Mmene Katatu Amathandizira Kutembenuza Mliri wa HIV Padziko Lonse
HAART ndichidule cha "mankhwala othandiza kwambiri a antiretroviral," omwe analembedwa kumapeto kwa zaka za m'ma 1990 pofuna kufotokozera momwe mankhwala ogwiritsira ntchito mankhwala omwe amagwiritsidwa ntchito pochizira HIV amathandizira.
Pambuyo pa HAART, kugwiritsa ntchito mankhwala amodzi kapena awiri a antiretroviral kawirikawiri sikunathandize bwino odwala omwe ali ndi kachilombo koyambitsa matenda a Edzi, zomwe zimapangitsa kuti munthu asathenso kulandira mankhwala komanso kuti sangathe kuthetsa vutoli.
Zinali ndi kukhazikitsa ma protease inhibitors mu 1996 kuti madokotala adatha kuphatikiza odwala atatu kapena kuposa omwe amachititsa kuti HIV isamayesedwe pazinthu zosiyanasiyana pa moyo wawo. Pomwe kufika HAART, madokotala ndi asayansi adatha kuona kupweteka kwakukulu kwa 50% pa chiwerengero cha imfa zokhudzana ndi AIDS ku US ndi Europe mu zaka zochepa (1995-1999).
Kuphatikizana ndi HAART, njira yambiri yogwiritsira ntchito mankhwala idalinso yotchuka kuti "mankhwala atatu" kapena "malo ogulitsa mankhwala osokoneza bongo katatu."
Masiku ano, mawuwa akhala akuphatikizidwa ndi ena amodzi, kuphatikizapo pulogalamu (kuphatikizapo mankhwala opatsirana pogonana) kapena, mosavuta kwambiri, ART (antiretroviral therapy).
Momwe HART Works
Mosiyana ndi mankhwala osakwatiwa kapena mankhwala ochiritsira awiri, kuphatikiza katatu kapena ma antiretroviral angagwiritse ntchito ngati timagulu, kuti athetsere kachilombo ka HIV kamene kangathe kukhalapo m'magulumagulu amodzi.
Ngati mankhwala osokoneza bongo amalephera kuthetsa mtundu wina wa tizilombo, wothandizira wina kapena onse awiri akhoza kukhala oposa.
Komanso, posunga tizilombo toyambitsa matenda ( osadziwika ), pali zochepa zomwe zimafalitsa mavairasi m'magazi ndi mwayi wochepa kuti kachilombo kameneko kamasokoneze.
Ndi chifukwa chake asanamangidwe ka HAART asanawonongeke mofulumira kwambiri: anthu ochepa omwe amatuluka mumtunduwu amaloledwa kupitiriza ndipo potsirizira pake kuwonjezeka kwa chiwerengero kukhala vuto lalikulu la tizilombo. Izi zikachitika, mankhwalawa satha kuimitsa kachilombo ka HIV kuti asawerenge, vuto limene timalongosola ngati "osagonjetsa mankhwala."
Mankhwala Ogwiritsa Ntchito ku HAART
Pakalipano pali magulu asanu a mankhwala opatsirana pogonana , omwe amaletsa gawo linalake mu moyo wa HIV:
- malowedwe kapena kulowa mu fusion (omwe akuphatikizapo otsutsana ndi CCR5)
- nucleoside ndi nucleotide reverse transcriptase inhibitors (NRTI / NtRTI)
- osati nucleoside reverse transcriptase inhibitors (NNRTI)
- integrase inhibitors
- protease inhibitors
Maphunziro ena a antiretroviral akufufuzidwa, pamene mankhwala obadwa atsopano amathandiza kuti zinthu zikhale zolekerera, kuchepetsa mavuto komanso kuchepetsa vutoli kwa odwala.
Tsogolo la HAART
Kuwonjezera pa kupatsirana kwachilombo ka HIV kwa anthu omwe ali ndi kachirombo ka HIV, HAART tsopano ikugwiritsidwa ntchito ngati njira yothetsera chiwerengero cha anthu omwe ali ndi chiopsezo chotenga kachilombo ka HIV. Njirayi, yomwe imadziwika ngati kuchepetsa (TasP) , yawonetsedwa kuchepetsa "chiwerengero cha tizilombo toyambitsa matenda" mumtundu wa anthu, zomwe zimapangitsa kuti zikhale zovuta kwambiri kupatsira munthu wodwala kachilombo kupita kwa munthu yemwe alibe kachilomboka.
Komanso, HAART yasonyezedwa kuti ichepetse chiopsezo cha matenda omwe ali ndi kachilombo ka HIV komanso omwe alibe HIV (kuphatikizapo khansa ndi matenda a mtima). Zotsatira zake, panopa HAART imayambika kwa anthu onse omwe ali ndi kachilombo ka HIV , mosasamala za chitetezo cha mthupi, ndalama, malo, mtundu, kapena kachilombo ka HIV.
Lingaliro la HAART likhoza kusinthika ndi chitukuko cha mankhwala osokoneza bongo omwe akhalapo kwa nthawi yaitali (omwe angalole kuti muzilombo zamwezi uliwonse kapena zam'miyezi itatu) ndi mankhwala omwe akutsatira mtsogolo omwe amaletsa kuchepetsa zakudya zamagulu katatu mankhwala osokoneza bongo.
Mayesero awiri a Phase III, otchedwa SWORD-1 ndi SWORD-2, amasonyeza kuti kugwiritsira ntchito Tivicay (dolutegravir) ndi Edurant (rilpivirine) kunachititsa kuti magazi asapitirire kwa milungu makumi anayi ndi makumi asanu ndi awiri. Chiyeso china chaching'ono, chotchedwa LAMIDOL, chinasonyeza kuti Tivicay yogwiritsidwa ntchito ndi lamivudine (wokalamba mankhwala osokoneza bongo) anali ndi mwayi wopeza zotsatira zomwezo kwa odwala omwe anali nawo kale.
Zotsatira:
> Sansone, G. ndi Frengley, J. "Mphamvu ya HAART pa Zimayambitsa Imfa ya Anthu Omwe Atha Posachedwapa AIDS." Journal of Urban Health. June 2000; 77 (2): 166-75.
> Cohen, M ;; Chen, Y .; McCauley, M .; et al. "Kupewa kachilombo ka HIV-1 ndi mankhwala oyambirira a antiretroviral." New England Journal of Medicine. August 11, 2011; 365 (6): 493-505.
> KUYAMBA KUYAMBIRA Gulu Lophunzira. "Kuyambitsidwa kwa mankhwala opatsirana pogonana ku Antiymmetomatic HIV Infection." New England Journal of Medicine. July 20, 2015; DOI: 10.1056 / NEJMoa1506816.
> Llibre, J .; Hung, C .; Brinson, C .; et al. "Phase III SWORD 1 & 2: kusinthana ku DTG + RPV imasunga virologic kudula mwa 48 wks." Msonkhano wa 2017 pa Retroviruses ndi Matenda Opondereza (CROI); February 13-16, 2017; Seattle; zolemba 44LB
> Joly, V .; Burdet, C .; Landman, R .; et al. "Zolonjezedwa za > dolutegravir > + lamivudine yosungirako ANRS 167 > LAMIDOL > kuyesedwa." Msonkhano wa 2017 pa Retroviruses ndi Matenda Opondereza (CROI); February 13-16, 2017; Seattle; 458.