Malangizo ochokera ku Dipatimenti ya Zaumoyo ya Umoyo ku United States
Mu May 2014, Dipatimenti ya Umoyo wa Anthu ku United States (DHHS) inanena za njira zothandizira anthu omwe ali ndi kachilombo koyambitsa matenda a Edzi, zomwe zimalimbikitsa kugwiritsa ntchito mankhwala opatsirana pogonana (ART) kwa anthu onse achikulire omwe ali ndi kachilombo ka HIV, mosasamala za chiwerengero cha CD4 kapena siteji ya matenda .
Malangizowo poyamba adayitanitsa ART pa CD4 chiwerengero pansi pa maselo 500 / mL, motsogozedwa moyenera kwa ART pa chiwerengero cha ma cell / mL 500.
Zolingalira za kachilombo ka HIV pa Kuzindikira
Chigamulo cha DHHS chimatsimikiziridwa ndi umboni wakuti mankhwala oyambirira akugwirizana ndi zotsatira zabwino zingapo, monga:
- kuchepetsa chiopsezo cha imfa ndi matenda opatsirana ndi matenda a HIV.
- kuchepetsa chiopsezo chotenga HIV kuchokera kwa mayi kupita kwa mwana.
- kuchepetsa chiopsezo chotenga kachilombo kwa munthu yemwe ali ndi HIV.
Malangizo omalizawa amathandizidwa ndi umboni wakuti kugwiritsa ntchito ART kungachepetse kwambiri kuti munthu amene ali ndi kachilombo ka HIV amachepetsedwe, njira yodziwika bwino yotchedwa Treatment as Prevention (TasP)
Zinawonetsedwanso kuti anthu omwe amapatsidwa kachilombo ka HIV amakhala osapitirira 53 peresenti kuti akhale ndi matenda aakulu , onse omwe ali ndi kachilombo ka HIV komanso osagwirizana nawo, kusiyana ndi munthu yemwe ART imachedwa.
Komanso, ART yamayambiriro imapereka osati zotsatira zokhazokha koma moyo wautali. Malingana ndi ofufuza a North American AIDS Cohort Cooperation on Research and Design (NA-ACCORD), munthu wa zaka 20 yemwe ali ndi kachilombo ka HIV angathe tsopano kuyembekezera kukhala ndi zaka makumi asanu ndi awiri zapitazi ngati atachiritsidwa panthawi yomwe adziwa.
Mosiyana ndi zimenezi, kufotokoza kachilombo ka HIV mpaka kachilombo ka CD4 kamene kamakhala pansi pa maselo 200 / mL kungachepetse moyo wa munthuyo pa zaka 15.
Malangizo a Thandizo Loyamba M'mabuku Osadziwika
Odwala omwe poyamba sanatengedwe (odwala mankhwalawa), gulu la US likuyamikira limodzi mwa magawo asanu ndi limodzi a mankhwala osokoneza bongo monga zosankha zawo zoyenera kutsata:
- Triumeq (dolutegravir + abacavir + lamivudine), amatengedwa kamodzi tsiku lililonse
- Tivicay (dolutegravir) + Truvada (tenofovir + emtricitabine), imatengedwa kamodzi tsiku lililonse
- Stribild (elvitegravir + cobicistat + tenofovir + emtricitabine), kamodzi kamodzi tsiku ndi tsiku
- Genvoya (elvitegravir + cobicistat + tenofovir AF + emtricitabine), amatengedwa kamodzi tsiku ndi tsiku
- Isentress (ratelgravir) + Truvada (tenofovir + emtricitabine), imatengedwa kamodzi tsiku ndi tsiku
- Prezista (darunavir) + Norvir (ritonavir) + Truvada (tenofovir + emtricitabine), amatengedwa kamodzi tsiku ndi tsiku
Chofunika chachikulu cha DHHS chikhalidwe chimaphatikizapo regimen wa mapiritsi otsika, nthawi yochepetsera, kuchepa kwa mbali, komanso kulepheretsa kusokoneza mankhwala.
Popeza kuti zikhalidwe zina zingalepheretse ena kutenga njira zomwe akufuna (monga Truvada odwala omwe ali ndi vuto la impso), DHHS imatchula njira zisanu ndi chimodzi zoyenera kupangira mankhwalawa monga:
- Atripla (efavirenz + tenofovir + emtricitabine), amatengedwa kamodzi tsiku lililonse
- Complera (rilpivirine + tenofovir + emtricitabine), itengedwa kamodzi tsiku lililonse
- Evotaz (atazanavir + cobicistat) + Truvada (tenofovir + emtricitabine), amatengedwa kamodzi tsiku ndi tsiku
- Reyataz (atazanavir) + Norvir (ritonavir) + Truvada (tenofovir + emtricitabine), amatengedwa kamodzi tsiku ndi tsiku
- Prezcobix (darunavir + cobicistat) OR Prezista (darunavir) + Norvir (ritonavir) atengedwa limodzi ndi Epzicom (abacavir + lamivudine), kamodzi tsiku ndi tsiku
Zotsatira:
Dipatimenti ya Zaumoyo ndi Zaumunthu (DHHS). "Malangizo othandizira kugwiritsira ntchito ma antiretroviral mu HIV-1-Akuluakulu Okhudzidwa ndi Achinyamata." Rockville, Maryland.
Hogg, R .; Althoff, K .; Samji, H ;; et al. Kuwonjezeka kwa chiyembekezo cha moyo pakati pa anthu omwe ali ndi kachilombo ka HIV ku United States ndi Canada, 2000-2007. "7th International AIDS Society (IAS) Conference on Pathogenesis, Treatment and Prevention Kuala Lumpur, Malaysia. June 30-July 3, 2013; Mfundo TUPE260.
Skarbinski, J ;; Furlow-Parmley, C ;; ndi Frazie, E. "Woimira Padziko Lonse Akuwerengera Chiwerengero cha Akuluakulu a HIV + Okalamba Amene Amalandira Chithandizo Chamankhwala, Anapatsidwa Zachilombo ka ART, ndi Pulogalamu Yowonongeka Kwachidakwa, 2009 mpaka 2010." Msonkhano wa 19 wa Retroviruses ndi Matenda Osakanikirana (CROI); Seattle, Washington; March 8, 2013; ndemanga yomveka # 138.
Lasry, A; Dipo, S .; Wolitski, R .; et al. "Kugonana kwa chiopsezo chotenga kachilombo ka HIV pakati pa anthu omwe ali ndi HIV / AIDS: kuyesa zotsatira za kugwirizanitsa njira zothandizira." AIDS . June 14, 2014; 28 (10): 1521-1529.
Kitahata, M .; Gange, S .; Abraham, A., et al. "Zotsatira za mankhwala oyambitsidwa ndi kachilombo ka HIV poyambirira ndi omwe amalembedwa kuti apulumuke." New England Journal of Medicine. April 30, 2009; 360 (18): 1815-1826.