Kulephera kuchitapo kanthu kungathe kupha anthu 425,000
Pazaka khumi zapitazi, akuluakulu a zaumoyo padziko lapansi apanga mwayi wopereka mankhwala opatsirana pogonana kwa anthu okhala padziko lonse lapansi. Malingana ndi bungwe la United Nations Joint Program on HIV / AIDS (UNAIDS), anthu pafupifupi 21 miliyoni adayikidwa mankhwala opatsirana pogwiritsa ntchito ma antiretroviral kumapeto kwa chaka cha 2017, ndipo chiwerengero cha ana omwe ali ndi kachilombo koyambitsa matenda a HIV kuyambira mu 2003,
Koma ngakhale momwe bungwe la UNAIDS ndi akuluakulu ena a zaumoyo padziko lonse lapansi likuyesa kuthetsa mliliwu pofika mu 2030, chizoloŵezi chosautsa chikhoza kufooketsa khama lawo: kuwonjezeka kwa kachilombo koyambitsa matenda osokoneza bongo omwe poyamba ankaganiza kuti ndi kosavuta ndi asayansi.
Ndi vuto lomwe silikukhudzanso maiko omwe alibe malire (monga omwe ali ku Africa omwe ali ndi vuto lalikulu la matenda opatsirana pogonana) koma m'mayiko omwe amapeza ndalama zambiri zomwe zimakhala zochepa kwambiri.
Zimayambitsa Mitundu Yambiri Yotsutsa Mankhwala Osokoneza Bongo
Kugonana ndi mankhwala ambiri ndi chinthu chowoneka mu matenda ena, monga chifuwa chachikulu (TB) ndi matenda a stapholococcal , momwe munthu wodwala matenda amalephera kuthana ndi mankhwala osiyanasiyana a mankhwala. Nthawi zina, kukana kungakhale koopsa kwambiri, monga matenda opatsirana kwambiri a TB (XDR TB) omwe amawonekera m'madera akumwera kwa Africa, omwe anthu ambiri amafa ndi njira zamankhwala zochepa.
Mofanana ndi mitundu ina yotsutsa , kuphuka kwa mankhwala osagwiritsidwa ntchito ndi mankhwala osokoneza bongo ambiri kumakhala chifukwa cholephera kumwa mankhwala ake nthawi zonse kapena monga momwe amachitira.
Mukatengedwera molondola, mankhwalawa amachititsa kuti tizilombo toyambitsa matenda tiwone ngati kuti "HIV sichitha kuoneka".
Pakapita nthawi, ngati mankhwala amalephera ndipo munthu amapezeka mankhwala ambiri, kusintha kwina kumatha kumangapo, kumanga imodzi potsatira.
Ngati munthu ameneyo amatha kupha wina, mankhwala osokoneza bongo amatha kupitirira, kufalikira kwa anthu pogwiritsa ntchito kugonana kapena kugwiritsa ntchito mankhwala osokoneza bongo .
Zovuta za Mavuto
Malinga ndi bungwe la World Health Organization (WHO), lomwe linasanthula deta kuchokera kuzipatala 12,000 m'mayiko 59, pafupifupi anthu 20 peresenti ya anthu omwe adayambitsa mankhwala ochepetsa kachilombo ka HIV adatuluka kuchipatala popanda chaka chimodzi. Mwa iwo omwe adatsalira pa chithandizo, pafupifupi 73 peresenti anadutsa mosagwirizana, pamene pafupifupi mmodzi pa atatu adalephera kupeza chiwerengero chosawoneka cha tizilombo mogwirizana ndi kupambana kwa mankhwala.
Mchitidwe uwu wa mavairasi pakati pa chiwerengero cha anthu umachulukitsa mwayi wotsutsa mankhwala ambiri, makamaka m'mayiko omwe ali ndi chiwerengero chachikulu cha anthu omwe ali ndi vutoli. Kuchulukitsa vutoli ndi mankhwala osokoneza bongo, omwe amasiya odwala popanda mankhwala ndipo amachititsa pafupifupi 36% zamakilomita m'mayiko osauka.
Ngakhale m'mayiko ngati US, chiŵerengero chachikulu cha matenda osadziwika (20 peresenti) ndi chiwerengero chochepa cha kusungidwa kwa odwala (40 peresenti) chasandulika ku chiwerengero chochepa cha chiwerengero cha mavairasi (28 peresenti).
"Kusatheka" Kutsutsana Kwa Mankhwala Osiyanasiyana Kumayambitsa Mavuto
Phunziro la 2016 kuchokera ku University College of London (UCL) linalimbikitsa chidwi chachikulu pakati pa asayansi omwe amaopa kuti chitukuko cha mankhwala osokoneza bongo angapindule zambiri zomwe zapambana pa nkhondo yapadziko lonse.
