Zachibadwa, Zipatala Ndiponso Zochita Pakhomokha Pewani Mbali pa Kusankha Mwanzeru
Poyambitsa mankhwala osokoneza bongo atsopano , kusankha njira yabwino yothandizira kachilombo ka HIV kumakhala kosavuta ngati kusankha tsiku limodzi, piritsi limodzi patsiku lina, piritsi limodzi. Ndipo mwa odwala atsopano omwe akuchiritsidwa, ndi zophweka ngati zomwe zimafuna kupyolera mwa mayeso angapo a magazi komanso kubwereza kwathunthu mbiri yachipatala kuti mudziwe kuti ndi mankhwala ati omwe angakuthandizeni kwambiri payekha.
Komabe, kusankha mwanzeru sikuli kosavuta. Ngakhale kukhala ndi njira yothetsera mavuto onse monga Atripla , Complera kapena Genvoya zingapangitse moyo kukhala wosalira zambiri kuchokera kumalo owonetsetsa, mazinthu, zam'chipatala kapenanso zochitika zaumwini nthawi zambiri zimapereka njira zina zothandizira mankhwala.
Potsirizira pake cholinga cha chithandizo chodziŵika bwino ndicho kupatsa mankhwala okhaokha kuti mankhwala anu azigwira ntchito kwa zaka zambiri zothekera ndi zotsatira zochepa zomwe zimayambitsa matendawa . Kuti muchite zimenezi pamafunika kufufuza zotsatirazi:
Mitundu ya Mankhwala Osokoneza Bongo Imene Amafunidwa mu Njira Yoyamba
Zotsatira za chithandizo cha mankhwala zasintha kwambiri zaka 10 zapitazo, kuchoka ku mankhwala ena (kapena magulu a mankhwala) omwe amadziwika kuti ali oopsa kwambiri kapena amakhala otheka kwambiri pokonza mankhwala osokoneza bongo .
M'nkhani zamakono za US , kulimbikitsidwa kwakukulu kwagwiritsidwa ntchito kwa integrase inhibitors (ISTIs) mu mankhwala oyamba, ndi mankhwala asanu ndi limodzi osankhidwa omwe amaphatikizapo mankhwala a ISTI darunavir (omwe amapezeka ku Triumeq ndi Tivicay ), raltegravir (Isentress) kapena elvitegravir (yomwe imapezeka ku Vitekta , Stribild , ndi Genvoya ).
Zomwe zimapangidwira kuti zikhale zovomerezeka zimaphatikizapo kulekerera, kuchepa kwa zotsatira za mankhwala, ndi mbiri yabwino yotsutsa (kutanthauza kuti amatha kuthetsa kulimbana ndi mankhwala omwe alipo kale). Mankhwala onse omwe amawakonda amawatenga kamodzi pa tsiku ndi tsiku, kuvomereza kuti kuchepetsa kugwiritsira ntchito ndi chinthu chofunikira kwambiri kuti mukhale ndi chidziwitso chabwino cha mankhwala .
Maonekedwe a Virus Anu
Palibe mtundu wina wa kachilombo ka HIV. Pakadwala kachilombo ka HIV, kachilombo ka HIV kadzasinthika nthawi zonse, ena mwa iwo amatha kutsutsa mankhwala. Pamene kachilomboka kamene kamasinthidwa kamadutsa kuchokera kwa munthu, munthu amatha kutsutsa (chikhalidwe chomwe chimatchulidwa kuti chimatsutsidwa kapena chotsutsana).
Ambiri mwa anthu asanu ndi limodzi atsopano omwe ali ndi kachilomboka ku US adzalandira chiwerengero cha mankhwala omwe ali ndi HIV. Kupeza mankhwala osokoneza bongo ambiri kumakhala kofala.
Pofuna kuonetsetsa kuti mankhwala anu oyamba amatha kuthana ndi zolepheretsa zoterezi, mayesero achibadwa (omwe amatchulidwa kuti ndi amtundu wina) amawunikira kuti mudziwe zomwe zimayambitsa kachilombo ka HIV. Kusankhidwa kwa mankhwala kumayambira pa kufufuza mosamalitsa zotsatira za genotypic.
Muzigawo zosagwiritsidwa ntchito mosagwiritsidwa ntchito mosagwiritsidwa ntchito molakwika, mankhwala osokoneza bongo amachokera ku kuunika kwa maphunziro a (a) mitundu yodziwika kapena yodalirika yomwe ilipo m'dera linalake ndi (b) mankhwala omwe alipo omwe amadziwika kuti angagonjetsedwe kotere.
Zinthu Zachilengedwe ndi Zaganizo
Mwachiwonekere, thanzi la wodwalayo limayendetsa momwe chithandizochi chimaperekedwa kwa anthu omwe ali ndi HIV.
Mmene chitetezo cha mthupi cha wodwala (chomwe chikuwerengedwa ndi CD4 count ) chikhoza kulimbikitsa kugwiritsa ntchito mankhwala amodzi pamtundu wina. Matenda ena amathanso kuletsa kugwiritsa ntchito mankhwala ena ochepetsa kachilombo ka HIV, mwina chifukwa mankhwalawa angawononge chikhalidwe choyambirira kapena chiwonongeko.
Zitsanzo mwa izi:
- Kugwiritsiridwa ntchito kwa tenofovir kumatsutsana ndi anthu omwe ali ndi vuto lalikulu la impso (renal) chifukwa akhoza kupangitsa impso kulephera kwa odwala ena. Mkhalidwe woterewu ukhoza kuletsa kugwiritsa ntchito mankhwala a tenofovir omwe ali ndi Viread, Truvada, Stribild, Complera, ndi Atripla.
