanekileyo kukuba unyango lwabantu ngabanye ukwenzela ukuba iziyobisi zakho zisebenze iminyaka emininzi ngangokunokwenzeka kunye nemiphumo engaphantsi kwemiqathango kunye nokunciphisa i-viral (njengokuba kulinganiswa nomthwalo we- HIV ). Ukwenza oko kudinga ukuphonononga oku:
Iintlobo zeDrugs ezikhethwa kwiTradio-Line yokuqala
Izikhokelo zonyango ziye zatshintshe kakhulu kwixesha elidluleyo le minyaka elidluleyo, ukufuduka kwezinye iziyobisi (okanye iiklasi zamachiza) ezaziwa ukuba zinetyhefu okanye zilungele ukuveliswa kweziyobisi .
Kwiikhokelo zamanje zase-US , kugxininiswe ngakumbi ekusebenziseni i-integrase inhibitors (ISTIs) kwindlela yokwelapha yokuqala, kunye neentetho ezine ezikhethiweyo ezibandakanya izidakamizwa ze-ISTI i-darunavir (efumaneka kwi- Triumeq naseTivicay ), i-raltegravir (Isentress) okanye elvitegravir (efumaneka kwiVitekta , Stribild , naseGenvoya ).
Ingqiqo yendawo ekhethiweyo ibandakanya ukunyamezela okulungileyo, imiphumo engaphantsi kwonyango, kunye neeprofayili zokuchasana eziphuculweyo (intsingiselo yokuba bayakwazi ukunqoba nayiphi na intsholongwane yamachiza intsholongwane enokuba nayo ngaphambili). Zonke iindlela zokwelapha ezikhethiweyo zithathwa kwimihla ngemihla, ukuvuma ukuba ukunciphisa ukusetyenziswa kubaluleke kakhulu ekugcineni ukunyanzeliswa kokunyanga .
Iimpawu zobomi beVirus yakho
Akukho nhlobo into enye yintsholongwane kaGawulayo. Kwinkqubo ye-HIV yokwelapha, intsholongwane iya kugqithiswa rhoqo, ezinye zazo zinikezela ukuchaswa kweziyobisi. Njengoko le ntsho longwane igqithiselwa ukusuka kumntu ukuya kumntu, ukuxhatshazwa kudluliselwa (imeko echazwe njengento esetyenziselwayo okanye ithoxiswayo).
Abaninzi kubantu abathathu abasanda kusulelwa kwi-US baya kufumana ukuchasene ubuncinane kwinqanaba le-HIV. Ukufunyaniswa kwamachiza amaninzi kwinqanaba eliqhelekileyo liqhelekile.
Ukuze kuqinisekiswe ukuba unyango lwakho lokuqala luyakwazi ukunqoba izithintelo ezinjalo, iimvavanyo zofuzo (ezibizwa ngokuba yi-genotyping) zenzelwa ukuchonga ukuguquka kwentsholongwane yakho kwaye nokuba ezo zinguqu zitshintshe. Ukukhethwa kwezidakamizwa kusekelwe kuhlalutyo oluchanekileyo lweziphumo ze-genotypic.
Kwizicwangciso ezingenamkhawulo-mithombo apho i-genotyping ingenziwanga rhoqo, ukukhethwa kwezidakamizwa kusekelwe ekuhlolisweni okufundisiweyo (a) kwiindawo ezahlukileyo ezichaziweyo okanye ezinokuthi zithintele ngaphakathi kwimihlaba ethile kwaye (b) iziyobisi ezikhoyo ezaziwa ukuba zinokutshintsha kangangoko ukungqinelana okunjalo.
Izinto zePhysical and Psychological Factors
Ngokucacileyo, yonke impilo yesigulane ibonisa indlela unyango oluqhelekileyo ngayo kubantu abane-HIV.
Isimo somzimba somzimba wesigulane (njengoko silinganiswe ngumlinganiselo we- CD4 ) singashukumisela ukusetyenziswa kwesinye isilwanyana ngaphezu kwesinye. Ezinye iimeko zonyango zingabandakanywa nokusetyenziswa kwee-antiretroviral agents, mhlawumbi ngenxa yokuba isiyobisi singakwandisa imeko esele ikhona okanye kubangele ukuphazamiseka kwempawu.
Phakathi kwemizekelo:
- Ukusetyenziswa kwe-tenofovir kunqatshelwe kubantu abanezintso ezinzima (intsholongwane) ukungasebenzi ngenxa yokuba kunokubangela ukuhluleka kwezintso kwezinye izigulane. Iimeko ezinjalo zingabandakanywa ukusetyenziswa kwezidakamizwa ze-tenofovir ezine-Viread, iTruvada, Stribild, Complera, ne-Atripla.
- Izigulane ezinexinzelelo, ukuxhalaba, isifo schizophrenia, ukuphazamiseka kwengqondo, okanye nayiphi na imeko enzulu yengqondo / yengqondo ingacetyiswa ngokusetyenziswa kwe-efavirenz, isicatshulwa esaziwayo ukuba sichaphazele ngqo inkqubo ye-nervous (kubangela amaphupha acacileyo, iingxaki zokuxininisa nokuphazamiseka kokulala) . Naliphi na le miqathango ingabandakanywa ukusetyenziswa kweSsuva kunye ne-efavirenz ene-Ariprip.
