Asayansi Akukonzekera Kwambiri Kupeza Njira Zothetsera Vuto la HIV, PrEP
Imodzi mwazitsitsimutso zazikulu zogonjetsa mankhwala osokoneza bongo ndizofunika kwambiri kuti munthu adziwe zolinga zachipatala . Kwa ena, ntchito ya tsiku ndi tsiku yogwiritsira ntchito mankhwala ochepetsa tizilombo toyambitsa matenda ingakhale yodabwitsa, makamaka ngati ikuyenda ndi maganizo kapena ntchito zomwe zingasokoneze miyoyo-ndi kumamatira -anthu omwe ali ndi HIV.
Zovuta kwambiri ndizo nkhanizi zomwe, ku US lero, anthu oposa 20% omwe ali ndi mankhwala ochepetsa kachilombo ka HIV amatha kukhala ndi chiwerengero cha tizilombo toyambitsa matenda osadziwika , chiyeso cha mankhwala opambana.
Poyankha, asayansi tsopano ayamba kufufuza mankhwala osokoneza bongo kwa nthawi yayitali, komanso njira zothandizira mankhwala, zomwe pamapeto pake zimalola kuti pakhale kamodzi pamwezi, kapena kamodzi kamodzi pamwezi, kapena kuchiza kachilombo ka HIV kapena kuchepetsa.
Mankhwala Osokoneza Bongo Kwanthaŵi yaitali
Mu 2013, ma antiretroviral awiri omwe akhala akutalika kwa nthawi yayitali adayambitsidwa pa msonkhano wa 7 wa International AIDS Society (IAS) ku Kuala Lumpur. Mankhwalawa ankawongolera ngati mankhwala osakanikirana, omwe makina ang'onoang'ono a mankhwala osokoneza bongo amaimitsidwa m'madzi, zomwe zimathandiza kuti mankhwalawa atuluke mwamsanga.
Choyamba, cabotegravir (yomwe imadziwikanso kuti GSK1265744) ndi ya mankhwala omwe amatchedwa integrase inhibitors , omwe amachititsa kuti tizilombo toyambitsa matenda tizitenga integrase kuti HIV iyenera kuchulukitsa. Yachiwiri, TMC278-LA , ndi mawonekedwe a nthawi yaitali a mankhwala a Edurant (ripilvirine) omwe akugwiritsidwa ntchito pa kachilombo ka HIV.
Mayesero angapo a maphunziro a Phase II asonyeza kuti kabotegravir imatulutsidwa bwino kwambiri imakhala yolekerera ndi moyo wochuluka wa pakati pa masiku 21 mpaka 50 (poyerekeza ndi maola 40 potsatira mlingo umodzi, pamlomo). Kafukufuku wofananawo wasonyeza kuti mankhwalawa anaonetsetsanso kuti mankhwala osokoneza bongo amakhala ochepa kwambiri m'magazi amtundu ndi m'mimba, omwe amasonyeza kuti angagwiritsidwe ntchito mofulumira, komanso nthawi yayitali ya pre-exposure prophylaxis (PrEP) .
Poyerekeza, kalasi ya Phase I inasonyeza kuti TMC278-LA idatha kusunga chiwerengero cha mankhwala osokoneza bongo m'magazi 12-26. Mankhwalawa anawonetsanso lonjezo monga PrEP, ndi zowonjezereka kwambiri zomwe zimawoneka m'matenda amtunduwu poyerekezera ndi ziwalo za m'mimba.
Kafukufuku wopitilira akukonzekera ndi cholinga chofutukula kafukufuku ku mayesero a Phunziro II ndi III.
Zomwe zimayambitsa matenda opatsirana pogonana
Asayansi a Oak Crest Institute of Science ku Pasadena, California adanena kuti kulikulirakulira komwe kumathandiza kuti pakhale mankhwala ochepetsa tizilombo ta antiretroviral tikaika pansi pa khungu.
Mofananamo pomangika kuzipangidwe zowonongeka kwa nthawi yayitali, chipangizocho chinasonyezedwa mu kufufuza koyambirira kuti athe kumasulidwa, ndikumasulidwa kumasulidwa kwa mankhwala a tenofovir alafenamide (TAF) kwa masiku 40.
