Mungaganize kuti zingakhale zophweka kuchita: Pangani mankhwala opangira mavitamini omwe mungagwiritse ntchito musanagonane kuti muphe HIV. Ndipotu, ngati chinachake chonga nonoxynol-9 chingachepetse chiopsezo cha mimba popha umuna, zingakhale zovuta bwanji kukhala ndi kachilombo ka HIV?
Chowonadi ndi chakuti chitukuko cha tizilombo ta microbicidal chadzala ndi mavuto ndi zovuta chifukwa chakuti poyamba zinakonzedwa zaka zoposa 25 zapitazo.
Nthawi zina, mphamvu ya wothandizira kuteteza kachilombo ka HIV mwadzidzidzi inachititsa kuti minofu ya mucosal iwonongeke kapena kuchepetsa kupititsa patsogolo m'malo moletsa HIV.
Nthawi zina, othandizirawo sakanatha kuteteza kachilombo ka HIV kapena kunayambitsa zotsatira zosautsa mtima kwa omwe akudwala.
Pakadali pano, palibe kachilombo ka HIV kamene kalipo kapena kakulimbikitsidwa kuti kagwiritsidwe ntchito. Komabe, owerengeka ochuluka omwe akufunidwa akufufuzidwa mwakhama, kuphatikizapo gel osagwiritsidwa ntchito pogwiritsa ntchito tenofovir, mphete zowonongeka kwa nthawi yaitali, ndi tizilombo toyambitsa matenda.
N'chifukwa Chiyani Microbicides Amati Ndi Yofunika Kwambiri?
Tizilombo toyambitsa matenda sitikuganiza kuti tigwiritse ntchito makondomu kapena kupewa njira zogonana zogwiritsira ntchito chitetezo , koma kuti tipeze chitetezo choonjezera pa nthawi yogonana-makamaka pa chilakolako chogonana kapena chogonana.
Komabe, kuchokera pa chithunzi chokwanira kwambiri, microbicides amawoneka monga njira zomwe zingachepetse kufalikira kwa HIV pakati pa anthu omwe ali pangozi.
Izi zikuphatikizapo amayi omwe ali pachiopsezo chochitidwa nkhanza kapena kugwiriridwa, kapena omwe amadziletsa kugonana sizingatheke (mwina chifukwa cha chilakolako chobereka ana, kapena chikhalidwe choletsera ufulu wawo ndi mphamvu zawo).
Zikuyembekezeratu kuti microbicides angathe kuthetsa amayi omwe ali pachiopsezo njira zowonjezera za chitetezero chawo pomwe akugwiritsa ntchito ogwiritsira ntchito chitetezo chowonjezereka ayenera kuti kondomu iphuphuke kapena ikanike panthawi yogonana.
Zovuta Kwambiri ku Research Microbicidal
Zambiri mwafukufuku oyambirira wa microbicidal anagwiritsira ntchito kugwiritsa ntchito mankhwala otsekemera kapena othandizira omwe angasinthe ma ARV kuti aphe HIV (kapena ayi).
Ena mwa oyambirirawo anali a nonoxynol-9 omwe tatchulawa, omwe amagwiritsa ntchito opaleshoni omwe amagwiritsa ntchito onse monga spermicide komanso m'maso. Kafukufuku wofufuza mchaka cha 2002 anapeza kuti kugwiritsa ntchito nonoxynol-9 kwowonjezera chiopsezo cha kachilombo ka HIV mwa amayi ndi 50 peresenti, ndipo zimakhala zovuta kwambiri pa zilonda za m'mimba zomwe zimawopsa.
Ena amagwiritsidwa ntchito kuti apitirizebe kuteteza mphamvu zamaliseche (kuphatikizapo zofufuzidwa zambiri za BufferGel ) zomwe zimalekereredwa ndi amayi, komabe pamapeto pake sizinapangitse kuchepetsa kuchepetsa HIV.
Njira zothandizira
Pali njira zingapo zomwe zingatheke kuti pakhale chitukuko choyenera cha HIV microbicide, chomwe chingathetsedwe m'magulu awiri.
Yoyamba ikhoza kusankhidwa kukhala osateteza kachilombo ka HIV , omwe amagwira ntchito ngati odwala kachilombo ka HIV (kuteteza chiwalo cha HIV kuti chilowetse maselo a chikazi) kapena kugwiritsa ntchito macromolecules otchedwa dendrimers omwe amamanga kachilombo koyambitsa matenda.
Ngakhale kuyesa koyambirira kwapambana sikunapindule ( PRO 2000 , Carraguard , sulphate ya cellulose), amatsenga angapo atsopano akufufuzidwa-kuphatikizapo dendrimer microbicide VivaGel , ndi ntchito yogwiritsiridwa ntchito ya dendrimers ndi CCR5 kulowa mu inhibitor Selzentry (maraviroc) yogwiritsidwa ntchito pamodzi mankhwala opatsirana pogonana (ART) .
Chachiwiri, ndi chodziwika kwambiri, gulu ndi antiretroviral microbicides . Kukula kwa ogwira ntchitowa kumachokera pa kafukufuku wogwiritsira ntchito tenofovir ndi mankhwala ena opatsirana pogwiritsa ntchito mankhwala opangira mavitamini, mphete, mafuta, ndi zina.
Phunziro la CAPRISA 004 mu 2010 linali loyamba kusonyeza kuti njirayi ikugwira bwino ntchito, pogwiritsira ntchito gelisi 1% tenofovir musanayambe komanso pambuyo pa kugonana kwa abambo 889 omwe alibe HIV.
