I-Genotyping kunye ne-Phenotyping Inokukwazi ukuchonga, kunye Nokuba uqikelele, ukuxhatshazwa kweMithi ye-HIV
Kwaba bantu banamathela ngokuthe ngqo kwiyeza, inqanaba elithile le-HIV linganyangekiyo kulindeleke ukuba liphuhlise ixesha elidlulileyo ngenxa yokuguquka kwemvelo kwintsholongwane. Kwezinye iimeko, ukuxhatshazwa kunokukhula ngokukhawuleza xa ukunyanzelisa ngokunyanisekileyo kuvumela ukuba abantu abanentsholongwane kaGawulayo baphumelele, bekhokelela ekugqibeleni ukuhluleka kokonyango.
Xa ukungaphumeleli kwonyango kwenzeka, ukudibanisa ezinye iziyobisi kufuneka kukhethwe ukwenzela ukucima le ntsha yabantu abanesifo sengculaza.
Ukuhlolwa kokunyamezela i-Genetic kukunceda ukucwangcisa oku ngokuchonga iintlobo zokungatshintshwa kweengxaki kumntu "wepilisi yamachiza," ngelixa ufumanisa indlela ezinokuthi izifo zintsholongwane zifumaneke kwii- antiretroviral agents .
Izixhobo ezibini eziphambili zisetyenziselwa uvavanyo lokushatshazwa kwemfuyo kwi-HIV: isilingo se- HIV kunye ne- HIV ye-phenotypic test .
Yintoni i-Genotype kunye nePhenotype?
Ngenkcazo, i-genotype yinto nje yokwenza i-genetic yendalo, ngelixa i-phenotype impawu ezibonakalayo okanye iimpawu zaloo mzimba.
Iimvavanyo ze-genotypic (okanye i-genotyping) ngomsebenzi ngokuchonga imiyalelo ezuze ngefa kwi-cell code coding, okanye i-DNA. Iimvavanyo zentetho (okanye i-phenotyping) ziqinisekisa ubungqina baloo miyalelo phantsi kwefuthe leemeko ezahlukeneyo zemeko.
Nangona ubudlelwane phakathi kwe-genotype kunye ne-phenotype abukho, i-genotyping inokuthi ibe yinto eqikelelwa ngayo i-phenotype, ingakumbi xa utshintsho kwi-code yezofuzo lunikezela utshintsho olulindelekileyo kwiimpawu okanye kwiimpawu-njengokuba kunjalo nokuphuhliswa kweziyobisi.
Ngonyango, ngakwinye icala, iqinisekisa "apha-kwaye-ngoku." Iinjongo zokuvavanya ukusabela komzimba kwiinguqu ezithile kwiingcinezelo zendalo-njengokuba i-HIV ifumaneka kumayeza ahlukeneyo kunye / okanye iziphumo zamachiza.
Ukuchaza i-HIV Genotyping
I-HIV ye-genotyping ngokuqhelekileyo iteknoloji eqhelekileyo isetyenziselwa ukuvavanya.
Injongo yesilingo kukufumanisa ukuguqulwa kwezinto eziphathekayo kwi- gag-pol kwingingqi yesifo sengqungquthela ye-virus (okanye i-code of genetic). Lo ngummandla apho i-reverse transcriptase, i-protease kunye ne-integrase-enzymes-iithagethi zezidakamizwa ezininzi ze- antiretroviral- zifakwe kwi-DNA chain.
Ngokuqala ukukhulisa i-genome ye-HIV isebenzisa iteknoloji ye- polymerase yokusabela (PCR), iteknoloji yebhanki ingakwazi ukulandelelana (okanye "imephu") i-genetics yesifo sengculaza isebenzisa ubuchwepheshe obuninzi bokufumanisa.
Ukutshintshwa kweenguquko (okanye ukuqoqwa kwemitshintshi) kuchazwa ngabachwephesha abahlalutyo ubudlelwane phakathi kweenguqu ezichongiweyo kunye nefuthe 'elindeleke ukuba lisebenzise kwizidakamizwa ezahlukeneyo ze-antiretroviral. Iinkcukacha ze-intanethi zinokukunceda ngokuthelekisa ulandelelwano lweemvavanyo kunye nelo "mthendeleko we-wild-type" (oko kukuthi, i-HIV engenakho utshintsho olwenqatshelwe).
Ukutolika kwezi mvavanyo kusetyenziselwa ukuchonga ukukhutshwa kwezidakamizwa, kunye nenani elikhulu leenguqu eziphambili ezinikezela kumazinga aphezulu okuchaswa kweziyobisi .
