Kuchiza kwa HIV kungakhale kovuta. Mankhwala othandiza amafunika kuphatikiza mankhwala ochepetsa kachilombo ka HIV. Izi zimadziwika ngati mapiritsi (kuphatikizapo mankhwala opatsirana pogonana), kapena HAART (mankhwala othandiza kwambiri ochepetsa kachilombo ka HIV). Kusakaniza kachirombo ka HIV kawirikawiri kumagwiritsa ntchito mankhwala osachepera awiri osiyana. Izi zimathandiza kuti tizilombo toyambitsa matenda tisakane mankhwala.
Maphunziro a mankhwala osokoneza bongo amagwiritsidwa ntchito:
- protease inhibitors (PIs) - zomwe zimalepheretsa mavitamini kuti asonkhanitse HIV virions
- nucleoside / nucleotide reverse transcriptase inhibitors (NRTIs) - zomwe zimapangitsa kuti HIV isasinthe RNA kukhala DNA kotero kuti ikhoza kupopedwa ndi maselo
- Osati nucleoside reverse transcriptase inhibitors (NNRTIs) - omwe amagwiranso ntchito monga NRTI, koma amamanga pamalo osiyana
- integrase inhibitors - zomwe zimapangitsa kuti HIV isagwirizane ndi mawonekedwe ake
- kulowa mu inhibitors - zomwe zimapewa HIV kuti isalowe mu maselo. Chigawo chimodzi cholowera mavitamini ndi ophwanya malamulo a ccR5. Izi zimaletsa puloteni yomwe HIV imamangiriza polowera maselo
Kalasi iliyonse ya mankhwala imakhala ndi ubwino ndi zovuta. Mwachitsanzo, madokotala ena amasankha kugwiritsa ntchito njira zothandizira nuc-sparing mankhwala kuti asapewe zotsatira, monga kukalamba msanga , zomwe zimagwirizanitsidwa ndi NRTIs. Komabe, akatswiri a kachilombo ka HIV amadziwa kuti palibe regimen imodzi yabwino kwa wodwala ali ndi HIV.
Pofotokoza chithandizo, ayenera kulingalira zinthu zingapo. Izi zikuphatikizapo zotsatirapo, kuyimitsidwa kwa mavairasi, komanso momwe odwala ayenera kutenga mapiritsi awo panthawi yake komanso monga momwe amachitira.
Zingakhale zovuta kusamalira nthawi ya mapiritsi ena. Kwa madongosolo ambiri, mapiritsi amayenera kutengedwa nthawi zosiyanasiyana.
Ena amayenera kutengedwa, ndi ena opanda, chakudya. Chifukwa chake zakhala zikukhudzidwa ndi zilembo zapiritsi imodzi zothandizira HIV. Mankhwalawa ali ndi mankhwala ochokera ku magulu angapo m'philo limodzi. Nthawi zambiri ndimakhala ndi HIV, kamodzi patsiku, ngakhale kuti ena angafunike kutengedwa kawiri patsiku. Pakalipano, mapepala angapo-mapepala amodzi amavomerezedwa ndi FDA:
- Atripla - yomwe ili ndi tenofovir, emtricitabine, ndi efavirenz (Yavomerezedwa 7/2006)
- Complera - yomwe ili ndi tenofovir, emtricitabine, ndi rilpivirine (Approved 8/2011)
- Stribild ("Quad") - yomwe ili ndi tenofovir, emtricitabine, elvitegravir, ndi cobicistat (Yavomerezedwa 8/2012)
- Genvoya - yomwe ili ndi elvitegravir, cobicistat, emtricitabine, ndi tenofovir alafenamide) (Yavomerezedwa 11/5/15)
Mapiritsi a mapiritsi amodzi amadziwikanso kuti ndizophatikizapo mlingo wokhazikika. Komabe, sizowonongeka kwa mlingo wonse ndi mapiritsi amodzi. Ena amafunika kugwiritsidwa ntchito pamodzi ndi mankhwala ena.
Kodi kupindula kwa kachilombo ka HIV kamodzi katsiku ndi kotani?