Zonsezi, chiwerengero cha matendawa chinachepetsedwa ndi 39 peresenti mu gulu losakhala la placebo, pamene anthu omwe ali ndi chiwerengero chokwanira (oposa 80 peresenti) adachepetsa 54 peresenti.
Mosiyana, mayesero a VOICE amawoneka ngati chinthu chotsalira. Pambuyo pa CAPRISA, Voice Trial anaphunzira zitsanzo ziwiri zosiyana zokhudzana ndi HIV-kugwiritsa ntchito tsiku ndi tsiku mankhwala osokoneza bongo ( Viread kapena Truvada ) kapena kugwiritsa ntchito gelisi ya tenofovir tsiku ndi tsiku-mwa akazi 5,029. Chigamulocho chinathetsedwa pamene palibe njira zomwe zapezeka kuti zikugwira ntchito.
Kafukufuku wofufuza pambuyo pake adatsimikiza kuti kulephereka sikungatheke kuchipatala, koma chifukwa cha kusowa kwathunthu pakati pa ophunzira (makamaka pakati pa achinyamata, akazi osakwatiwa). Kufufuza kwina kudzakuthandizani kuti muwone bwino zomwe zimayambitsa khalidwe.
Njira Yobwerera
Pambuyo pa kuyambiranso kwa kuyesa kwa VOICE, kukakamizidwa kwakukulu kunapangidwa pofuna kufufuza njira zina zopititsira patsogolo ma microbicidal agent. Zotsatira zakhala zikuphatikizapo. Pakati pa mayesero a Phase II ndi III posachedwa anamaliza:
- FACT 001 Chiyeso, chomwe chinapempha amayi 2,900 ku South Africa, chinapereka gawo limodzi mofanana ndi zomwe zinagwiritsira ntchito CAPRISA 004 (1% ya gelisi ya tenofovir musanakhale ndi kugonana). Malinga ndi zotsatira zotsutsa, palibe kuchepetsa chiwerengero cha matenda opatsirana pogonana pakati pa ogwiritsa ntchito.
- ASPIRE (MTN-020) inafotokoza kufunika kwa mphete yamkati yomwe ili ndi dapivrine (mankhwala amphamvu kwambiri omwe amachititsa kuti tizilombo toyambitsa matenda tiyesetse) pamene tigwiritsidwa ntchito kwa mwezi umodzi mwa amayi 3,476 ku Africa. Zotsatira mu 2015 zasonyeza kuti 27% ya kuchepetsa chiopsezo cha kachilombo ka HIV pakati pa amai pogwiritsa ntchito dalivirine ring, makamaka kwa amayi a zaka zoposa 21. Amayi ochepera zaka 21 sanatetezedwe pang'ono, makamaka chifukwa chogwiritsa ntchito chipangizo chosagwirizana .
- Chimodzimodzinso, Phunziro la RING (IPM 027) Phunziroli likufufuzanso mphete ya dapivirine m'mayi 1,650 ku Uganda ndi South Africa mu mayesero a Phase III. Ophunzira adzagwiritsa ntchito mphetezo kwa zaka ziwiri. Zotsatirazo zinali zabwino kwambiri kuposa zomwe zimawoneka mu phunziro la ASPIRE, ndi kuchepetsa kwathunthu kwa 37%. Apanso, zotsatira zinali zabwino pakati pa amayi a zaka 21 ndi kupitirira. Palibe phindu lomwe linawonedwa mwa amayi a zaka 18-21.
- Panthawiyi, MTN 017 idzafufuza ntchito ya gelisi yamadzimadzi a tenofovir pamodzi ndi ntchito ya Truvada tsiku ndi tsiku mu gulu la amuna 186 omwe amagonana ndi amuna (MSM) ndi akazi osamvera . Phunziro la Phase II linapitilira masabata asanu ndi atatu, ndipo maulendo apamwamba amavomereza kuti amavomerezedwa ndi kutsatira malamulo ambirimbiri.Phunziroli likhoza kuwonetsetsa kuti kugwiritsira ntchito gelisi kumathandiza komanso kuteteza kale.
- Pomaliza, mu March 2014, kafukufuku wa nyama omwe anachitidwa ndi Centers for Disease Control and Prevention (CDC) adasonyeza kuti gelisi yamagetsi pogwiritsira ntchito antiretroviral Isentress (ratelgravir) ikhoza kuteteza kachilombo ka HIV kwa amayi atatha kugonana. Palibe mawu komabe ngati phunziroli lidzawonjezeredwa kupyola umboni weniweni wamakono.
Zochitika zina za kafukufuku zikufufuza za chitukuko cha mafilimu ochepa, omwe amatulutsa mwamsanga, komanso ma ARV osiyanasiyana.
Zotsatira:
Abdool Karim, Q .; Abdool Karim, S .; Frohlich, J .; et al. "Kugwira Ntchito ndi Kutetezeka Gel Tenofovir, Antiretroviral Microbicide, pofuna Kuteteza HIV ku Akazi." Sayansi. September 3, 2010; 329 (5996): 1168-1174.
Microbicide Trials Network (MTN). "Za Microbicides Fact Sheet: Microbicide Mayankho Network." Pittsburgh, Pennsylvania. Zolemba zowonetsedwa pa March 25, 2014.
Dobard, C .; Sharma, S .; Parikh, U .; et al. "Chitetezo Chotsatira cha Macaques kuchokera ku Vaginal HIV / Infection by Topical Integrase Inhibitors." Sayansi Kusandulika Mankhwala . March 12, 2014. 6 (227): 227ra35.