Momwe mankhwala ophera kachilombo ka HIV amagwirira ntchito

Pali mankhwala ogwiritsidwa ntchito pochiza kachirombo ka HIV komwe kangapangitse majekeseni ena a antiretroviral (ARVs) akamagwiritsidwa ntchito pamodzi. Ambiri amadziwika kuti "boosters," mankhwalawa amalola madokotala kuchepetsa kuchuluka kwa mlingo wa ARV komanso kuchepetsa kuchuluka kwa zotsatira zake.

Zowonjezera kachilombo ka HIV, zomwe zimadziwika kuti pharmacokinetic enhancers, siziyenera kusokonezeka ndi mavitamini kapena mavitamini omwe amagulitsidwa ngati "ziwopsezo za mthupi," zomwe sizidziwika kuti zimateteza kapena kumenyana ndi HIV.

Kuyamba kwa Zopangira HIV

Pamene HIV protease inhibitors (PIs) idapezeka koyamba pakati pa zaka za m'ma 1990, chimodzi chovuta kwambiri kwa ofufuza chinali mofulumira kwambiri momwe mankhwalawa anagwiritsiridwa ntchito pachiwindi ndi kuchotsedwa m'magazi. Zotsatira zake, ma PIs amafunika kawiri-katatu-tsiku lililonse. Sikuti mitsempha yapamwamba yowonjezera chiopsezo cha mankhwala osokoneza bongo, mapiritsi apamwamba amapangitsa kuti zovuta zikhale zovuta kwambiri (komanso chitukuko cha kukana mosavuta).

Mu 1996, mankhwala a Norvir (ritonavir) adavomereza kuti agwiritsidwe ntchito mu HIV ndi US Food and Drug Administration (FDA). Ngakhale mankhwalawa amadziwika kuti ali ndi mankhwala oletsa tizilombo toyambitsa matenda, posakhalitsa anapeza kuti, ngakhale pang'onopang'ono kwambiri, zikhoza kulepheretsa muyeso womwewo (CYP3A4) umayenera kuwonetsa PIs.

Kutulukira kumeneku kunakhudza njira yomwe PIs idakhaliridwa. Masiku ano, Norvir sagwiritsidwa ntchito mobwerezabwereza kuti athetseretu mankhwala, koma m'malo mwake kuwonjezera mphamvu ya antchito a PI, pamene akuchepetsa zotsatira zogwiritsidwa ntchito ndi mankhwala.

Mankhwalawa amathandizanso kuti pakhale mgwirizano wa mankhwala PI, Kaletra (lopinavir + ritonavir).

(Chonde dziwani kuti Norvir akhoza kusokoneza majekeseni a mankhwala ena omwe mungakhale nawo, nthawi zina zimakhala zovuta kwambiri. Dalitsani dokotala wanu za mankhwala omwe mumagwiritsa ntchito ngati Norvir kapena Kaletra atchulidwa.)

Tsogolo la Zowonjezera za HIV

Zaka zaposachedwapa, pakhala kuyang'anitsitsa kwakukulu komwe kunayambika chitukuko cha zina zowonjezera kachirombo ka HIV. Zimalingalira kuti mawotchi ofananawo sangangowonjezera mphamvu za ma ARV, koma amachitanso zofanana ndi magulu ena a ARV-zomwe zingathe kuwonetsa mgwirizano, kamodzi tsiku ndi tsiku, pamene kulola kuti "chikhululukiro" chachikulu chikhale chosowa kapena kuperewera kwa mankhwala zimachitika.

Mu 2012, patatha zaka 16 kuchokera pamene Norvir, kachiwiri kachiwiri ka mankhwala osokoneza bongo adagonjetsedwa ndi FDA. Chotupa (tybost) (cobicistat) , chigawo chimodzi cha mankhwala osakaniza mankhwala omwe amachititsa mankhwalawa (Stv.) (Elvitegravir + cobicistat + tenofovir + emtricitabine) , amavomereza kuti atseke mapuloteni a CYP3A4 ndi mapuloteni ena a m'mimba omwe amadziwidwa kuti asokoneze mankhwala osokoneza bongo.

Ngakhale kuti ilibe mankhwala oletsa tizilombo toyambitsa matenda, Tybost imatha kuwonjezera mphamvu ya elvitegravir, HIV integrase inhibitor, pomwe ikupeza zotsatira zofanana ndi PI Reyataz (atazanavir) ndi Prezista (darunavir) ndi nucleotide analogue Viread (tenofovir).

Kumayambiriro kwa chaka cha 2015, a FDA adavomereza mankhwala awiri omwe amagwiritsidwa ntchito ndi Tibost, kuphatikizapo Evotaz (atazanvir + cobicistat) ndi Prezcobix (darunavir + cobicistat) .

Zowonjezera zowonjezereka zimayang'aniridwa, kuphatikizapo buku la CYP3A4 inhibitor yopangidwa ndi Sequoia Pharmaceuticals.

_Zotsatira:

_{National Institute of Allergies and Infectious Diseases (NIAID). "Awiri atsopano protease inhibitors omwe amavomerezedwa ndi FDA. Chakudya ndi Mankhwala Osokoneza Bongo. " NIAID AIDS Agenda. Bethesda, Maryland; March 1996; 4-5.}

_{US Food and Drug Administration (FDA). "FDA imavomereza Piritsi Yatsopano Yophatikizira Yopereka HIV kwa Odwala Ena." Silver Spring, Maryland; ndondomeko yofalitsa yomwe inatulutsidwa pa August 27, 2012.}

_{Gallant, J .; Koenig, E .; Andrade-Villanueva, J ;; et al. "Cobicistat Versus Ritonavir ngati Pharmacoenhancer ya Atazanavir Plus Emtricitabine / Tenofovir Disoproxil Fumarate Mu Odwala-Omwe Ali ndi HIV Odwala 1 Odwala: Sabata 48 Zotsatira." Journal of Infectious Diseases. July 1, 2013, 208 (1): 32-39 .}

_{Bristol-Myers Squibb. "Evotaz (Atazanvir + cobicistat) - MFUNDO ZONSE ZOKUTHANDIZA." New York, New York.}

_{Bristol-Myers Squibb. "PREZCOBIX - KUDZIWA ZONSE ZOKUTHANDIZA." New York, New York.}