Pali zifukwa zingapo zomwe zingapindule ndi ma tebulo omwe ali ndi kachilombo ka HIV. Phindu lalikulu kwambiri, kwa odwala onse ndi ogulitsa, ndilosavuta kuti mabungwewa azitenga. Mapiritsi limodzi, kamodzi patsiku, ndi ovuta kwambiri kwa odwala ambiri kuti azindikire kuposa mapiritsi ambiri.
Izo ndi zoona ngakhale zitatha zonse kutengedwa nthawi yomweyo. Izi zikutanthauza kuti odwala kachilombo ka HIV amatha kumwa mankhwala awo nthawi zonse. Mofananamo, mankhwalawa adzakhala othandiza kwambiri.
Chinthu chinanso chogwirizana ndi chakuti odwala amatha kulandira bwino malamulo awo ndi dongosolo limodzi la mapiritsi. Odwala amatenga mapiritsi angapo sangadandaule kwambiri ngati atasiya imodzi mwa malamulo awo, kapena ngati sangakwanitse kubwezeretsanso. Iwo akhoza kuganiza kuti "ataphimbidwa" bola ngati iwo akadali kutenga chinachake. Komabe, mayendedwe a kanema amalembedwa monga kuphatikiza pa chifukwa.
Kugwiritsa ntchito mankhwalawa molakwika kumawonjezera chiopsezo cha kulephera kwa mankhwala ndi kukana mavairasi.
Mosiyana ndi zimenezi, vuto lalikulu la mapiritsi a limodzi ndi nambala yochepa ya zosankha. Pakalipano pali mankhwala ochepa okha omwe amapezeka pamsika, ndipo aliyense amachokera ku kuphatikiza kwa tenofovir ndi emtricitabine yomwe imagulitsidwa monga Truvada. Choncho odwala omwe amalephera kulekerera ena mwa mankhwalawa sangathe kusinthana kuchipatala chokha. Palibenso njira yoti madotolo athe kusintha mlingo wa mankhwala omwe ali nawo mu regimen. Mapiritsiwa amadziwika kuti ndizowonongeka mlingo pa chifukwa. Ngakhale kuti angagwire ntchito bwino kwa odwala ambiri, madokotala ena angapeze kuti sangathe kusinthasintha. Izi zingakhale zowona makamaka kwa madokotala akuyesera kuthetsa poizoni ndi zotsatira zina.
Kodi Ndiyenera Kuyankhula kwa Dokotala Wanga Pa Dipatimenti Yodziphatikiza Pulogalamu?
Ngati muli ndi kachilombo ka HIV ndipo muli ndi vuto lotsatira ndondomeko yanu yamakono, ndiye inde. Muyenera kulingalira mozama kuyankhula ndi dokotala wanu ngati mapiritsi a patsiku amodzi, tsiku limodzi angakhale abwino kwa inu. Chilichonse chomwe chimakupangitsani kukhala kosavuta kuti mutenge mankhwala anu chikhoza kusintha bwino.
Komabe, mankhwalawa sali woyenera kwa aliyense. Zingawononge zotsatira zina zomwe zingakhale zovuta kwa odwala ena. Iwo ndi okwera mtengo: pakali pano, zosankha zapadera zokha zilipo, ndipo ma generic sangakhale akugulitsa msika kwa zaka zingapo. Kuonjezera apo, anthu omwe ali ndi mbiri yochiritsira, kapena omwe alibe mankhwala, sangayembekezere kukhala oyenerera piritsi imodzi.
Kwa anthu omwe ali okondwa ndi chithandizo chawo cha HIV, khalani omasuka. Mankhwalawa sali okwanira pazinthu zina zomwe muyenera kuwona kuti mukufunika kulumphira sitimayo. Ngati regimen yanu ikugwira ntchito bwino, ili ndi poizoni wochepa, ndipo muli omasuka kutenga izo, ndizo zabwino. Sizolakwika kuti muyankhule ndi dokotala wanu ngati mukukhala mukuchiritsidwa chifukwa cha inertia kapena chifukwa choyenera. Komabe, kukambirana sikukutanthauza kuti muyenera kusintha.