Ulwaphi unyango lweThathu luye lwaguqula iHIV Epidemic Around
I-HAART ingumxholo othi "unyango oluchithwe kakhulu lwe-antiretroviral," igama eliqulunqiwe ngasekupheleni kweminyaka yama-1990 ukuchaza ukusebenza kweemveliso zonyango ezisetyenziswa ekuphatheni i-HIV.
Ngaphambi kwe-HAART, ukusetyenziswa kwesinye sezidakamizwa ze-antiretroviral bekuye kwaphela ukuphumelela kwizigulane ezine-HIV, okubangelwa ukungaphumeleli kwonyango ngokukhawuleza kunye nokungakwazi ukukhusela ngokupheleleyo umsebenzi wentsholongwane.
Kwakungokungeniswa kwe-protease inhibitors ngo-1996 ukuba oogqirha bakwazi ukudibanisa i-adjithali ezintathu okanye ngaphezulu kwiindlela eziyimpembelelo zokumisa igciwane lesandulela ngculaza ekuchazeni kwiindawo ezahlukeneyo kumjikelezo wobomi. Ngokuza kwe-HAART, oogqirha kunye nososayensi bakwazi ukuphawula ukuwa kwe-50% ekudleni kwenani le-AIDS echaphazelekayo e-US naseYurophu kwiminyaka emithathu emfutshane (1995-1999).
Ukongeza kwi-HAART, indlela yokusetyenziswa kweziyobisi ezininzi yayidume ngokubizwa ngokuthi "unyango oluthathu" okanye "i-cocktail kathathu".
Namhlanje, eli gama liye laxhaswa ezinye i-monikers, kubandakanywa neKART (intsebenziswano ye-antiretroviral therapy) okanye, ngakumbi nangakumbi, i-ART (unyango lwe-antiretroviral).
IHART Works
Ngokuchasene nesichengisi esisodwa okanye izidakamizwa ezimbini zamachiza, ukudibanisa kwe-antiretroviral yesithathu okanye ngaphezulu kunokusebenza njengeqela lesigxina, ngokukhawuleza kuthintela iindidi ezahlukahlukeneyo ze- HIV ezinokuthi zibekho kwi-viral population.
Ukuba esinye isilwanyana asikwazi ukunqanda uhlobo oluthile lwe-viral, enye okanye zombini enye i-arhente iya kuba yinto engaphezulu yokwenza njalo.
Ngaloo nto, ngokugcina igciwane lesandulela ngculaza ( ingabonakali ), zikhona ezimbalwa iintsholongwane ezijikelezayo kwigazi kunye namathuba ambalwa ukuba intsholongwane iguqule ingxaki yokumelana.
Yingakho isandulela-HAART esasilungele ukukhawuleza ngokukhawuleza: abantu abancinci beminyango bavunyelwe ukuba baqhubeke kwaye banyuke ekugqibeleni kwinani ukuba babe yingxaki ye-viral. Xa oku kwenzekayo, iziyobisi azisakwazi ukunqanda i-HIV ekuphenduleni, imeko esichaza ngayo ngokuba "inganyangekiyo."
Iziyobisi ezisetyenziswa kwi-HAART
Kukho iiklasi ezintlanu ze-antiretroviral izidakamizwa , ngasinye sivimbela isigaba esithile kumjikelezo wobomi be-HIV:
- Ukungena okanye ukungena kwi-inhibitors (equka i- CCR5 ye-receptor antagonists)
- i-nucleoside kunye ne-nucleotide reverse transcriptase inhibitors (i-NRTI / i-NtRTI)
- i-non-nucleoside reverse transcriptase inhibitors (i-NNRTI)
- integrase inhibitors
- protease inhibitors
Ezinye iiklasi ze-antiretrovirals ziphandwa, ngelixa izidakamizwa zitsho zitsha zijolise ekuphuculeni ukunyamezela, ukunciphisa imiphumo emibi kunye nokwenza lula ukulandelelana kwabo bafumana unyango.