- Odwala omwe ali ndi matenda ovutika maganizo, nkhawa, schizophrenia, matenda ochititsa munthu kusinthasintha maganizo, kapena vuto lina lililonse la maganizo / maganizo a anthu amatha kuchenjezedwa kuti agwiritse ntchito efavirenz, mankhwala omwe amachititsa kuti mitsempha yambiri iwonongeke. . Zonsezi zikhoza kupatula kugwiritsa ntchito Sustiva ndi mankhwala a efavirenz Atripla.
- Anthu omwe ali ndi vuto la chiwindi (omwe akudwala matenda a chiwindi) omwe amadziwika kapena omwe amapezeka (omwe ali ndi chiwindi) ayenera kupeŵa mankhwala aliwonse omwe angapangitse vutoli. Izi zimayambitsidwa ndi mankhwala a chiwindi mu chiwindi, zomwe zingayambitse kumanga mankhwala omwe amapezeka poizoni (hepatotoxicity). Kugwiritsiridwa ntchito kwa Aptivus (tipranavir) kumatsutsana pazochitika ngati zimenezi, monga ma antiretroviral angapo omwe amawonetsetsa kwambiri chiwindi.
Kuyanjana kwa Mankhwala Osokoneza Bongo
Kugwiritsira ntchito mankhwala osokoneza bongo ndizofala mthupi mwa wodwala pa kachilombo ka HIV, ndipo kuyankhulana kwina komwe kumafuna kusintha kwa mlingo ndi ena kumafuna kuthetsa kachilombo ka HIV kapena mankhwala ogwirizana.
Chimodzi mwa zochitika zowonjezereka zimaphatikizapo mankhwala omwe amagwiritsidwa ntchito pochiza chifuwa chachikulu (TB), osagwiritsa ntchito mankhwala osokoneza bongo osachepera 13 omwe amatsutsana ndi mankhwalawa ndi rifampin ndi rifapentine.
Mofananamo, mankhwala khumi ndi awiri a kachilombo ka HIV sagwiritsidwe ntchito limodzi ndi mankhwala ena a chiwindi , omwe amagwiritsidwa ntchito pamodzi kuchepetsa mphamvu ndi zotsatira za mankhwala kapena mankhwalawa. Chimodzimodzinso ndi mankhwala ochepetsa mankhwalawa a Mevacor (lovastatin) ndi Zocor (simvastatin), omwe sayenera kutengedwa ndi ambiri a H.IV protease inhibitor class drug s .
Chodabwitsa kwambiri, mwinamwake, njira yothetsera zitsamba za St. John's Wort zimatsutsana kuti zigwiritsidwe ntchito ndi mankhwala onse opatsirana pogonana monga momwe zimadziŵira kuchepetsa vuto la mankhwala m'magazi.
Ndikofunika kuti mulangize dokotala wanu za mankhwala alionse, onse omwe atchulidwa komanso osalangizidwa, omwe mukuwatenga nthawi zonse kapena ayi.
Zochitika Zamoyo ndi Zina Zoganizira
Kudziwa zachipatala cha HIV kumaganizira momwe moyo wa munthu umakhalira komanso m'mene chithandizo chingasokonezere moyo umenewo. Ndipo nthawi zambiri sichimavuta. Ngakhale m'mabwalo ooneka ngati "osavuta" -momwe, mwachitsanzo, ntchito yosasintha yosagwiritsidwa ntchito yosokoneza ubongo angachititse kuti matenda a efavirenz asasokonezedwe-chithandizo chowonjezereka chiyenera kuchitidwa pofuna kutsimikizira kuti chithandizo choyenera chingafanane ndi chitsimikizo cha wodwalayo monga zotsatira za kuchipatala.
Akazi omwe ali ndi zaka zakubadwa, ayenera kulangizidwa za chiopsezo cha efavirenz pa chitukuko cha mwana ndikumapereka chithandizo china kuti athe kutenga mimba.
Kwa odwala achikulire, omwe ali ndi chiwerengero chachikulu cha matenda a impso, tenofovir ikhoza kusinthidwa kuti asathenso kuthetsa vutoli.
Odwala pa mankhwala a methadone (omwe amagwiritsidwa ntchito pochizira opioid) angathenso kupewedwera efavirenz, komanso Viramune (nevirapine) ndi Kaletra (lopinavir / ritonavir) , chifukwa angathe kuchepetsa mphamvu za mankhwala onse. Mu mpweya womwewo, kulingalira kumafunika kugwiritsidwa ntchito ponena za kugwiritsa ntchito njira zosavuta zochizira pakati pa anthu omwe kumangiriza kusagwirizana nthawi zambiri kumakhala kovuta.
Zotsatira:
Dipatimenti ya Zaumoyo ndi Zaumunthu (DHHS). "Malangizo othandizira kugwiritsira ntchito ma antiretroviral mu HIV-1-Akuluakulu Okhudzidwa ndi Achinyamata." Rockville, Maryland; yafika pa February 15, 2016.
Li, J ;; Kim, D .; Linley, L .; et al. "Kupenda mosamala kumasonyeza kuti anthu ambiri alibe kachilombo koyambitsa matendawa." Msonkhano wa 2014 pa ma retroviruses ndi matenda opatsirana (CROI); Boston, Massachusetts. March 3-7, 2014; chosamveka 87.