- Abantu abanokukhubazeka kwesibindi (ababandakanya abo abane-hepatitis) kufuneka baphephe nayiphina imithi enokuthi ibenze nzima. Oku kubangelwa imetabolism yalezi ziyobisi esibindi, ezingakhokelela ekwakheni iikhemikhali ezinobuthi (imeko eyaziwa ngokuba yi-hepatotoxicity). Ukusetyenziswa kwe-Aptivus (tipranavir) kunqatshelwe kwiimeko ezinjalo, njengoko zininzi zee-antiretroviral agents ezibonakalisa ukonakala okukhulu kwesibindi.
Ukusebenzisana kweziyobisi
Ukusebenzisana kweziyobisi ngezidakamizwa kubonakala ngokuqhelekileyo kwisigulane ngeyeza le-HIV, kunye nokusebenzisana okufuna ukuba utshintsho kwi dose nabanye bafuna ukuphelisa i-HIV okanye izidakamizwa ezihambelanayo.
Enye yezinto eziqhelekileyo ukusebenzisana kubandakanya iziyobisi ezisetyenziselwa ukunyanga isifo sofuba (TB), ngaphandle kwee-molecule zamachiza ezingekho ngaphantsi kwe-13 ezichasene nokusetyenziswa kwezidakamizwa ze-TB rifampin kunye ne-rifapentine.
Ngokufanayo, izidakamizwa ze-HIV ezingasetyenziswanga kunye nezinye izidakamizwa ze-hepatitis C, ukusebenzisana kwazo kunye nokunciphisa ukusebenza kunye neziphumo zenye okanye zombini iziyobisi. Kuyafana nokusetyenziswa kwezidakamizwa zokunciphisa i-lipid Mevacor (lovastatin) kunye neZocor (simvastatin), engafanele ithathelwe kunye ne-H.IV protease inhibitor yezidakamizwa zeklasi.
Okumangalisayo kukuba, mhlawumbi, i-rem-rem-remedy ye-herbal remedy St. John's Wort iyachithwa ukusetyenziswa kunye nayo yonke imishanguzo ye-HIV njengoko iyaziwa ngokunciphisa kakhulu ukuxinwa kweziyobisi kwigazi.
Kubalulekile ukuba uhlale ucebisa ugqirha wakho malunga naziphi na iziyobisi, zombini ezimiselweyo kwaye ezingezimiselweyo, ukuba uthatha ukuba ngokuqhelekileyo okanye cha.
Izinto zokuphila kunye nezinye izinto
Ulwaphulo lwe-HIV olunolwazi luqwalasela indlela yokuphila komntu kunye nendlela unyango olunokuchaphazela ngayo indlela yokuphila. Kwaye kaninzi ayilula ngokulula. Kwimeko ebonakalayo "elula" -ukuthi, ngokomzekelo, umsebenzi wokutshintshwa ngokungaqhelekanga kunokukwenza ukuba i-efavirenz ingenakuxolisa-ingqalelo enyamekileyo yokunyamekela ingqalelo ukuba unyango lulungelelaniswa nesimo sengqondo somntu. iziphumo zekliniki.
Abafazi abaneminyaka engama-100 ubudala, umzekelo, kufuneka bacebise malunga nomngcipheko we-efavirenz ekuphuhlisweni komntwana kunye nokumiselwa kolunye unyango kufuneka kubekho ukukhulelwa.
Kwizigulane ezindala, ngubani njengabantu abaninzi abanokukhubazeka kweengtso, i-tenofovir ingathatyathwa endaweni ukuze kuphephe ukukhubazeka komntu.
Izigulane kwiyeza le-methadone (ezisetyenziselwa ukunyanga umlutha we-opioid) zinokucetyiswa ukuba ziphephe i-efavirenz, kunye ne- Viramune (i-nevirapine) ne- Kaletra (lopinavir / ritonavir) , njengoko zinokunciphisa ukuphumelela kwezi zonyango. Ngumoya ofanayo, kufuneka ukuba kwenziwe ingqalelo malunga nokusetyenziswa kwezindlela zokwenza unyango olulula lula abantu apho ukuthobela ukuhambelana kubonakala kunzima.
Imithombo:
ISebe lezeMpilo kunye neNkonzo zoLuntu (DHHS). "Izikhokelo zokusetyenziswa kwee-Antiretroviral Agents kwi-HIV-1-abadala nabachaphazelekayo." Rockville, Maryland; fi kelele ngoFebruwari 15, 2016.
Li, J .; Kim, D .; Linley, L .; okqhubekayo. "Ukuphonononga okunomdla kubonakalisa ukunyanzeliswa kokusasazeka kweziyobisi zeHIV." Ingqungquthela ye-2014 kwi-Retroviruses kunye neeNtsholongwane eziKhuselekileyo (CROI); EBoston, eMassachusetts. Matshi 3-7, 2014; ezingabonakaliyo 87.