Ikusasa le-HAART
Ukongezelela ekunikezeni ukunyanzelwa kweNTSHOLONGWANE KAGAWULAYO kubantu abanesifo, i-HAART isetyenziswe njengendlela yokwenza uhlalutyo lwezinga lokusuleleka kwiintsholongwane ezininzi ezikhuselekileyo. Isicwangciso, esaziwa njenge- reatment njenge-prevention (TasP) , siboniswe ukunciphisa "umthamo wentsholongwane yoluntu" ngaphakathi koluntu, okwenza kube nzima kakhulu ukudlulisa intsholongwane kumntu osulelekileyo ukuya kumntu ongenasifo.
Ngaphezu koko, i-HAART iboniswe ukunciphisa umngcipheko wesifo se-HIV kunye nesingenayo i-HIV (kuquka i-cancer kunye nesifo senhliziyo) ngo-58% xa kuqalwe ngexesha lokuxilongwa. Ngenxa yoko, ngoku kukhuthazwa ukuba i-HAART iqaliswe kubo bonke abantu abanentsholongwane kaGawulayo , kungakhathaliseki imeko ye-immune, ingeniso, ummandla wendawo, ubuhlanga, okanye umthamo wentsholongwane kaGawulayo.
Ingcamango ye-HAART nayo inokutshintsha kunye nokuphuhliswa kwee -adress antiretroviral zonyango (ezinokuthi zivumele ii-injection zenyanga okanye zenyanga) eziza kulandela ukunciphisa i-cocktail ye-drug kathathu njengamachiza ambalwa.
Izilingo ezimbini ezibalulekileyo zeSigaba III, ezibizwa ngokuba yi-SWORD-1 kunye ne-SWORD-2, zibonise ukuba ukusebenzisa iTivicay (dolutegravir) kunye ne-Edurant (rilpivirine) kubangele ukunyanzeliswa kwegciwane lesifo sengculaza ngeeveki ezingama-48 ezineempembelelo eziphantsi. Olunye uvavanyo oluncinci oluthiwa yi-LAMIDOL, lubonise ukuba i-Tivicay esetyenziswe ne-lamivudine (i-drug generation) yayinokukwazi ukufezekisa iziphumo ezifanayo kwizigulane ezaphathwa ngaphambili.
Imithombo:
> Sansone, G. noFrengley, J. "Impembelelo ye-HAART kwiZizathu zokufa kwabantu abane-AIDS-stage-stage." Umbhalo wezeMpilo zeMixeko. Juni 2000; 77 (2): 166-75.
> Cohen, M .; Chen, Y; McCauley, M .; okqhubekayo. "Ukuthintela usulelo lwe-HIV-1 ngonyango lokuqala lwe-antiretroviral." I-New England Journal of Medicine. Agasti 11, 2011; 365 (6): 493-505.
> ISIGABA SOKUQALA IQela lokuFunda. "Ukuqaliswa kweNtsholongwane kaGawulayo kwi-Antiretroviral Infection." I-New England Journal of Medicine. Julayi 20, 2015; INGXELO: 10.1056 / NEJMoa1506816.
> Llibre, J .; I-Hung, iC .; Brinson, C .; okqhubekayo. "Isigaba III I-SWORD 1 & 2: ukutshintshela kwi-DTG + RPV igcina ukunqandwa kwe-virologic ngama-48 wks." 2017 INgqungquthela kwi-Retroviruses kunye neZifo zoKhuseleko (Opportunistic Infections (CROI); NgoFebruwari 13-16, 2017; Seattle; 44LB
> Joly, V .; Burdet, C; Landman, R .; okqhubekayo. "Uthembisa iziphumo ze > dolutegravir > + ukugcinwa kwe-lamivudine kwi-ANRS 167 > LAMIDOL > ityala." 2017 INgqungquthela kwi-Retroviruses kunye neZifo zoKhuseleko (Opportunistic Infections (CROI); NgoFebruwari 13-16, 2017; Seattle; 458.