Unyango lwe-HIV lunokuba nzima. Uphuhliso olufanelekileyo ludinga inhlanganisela yeyeza-antiretroviral. Oku kwaziwa ngokuba yiCART (unyango lwe-antiretroviral edibeneyo), okanye i- HAART (unyango olukhuselekileyo lwe-antiretroviral therapy). Ukuxhatshazwa kweNtsholongwane kaGawulayo ngokuqhelekileyo isebenzisa iziyobisi kumanqanaba amabini ahlukeneyo unyango. Oku kunceda ukugcina intsholongwane ingakwazi ukuchasana nonyango.
Iiklasi zokusetyenziswa kweziyobisi ezisetyenziswa kwi-HIV ziquka:
- i-protease inhibitors (i-PIs) - evimba i-enzyme efunekayo ukudibanisa i-HIV virions
- i-nucleoside / nucleotide reverse transcriptase inhibitors (i-NRTIs)-leyo igcina i-HIV ekuguquleleni i- RNA kwi- DNA ukuze ikopishwe yiiseli
- ii-non-nucleoside reverse transcriptase inhibitors (i-NNRTIs) - ezenza umsebenzi ofanayo njenge-NRTIs, kodwa zibopha kwindawo eyahlukileyo
- integrase inhibitors - ezigcina i-HIV ekudibaniseni i-genome yayo kwiiseli
- ukungena kwi-inhibitors-ezikhusela i-HIV ukungena kwiiseli. Enye i-subset ye-inhibitors yokungena yi-ccR5 i-co-receptor antagonists. Ezi zibhloko iprotein ekuthi i-HIV ibophe xa ifaka iiseli
Iklasi ngalinye leziyobisi linokuba luncedo kunye nokungalungi. Ngokomzekelo, abanye oogqirha bakhetha ukusebenzisa i- nuc-sparing treatment regimens ukukhusela imiphumo emibi, njengokuguga kwangaphambili , ezidibene ne-NRTIs. Nangona kunjalo, iingcali ze-HIV ziyazi ukuba akukho rhujimenti enye ilungile kuyo yonke isigulane esine-HIV.
Xa bechaza unyango, kufuneka baqwalasele inani lezinto. Oku kubandakanye nemiphumo emibi, ukunganyanga kwintsholongwane, kunye nokuba zeziphi izigulane ziza kuthatha zonke iipilisi zabo ngexesha kunye njengoko ziyalathwayo.
Kungaba nzima ukulawula ixesha leempawu ezithile zeepART. Kwiirimim ezininzi, iipilisi kufuneka zithathwe ngamaxesha ahlukeneyo emini.
Abanye kufuneka bathathwe kunye, kunye nabanye ngaphandle, ukutya. Kukho ke ukukhula kwenzalo kwi-one-table regimens ye-HIV unyango. Ezi rejim ziqulethe izidakamizwa ukusuka kwiiklasi ezininzi kwiipilisi enye. Ingundoqo yentsuku yentsholongwane kaGawulayo, nangona abanye bangadinga ukuthathwa kabini ngosuku. Okwangoku, iirhafu ezininzi zeethebhulethi zivunyiwe yi-FDA:
- I-Atripla - equlethe i-tenofovir, emtricitabine, kunye ne-efavirenz (ivunyelwe 7/2006)
- I-Complera - equlethe i-tenofovir, i-emtricitabine, ne-rilpivirine (ivunyiwe 8/2011)
- Stribild ("Quad") - equkethe i-tenofovir, emtricitabine, elvitegravir, kunye ne-cobicistat (Iyavunyelwa ngo-8/2012)
- UGenvoya - equle i-elvitegravir, i-cobicistat, i-emtricitabine, kunye ne-tenofovir alafenamide) (Yamkelwe ngo-11/5/15)
Iipilisi zeepilisi ezilodwa ziyaziwa njengezihlanganisi zedayiti ehleliweyo. Nangona kunjalo, akuyiyo yonke inhlanganisela ye-dose edibeneyo yimijista yeepilisi enye. Ezinye zifuna ukusetyenziswa kunye kunye nezinye iziyobisi.
Ziziphi iingenelo zentsuku nje yentsholongwane kaGawulayo?