Mufukufuku wawo, asayansi a UCL adafufuza kafukufuku wa odwala 712 omwe adalandira mankhwala opatsirana pogonana pakati pa chaka cha 2003 ndi 2013 ndipo adalephera kuchipatala choyamba.
Mwa awa, odwala 115 (16%) anali ndi vuto la HIV ndi kutetezedwa kwa anthidine analog, mtundu womwe umagwirizanitsidwa ndi mankhwala oyambirira monga AZT ndi 3TC. Chodabwitsa n'chakuti odwala 80 peresenti amatsutsidwa ndi tenofovir, mankhwala atsopano omwe amalembedwa padziko lonse lapansi.
Izi zinali zodabwitsa kwa anthu ambiri m'madera ofufuza, omwe ankaganiza kuti mtundu uwu wa mankhwala osokoneza bongo amalephera, ngati sizingatheke.
Ngakhale kuti nthawi yambiri idadziwika kuti kuchuluka kwa tenofovir kunalikukula-kuchokera 20% ku Ulaya ndi US kuposa 50 peresenti m'madera Africa-ambiri amakhulupirira kuti mitundu iwiri ya kusinthasintha kwamasinthasintha sikukanakhalapo.
Ngati chikhalidwe chikupitirira, anthu ambiri amaganiza kuti zotsatira zake zingakhale zazikulu. Kafukufuku wina wanena kuti matenda osagonjetsa kachilombo ka HIV angabweretse anthu oposa 425,000 ndi matenda 300,000 atsopano pazaka zisanu zotsatira.
Pakalipano, opitirira 10 peresenti ya anthu omwe amayamba kachilombo ka HIV pakati ndi kumwera kwa Africa akutsutsana ndi mankhwala oyamba, pamene 40 peresenti adzatsutsana ndi mzere wachiwiri ndi mankhwala ochiritsira. Kuphatikizidwa kwa tenofovir ndi kuthamanga kwa animidine kufanana kumayambitsa vutoli mwa kuchepetsa kukhudzidwa kwa munthu osati mankhwala amodzi kapena awiri okha, koma magulu onse a mankhwala.
Kusintha Mchitidwe
Ngakhale kufalikira kwa kachilombo ka HIV-mogwirizana ndi njira ya United Nations ya 90-90-90 yothetsera- ndikofunikira kuthetsa mliriwu, chofunikira kwambiri ndizofunika kuti tigwire ntchito mu matekinoloje ndi kupeza njira zothetsera zothetsa zowononga mankhwala kutsatira. Izi ndizochenjezedwa ndi akuluakulu a WHO, omwe akunena kuti popanda njira zowonetsetsa kuti wodwala akusungidwa, kusamalidwa kwa mapulogalamu osokoneza bongo sikungathe kukhala ndi mliriwu.
Chiyembekezo, pakali pano, chikugwiritsidwa ntchito pa mankhwala omwe amayesedwa ndi ibalizumab, omwe adapatsidwa mphamvu ndi US Food and Drug Administration mu 2015. Mankhwala osokoneza bongo amaletsa HIV kulowa mu selo ndipo wasonyeza kuti akugonjetsa mankhwala ambiri a mankhwala osokoneza bongo- Matenda osagonjetsedwa m'mayesero a anthu. Ngakhale kuti sizinaperekedwe chilolezo ndi FDA, momwe zinthu zikuyendetsera mwamsanga nthawi zonse kuchokera pamwezi 6 mpaka chaka.
Kafukufuku wina waperekanso kuti mawonekedwe atsopano a tenofovir (otchedwa tenofovir AF) angathe kuthana ndi kutsutsidwa ndi mawonekedwe a "achikulire" omwe amatchedwa tenofovir DF.
Kuchokera pamalingaliro a munthu payekha, kupeweratu kumakhalabe kofunika kuti tipeŵe kufalikira kwambiri kwa mankhwala osokoneza bongo. Imafuna kuti anthu onse omwe ali ndi kachilombo ka HIV azitsatira njira zothandizira anthu omwe ali ndi kachilombo koyambitsa matenda.
> Zotsatira:
> Gregson, J ;; Kaleebu, P .; Marconi, V .; et al. "Kusagwiritsa ntchito mankhwala osokoneza bongo a HIV-1 kwa mankhwala otchedwa thymidine akutsatira kulephera kwa mzere woyamba wa tenofovir pamodzi ndi analogue ya cytosine ndi nevirapine kapena efavirenz m'munsi mwa Sahara Africa. Matenda Opatsirana a Lancet. November 30, 2016; S1473-3099 (16) 30469-8.
> Gulu Lophunzira la TenoRes. "Mliri wadziko lonse wa matenda osokoneza bongo pambuyo pa kulephera kwa WHO kunalimbikitsa zigawo zoyamba za anthu akuluakulu omwe ali ndi kachilombo ka HIV. Matenda Opatsirana a Lancet. January 28, 2016; lofalitsidwa pa intaneti.