Ulwaphi Ulwaphulo lweeNyango eziNika iHIV engenamandla
Akukho nto inokuqiniseka ukuba iziyobisi ezisetyenziselwa ukunyanga i-HIV ziye zahamba ngokugqithiseleyo kwiminyaka engama-20 edluleyo. Yintoni abanye abangayiboniyo ukuba i- antiretroviral izidakamizwa ziphucule kangakanani ukususela ngo-1996 xa unyango lokuqala lwezonyango luye lwaguqula le nkqubela yesifo.
Imbali emfutshane ye-Antiretroviral Therapy
Ngaphambi kowe-1996, ubude bomyinge wobomi bomntu oneminyaka engama-20 ubudala osandululweyo abane-HIV beyiminyaka eyi-17.
Ngelixa izidakamizwa ze-antiretroviral zexesha zilawulwa ukuthoba isifo, ukunganyangeki kwezidakamizwa kwakhawuleza kwaye abantu bahlala befumana abantu abambalwa, nakweyiphi na, unyulwa emva kweminyaka emfutshane.
Ngelo xesha, umthwalo wemihla ngemihla unokumangalisa. Kwezinye iimeko, umntu uya kujongana neepilisi ezingama-30 okanye ngaphezulu ngosuku, edlalwa ngekhefu kwiiyure ezine ukuya kweyesithandathu.
Emva koko, ngo-1995, iklasi elitsha lamachiza ebizwa ngokuba yi-protease inhibitors yaqaliswa. Kwiminyaka emithathu kamva, uphando oluthathu luye lwaqinisekisa ukuba ukusetyenziswa kweyeza elinesithathu kunokwenza ulawulo olupheleleyo lukhusele intsholongwane kwaye lunqande isifo ukuba siphumelele .
Kwiminyaka emibini emfutshane, ukuqaliswa kokunyangwa kwamanyathelo kubangele ukuphazamiseka kwe-60 ekhulwini ekufeni kunye nezifo ezinxulumene ne-HIV. Esi sityhilelo sagxila kwizinto ezaza kwaziwa njengexesha le- HAART (unyango olukhuselekileyo lwe-antiretroviral).
Uphuhliso lwezoNyango
Nangona kungekho ngaphandle kwemingeni yayo, unyango lwe-antiretroviral lwangoku luye lwaya phambili apho iziyobisi ezinobungozi ziyisithunzi nje sento ababeyisebenzisayo.
Ukuxhatshazwa kwezidakamizwa ngokukhawuleza kuphuhlise ngelixa i-dosing ifuna iipilisi enye ngosuku.
Okona kubaluleke kakhulu, ngokunyanga okufanelekileyo, umntu osandul 'usulelekileyo unentsholongwane kaGawulayo unokulindela ukufumana ixesha elide elisondeleyo lokuphila . Ngokwe-North American AIDS Cohort Ukusebenzisana koPhando noyilo, umfana oneminyaka engama-20 ubudala osuleleke namhlanje unokuphila kwiminyaka engama-70 nangaphezulu.
I-Antiretrovirals isebenza njani
Izidakamizwa ze-antiretroviral azisebenzi ngokubulala igawulayo. Kunoko, bajolise kwaye bavimbele amanqanaba ahlukeneyo kwintsholongwane yobomi . Ngokwenza njalo, intsholongwane ayikwazi ukuphindaphinda kwaye yenza iikopi ngokwayo. Ukuba unyango luqhubeka luphazamiseka, i-viral population iya kwehla kwindawo ekubhekwa ngayo ingabonakali .
Ngenxa yokuba intsholongwane ayilwanga, ingaphinda ivele (ihlawulelo) ukuba unyango lukhawuleza. Kuyafana okufanayo ukuba iziyobisi azihambisani njengoko zichazwe. Ngokuhamba kwexesha, ukulandelelana kwe-dosing kungahambisani nokuphuhliswa kweziyobisi kwaye ekugqibeleni ukuhluleka kweyeza .