Mosiyana ndi tenofovir disoproxil fumarate (TDF), yomwe imagulidwa kwambiri ku Viread ndipo imakhala ndi mankhwala a Truvada ndi Atripla , TAF imaonedwa kuti ndi yotsogolere ya molekyu yomwe imawoneka bwino kwambiri pa mankhwala osokoneza bongo pamtingo waukulu kwambiri kuposa TDF.]
Ngakhale kuti kafukufuku panopa akugwiritsira ntchito chipangizo cha PrEP, akuti ena omwe amagwiritsa ntchito nthawi yaitali angathe kugwiritsidwa ntchito popereka mankhwala othandizira odwala kachilombo ka HIV.
Kafukufuku wamtsogolo akuyembekeza kutsegula chitseko cha chitukuko cha implants chomwe chingathe kukhala chaka chimodzi kapena kuposerapo.
Mitundu ya Intravaginal Microbicidal
Akatswiri a sayansi akhala akuyesetsa kuti athandize amayi omwe ali pachiopsezo choteteza chitetezo ku HIV, makamaka m'madera omwe kulimbikitsidwa kwa amayi kugonana. Zambiri mwa njirazi, kaya mwa njira ya oral PrEP kapena microbicides , zatha kulephera kufufuza chifukwa cha kusowa kwachitsulo komanso kuchepa kwa mankhwala osokoneza bongo m'magazi , ngakhale amayi omwe ali ndi mphamvu zowonongeka.
Pofuna kuthana ndi makondomuwa, magulu ambiri ofufuza akufufuza kugwiritsa ntchito mphete zomwe zimatha kutulutsa mankhwala osokoneza bongo kwa mwezi umodzi pa nthawi.
Chovalacho, chosakwanira chotchedwa elastomer scaffold chophatikizidwa ndi mankhwala osokoneza bongo, chingalole kuti mkazi avale chipangizochi mosawoneka kwa nthawi yonse yogwiritsira ntchito.
Zotsatira zoyambirira zawonetsa kulekerera kwa mphete yowonjezereka yomwe ili ndi kuyesera mankhwala dapivirine (TMC120 ) ndi kupatsirana bwino kwa mankhwala kumtundu wapansi wa chiberekero kwa masiku 33.
Mayesero awiri a mgwirizano wa Phase III, Ring Ring ndi ASPIRE, akuyang'anitsitsa chitetezo cha mphete komanso chitetezo chake chokhazikika pakati pa gulu la amayi okwana 4,500 omwe alibe kachilombo ka HIV.
Zotsatira:
Zachigawo za US za Kuletsa ndi Kupewa Matenda (CDC). "CDC Fact Sheet | HIV ku United States: Maphunziro a Care." Atlanta, Georgia; inasindikizidwa mwezi wa July 2012.
Spreen, W; Margolis, D .; ndi Pottage, J ;; "Mankhwala opatsirana pogwiritsira ntchito kachilombo ka HIV kwa nthawi yaitali." Zomwe zilipo panopa pa HIV ndi Edzi. November 2013; 8 (6): 565-571.
Margolis, D .; Brinson, C; Eron, J ;; et al. "744 ndi rilpivirine ngati mankhwala awiri osamalidwa pakamwa: LAI116482 (LATTE) sabata 48 zotsatira." Msonkhano wa 21 pa Retroviruses ndi Matenda Opondereza (CROI 2014); Boston, Massachusetts; March 3-6, 2014; Mfundo 91LB.
Gunawardana, M .; Remedios-Chan, M .; Miller, C ;; et al. "Pharmokinetics ya Tenofovir Long-Acting Alafenamide (GS-7340) Kuika Zowonjezera kwa HIV Prophylaxis." Antimicrobial Agents ndi Chemotherarpy. April 20, 2015; lembani: 10.1128 / AAC.00656-15.
Nel, A; Smythe, S .; Mnyamata, K .; et al. "Kutetezeka ndi pharmacokinetics ya dapivirine yoperekedwa kuchokera ku matrix ndi malo osungiramo mapiritsi omwe ali m'mimba mwa amayi omwe alibe HIV." Journal of Get Immune Deficiency Syndrome. 2009; 51 (4): 416-423.