Kukho iinzuzo ezinokubakho kwiirhafu ze-tablet enye. Enye inzuzo enkulu, kubini izigulane kunye nababoneleli, ngaba kulula kangakanani le mijelo. Iphilisi enye, kanye ngosuku, kulula kakhulu kwizigulane ezininzi ukugcina umkhondo weepilisi ezininzi.
Kuyinyaniso nokuba ngaba bonke bangathathwa ngexesha elifanayo. Oku kuthetha ukuba izigulane ezinegciwane lesandulela ngculaza ziyakwazi ukuthabatha iipilisi zazo ngokuqhubekayo. Ngokufanayo, ezo nkunkuma ziya kusebenza ngakumbi.
Enye inzuzo enxulumene nayo kukuba izigulane zinokuthi zithathe imimiselo yazo ngokuchanekileyo kunye ne-regimen enye. Izigulana ezithatha iipilisi ezininzi zingenakukhathazeka kangangoko ukuba ziphuma enye yemigqaliselo yazo, okanye ukuba abanako ukukwazi ukuyizalisa enye. Basenokucinga ukuba "bahlanganiswa" nje ngokuba besathatha into ethile. Nangona kunjalo, ii-regimens zekhadi zichongwe njengezidibeneyo ngesizathu.
Ukuthatha ezi iirimimim ngokungekho kakuhle kwandisa umngcipheko wokungaphumeleli unyango kunye nokunyanzelwa kwintsholongwane.
Ngokwahlukileyo, ininzi enkulu yokulahlekelwa kweerigimens enye yelinye inani elikhethiweyo lokukhetha. Kukho nje isibini sezilwanyana ezikhoyo kwiimarike, kwaye nganye isekelwe kudibaniso lwe-tenofovir kunye ne-emtricitabine edlalwa njengeTruvada. Ngoko izigulane ezinobunzima bokunyamezela nokuba zezi ziyobisi aziyi kukwazi ukutshintshela kwi-single-tablet. Akukho ndlela yokuba oogqirha bahlalutye amanani eziyobisi ngamanye kwi-regimen. Ezi pilisi zibizwa ngokuba yi-combination-dose combination for a reason. Nangona bekwazi ukusebenza kakuhle kwizigulane ezininzi, abanye oogqirha banokufumana ukungabikho kokuguquguquka kwemida. Oku kunokwenene oogqirha abazama ukulawula utywala kunye nezinye iziphumo ezibi.
Ngaba Ndimele Ndixoxe Nodokotela Wanga Ngomlinganiselo Wee-Tablet?
Ukuba unentsholongwane kaGawulayo kwaye unenkathazo yokuthobela i-regimen yonyango yakho, ke ewe. Kufuneka uqikelele ukuthetha nogqirha wakho malunga nokuba i-pill ye-do-day-fixed-dose ifanelekile. Nantoni na eyenza kube lula kuwe ukuthatha amayeza akho unokuphucula ukuphumelela kwayo.
Nangona kunjalo, la mayeza awafanelekanga kuwo wonke umntu. Zingabangela iziphumo ezisecaleni ezingaba yingxaki kwizigulana ezithile. Ziyabiza kakhulu: okwangoku, ukhetho lwegama lomgama kuphela lukhoyo, kwaye iinguqulelo zesi-generic aziyi kushaya iimarike iminyaka emininzi. Ukongezelela, abantu abaneembali zonyango olunzima, okanye abaphikisana nonyango, akunakwenzeka ukuba bakwazi ukufumana imirhumo enye yeepilisi.
Kubantu abonwabileyo ngonyango lwabo lwe-HIV, baxinxe. La machiza akwanele ukuphuculwa kweminye imirhumo ekufuneka uve ngayo imfuneko yokungena kwiinqanawa. Ukuba i-regimen yakho yangoku isebenza kakuhle, inobungozi obuphantsi, kwaye ukhululekile ukuyithatha, into enhle. Akukaze kube yinto engalungile ukuthetha nodokotela wakho malunga nokuba uhlala unyango ngenxa ye-inertia okanye kuba kuyona ndlela ikhethekileyo. Nangona kunjalo, ukuba nencoko ayithethi ukuba uguqule.