Iiklasi ze-Antiretroviral Drugs
Ukudibanisa unyango lwe-HIV lusebenza ngokuthintela amanqanaba amanqanaba omjikelezo wobomi be-HIV kanyekanye. Kukho iiklasi ezintlanu zezidakamizwa ze-antiretroviral, ngasinye sichazwe yinqanaba lomjikelezo wobomi zivimbela:
- Inhibitors yokungena
- Nucleoside reverse transcriptase inhibitors
- I-non-nucleoside reverse transcriptase inhibitors
- Integrase inhibitors
- Protease inhibitors
Zonke zixelelwe, zikhona izidakamizwa ezingama-39 ezichasene ne-antiretroviral ezivunyiweyo yi-US Food and Drug Administration, kubandakanya i-12 edibeneyo yokusetyenziswa kweziyobisi (FDC) eziqulethe ezimbini okanye ngaphezulu kweziyobisi.
Okutsha, izidakamizwa eziphambili ziphuhliswayo eziza kunciphisa iziyobisi ezintathu.
Ezinye iziqulatho zingavumeleka ukuba zifumane ii-injections zenyanga enye okanye enye ngekota.
Kutheni iCandelo loPhando lweNyango liSebenza
Xa zisetyenziselwa ukudibanisa, izidakamizwa ze-antiretroviral zisebenza njengethimba lethegi yezinto eziphilayo ezinokukwazi ukunciphisa ngokugqithiseleyo uninzi lweenguqulelo zentsholongwane ezinokuthi zingabikho kwi-HIV yabantu. Ukuba isicatshulwa A asikwazi ukunqanda ukuguqulwa okuthile, ngoko i-B neC ingasetyenziswa ngokukhohlisa.
Ukuhlolwa koxinzelelo lwe-Genetic kunika oogqirha izixhobo kufuneka zichonge utshintsho olungapheliyo phambi kokuba unyango luqaliswe, Ngokwenza njalo, ugqirha unokukwazi ukulungisa unyango ngokukhetha ezininzi iziyobisi ezinokukwazi ukucima ezo zinguqulelo.
Ngokugcina i-viral population inophelelwa ngokupheleleyo, akusebenzi nje kuphela izidakamizwa zisebenza ixesha elide, zikho iziphumo ezincinci ezimbalwa.
I-antiretrovirals ingasetyenziselwa ukunciphisa umngcipheko wokudluliselwa kwe-HIV kumama ukuya kumntwana , ukukhusela intsholongwane emva kokutshatyalaliswa ngengozi , okanye ukunceda umntu ongenagciwane lengculaza ukuba angaphephekiyo .
> Imithombo:
> Hogg, R .; Samji, H .; Cescon, A., et al. "Utshintsho lwexesha loLuntu kuLindleko lwe-HIV + Abantu ngabanye: eNyakatho Melika." INgqungquthela ye-19 kwi-Retroviruses kunye neZifo eziKhuselekileyo (CROI). Matshi 7, 2013; Seattle; ngomlomo 137.
> Kitahata, M .; Gange, S .; Abraham, A., et al. "Impembelelo yonyango lokuqala lwe-antiretroviral ye-HIV kwindlela yokuphila." I-New England Journal of Medicine. Aprili 30, 2009; 360 (18): 1815-1826.
> I-Sax, i-P .; Meyers, J .; Mugavero, M., et al. "Ukuxhomekeka kwi-Antiretroviral Treatment and Correlation kunye neNngcipheko yeZibhedlele phakathi kwabasebenzi be-HIV abasemagunyeni ase-United States." I-10 ye-International Congress kwi-Treatment of drugs kuGawulayo. Novemba 8, 2010; Glasgow; ngomlomo 0113.
> Isebe lezeMpilo laseMelika kunye neeNkonzo zoLuntu (DHHS). "Izikhokelo zokusetyenziswa kwe-Agent antiretroviral s kwi-HIV-1-abadala nabachaphazelekayo." Rockville, Maryland; hlaziywa ngoJulayi 14, 2016.