Ukuchaza intsholongwane kaGawulayo
Intsholongwane kaGawulayo ihlola ukukhula komntu kaGawulayo phambi kweso sigqirha, ngoko uthelekisa ukuba ukukhula kolawulo, uhlobo lwegciwane lesandulela ngculaza kwisisifo esifanayo.
Njengazo zokuhlola i-genotypic, iimvavanyo ze-phenotypic ziphakamisa ummandla we-gag-pol we-genome ye-HIV.
Eli candelo lekhodi yomfuzo "lixhaswa" kwi-clone ye-wild-type usebenzisa i -DNA ye-recombinant technology . Intsholongwane ephumayo isetyenziselwa ukuthelela iiseli zamammalia kwi-vitro (kwibrabhu).
Isampuli yentsholongwane yabe isetyenziselwa ukunyuka kweempawu ezahlukeneyo zee-antiretroviral kude kube ngu-50% kunye ne-90% yokunciphisa intsholongwane. Iingcamango zithelekiswa neziphumo ezivela kulawulo, isampula yesimo sendle.
Utshintsho oluthile oluthile lwe "pli" lunikeza uluhlu lwamaxabiso okumiselwa kweziyobisi. Ukutshintsha kwexesha elinesibini kuthetha ukuba ii-ezine izixa zonyango zifunekayo ukuphumeza ukunyanzelwa kwe-viral kufana nelo hlobo lwendalo.
Ixabiso elikhulu le-fold, engaphantsi kwintsholongwane yintsholongwane.
Ezi zithethe zibekwe kwiindawo eziphantsi kweeklinikhi kunye neekliniki ezingaphezulu, kunye namaxabiso aphezulu anikezela kumanqanaba aphezulu ekuchaseni iziyobisi. (Jonga ingxelo yesampula .)
Uvavanyo loMelana noVukani lweNtsholongwane?
EU.S., ukuhlolwa koxhatshazo lwezofuzo ngokuqhelekileyo kwenziwa kwizonyango ze-naïve ukuze zichonge ukuba zikhona naziphi "ezifunyenwe" ukuchaswa kweziyobisi. Izifundo e-US zibonisa ukuba phakathi kwe-6% kunye ne-16% yesandulela-ngculazi iya kugxothwa ubuncinane kwisinye sezidakamizwa zonyango, ngelixa phantse ama-5% aya kunqandwa kumgangatho omnye weyeza.
Ukuhlolwa koxinzelelo lwe-Genetic kusetyenziswa kwakhona xa ukuxhatshazwa kweziyobisi kukhankanywa kubantu ngabanye onyango. Ukuvavanywa kwenziwa ngelixa isigulane sithatha i-regimen engaphumelekanga okanye kwiiveki ezine zokuyeka unyango ukuba umthamo wentsholongwane ungaphezu kweikopi ezingama-500 / mL. Ukuhlolwa kwe-Genotypic ngokuqhelekileyo kukhethwa kula maxesha njengoko bebiza imali encinci, babe nexesha lokukhawuleza ngokukhawuleza, kwaye banikele ubukhulu obuninzi bokufumanisa imixube ye-virus-resistant type and resistant virus.
Ukuhlanganiswa kwama-phenotypic kunye nokuhlolwa kwe-genotypic ngokuqhelekileyo kukhethwa kubantu abanokuxhatshazwa kweziyobisi ezininzi, ngokukodwa kulabo bavelele kwi- protease inhibitors .
Imithombo:
I-World Health Organization (WHO). "Iphepha leNtsholongwane yeNtsholongwane kaGawulayo." Geneva, eSwitzerland; NgoAprili 11, 2011.
Kim, D .; Ziebell, R .; Saduvala, N; okqhubekayo. "Ukuqhubela phambili kwintsholongwane kaGawulayo-1 yintsholongwane ye-ARV-inxulumene nokutshintshwa kwezidalwa: iindawo ezili-10 ze-HIV, i-US, 2007-2010." INgqungquthela ye-20 kwi-Retroviruses kunye neZifo eziHlangayo. Atlanta, Georgia; Matshi 6, 2013; Umlomo osisigxina 149.
Iziko zeSizwe zezeMpilo (NIH). "Izikhokelo zokusetyenziswa kwee-Antiretroviral Agents kwi-HIV-1-abadala nabachaphazelekayo." EBethesda, eMaryn; Oktobha 11, 2013.