Ngisho Ngisho Nokufunda Kungaphumeleli Ngaphambi Kokucwaninga nge-HIV
"Ukungqubuzana" igama elisetshenziselwa njalo-abanye bangase bathi njalo-lapho bechaza ukuthuthuka kwezesayensi ze-HIV. Futhi ngenkathi kube khona ngempela abaguquleli bezemidlalo eminyakeni yamuva , igama livame ukusikisela ukuthi siseduze nomuthi noma ikhambi esiyilo ngempela.
Lokhu kungenzeka uma ucwaningo lungachazwa kabi noma intatheli ehluleka ukubeka isayensi esimweni esifanele. Futhi lokho kuyamahloni, kunikezwe ukuthi lokho okubikwayo kuvame ukubaluleka ngempela.
Ngokusobala, akufanele neze kube yingxenye yokubika kwezesayensi, into esiyifunde emuva ngo-1984 lapho uNobhala wezeMpilo noMnyango WezeMisebenzi uMargaret Heckler esho ukuthi sizoba nomgomo wokugoma i- HIV "eminyakeni emibili."
Akuyona nje imibono engafanele njengalezi zindlela zokuzethemba zomphakathi, zivame ukuba nomthelela oqondile empilweni yomphakathi. Ucwaningo oluningi luye lwabonisa ukuthi ukucabanga komuntu engozini-ukuthi kungakanani noma kumncane umuntu ozizwa engozini-kungathonywa ngokuqondile kokubili ikhwalithi kanye nomthombo wemithombo yezindaba abayifunayo.
Sibone lokhu ngo-2016 lapho indoda enesandulela - ngculaza ngaphambi kokusakaza i-prophylaxis (i-PrEP) ibikwa ukuthi igciwane lesandulela ngculaza naphezu kokuthatha ukwelapha nsuku zonke. Ngaphandle kokuqukethwe, imibiko yenze iphutha ngokuthi isifo "esingavamile" esingaxilanga izidakamizwa sasisakaza abantu, singabazeki ngokuthi i-PrEP yayingasetshenziswa yini isinyathelo njengoba izikhulu zezempilo zimenyezelwe.
Sibheka izinkinga ezinhlanu ze-HIV "zakamuva" ezenza kube yilokho kodwa zihlola lokho esikufundile, kokubili okuhle nokubi, ngemuva kwalokhu kuphazamiseka.
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Umgomo we-AIDSVAXNgo-1995, umuthi wokugoma we-AIDSVAX wawutholakala kakhulu emaphephandabeni uma izindaba ziqeda ukuthi zenze umphumela wokuzivikela omzimba wokuvikela omzimba omncane, isifundo seSigaba II samavolontiya omuntu.
Lokhu kwaholela umenzi womgogodla, uVaxGen, ukuba athumele isicelo sokuqhuba isilingo esikhulu seSigaba III ngaphakathi kwe-US-isicelo esagcina sinqatshiwe lapho kuboniswa ukuthi amavolontiya amaningana atheleleke ngesikhathi sovivinyo lokuqala.
Ngokungaqiniseki, ubuholi be-VaxGen babethinta umphakathi wesayensi wezwe jikelele futhi ekugcineni bafika ucwaningo ngo-2002. Leli cala, i-alas, alizange livimbele noma linciphise ukutheleleka phakathi kwabahlanganyeli bokufunda.
Naphezu kwezindaba, le nkampani yakhipha masinyane ukushicilelwa okushiwo ukuthi umgomo wagcizelela ukusebenza kwamanye amazwe (ikakhulukazi abamnyama nabase-Asia), futhi waze wahamba waze wabonisa ukuthi umuntu omele ukhetho angatholakala ngaphambi kuka-2005.
Kusukela ngaleso sikhathi, i-AIDSVAX ihlolwe ngokuhambisana nomunye umuthi, futhi ngo-2009, uhlelo oluhlangene lwaphumelela ukufeza ukusebenza kwamaphesenti angu-31 ekuvimbeleni i-HIV.
Leyo miphumela yabizwa masinyane ngokuthi "yinto ebaluleke kakhulu emlandweni" yi-AIDS Vaccine Advocacy Coalition. Lokhu kwaholela ekuphumeni kwemibiko ebonisa ukuthi ososayensi babeseduze "nokuphulukiswa okusebenzayo" kwe-HIV (okusho ukuthi igciwane lingalawulwa umgomo kunokuba ngamaphilisi).
Lezi ziphakamiso ziye zahlukumezeka kakhulu kusukela ngaleso sikhathi, ezinombukiso obuncane bokusekela izimangalo. Noma kunjalo, isilingo esisha seSigaba III saqala ngokugcwele eNingizimu Afrika ngo-2016, futhi sasebenzisa futhi i-AIDSVAX kanye nomuthi wokugonyana ofanayo owasetshenziswa emuva ngo-2009.
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I-Mississippi BabyBambalwa "ukuphumelela" okuye kwafaka ukunakekelwa kwezindaba eziningi ukuthi umntwana waseMisissippi , ongumfana ongenagama ongacatshangelwa ukuthi uphilile nge-HIV emuva ngo-2013.
Uzalwe umama onesandulela ngculazi, ingane yaphathwa ngendlela ehlukumezayo yokwelashwa kwama-antiretroviral amahora angu-30 ngemva kokubeletha. Lapho umntwana eneminyaka engu-18 ubudala, umama washiya ngokunakekelwa ukunakekelwa futhi washiya ingane ngaphandle kokwelashwa izinyanga ezingaphezu kwezinhlanu.
Lapho umama nengane ekugcineni bebuya, odokotela bamangala lapho bethola ukuthi ingane yayingekho igciwane elibonakalayo emasampini egazi noma amathisipuni. Lokhu kwaholela ekucatshangweni okungokwemvelo ukuthi ukwelashwa okukhulunywe ngesikhathi sokutheleleka kungaphumelela ukutheleleka endleleni.
Izinkolelo ezazivame kakhulu, kwaze kwaba yilapho kuvele izikhukhula zezindaba, ethi ezinye izingane ziye zazuza umphumela ofanayo ngenxa yokwelapha kokuthunyelwa kwezidingo. (Ngokumangalisayo, ngokungafani nomntwana we-Mississippi, akekho kulaba bantwana abake baphathwe ukwelashwa ngenxa yezizathu zokuziphatha.)
NgoJulayi 2014, ekuphakameni kwe-media hype, odokotela babika ukuthi leli gciwane lase libuyele (liphindaphinda) emntwaneni we-Mississippi. Lokhu kusikisela ukuthi igciwane alizange lisuswe njengoba abanye bekholwe kodwa lifihliwe emagodini amancane asekulungele ukuphinde avele ngaphandle kokulashwa okuqhubekayo.
Izifundo zokuqhubeka nokuphenya ukwelashwa kwe-HIV ezinonya ezinsweni ezisanda kuzalwa ziye zahlehliswa.
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Ukuchazela ukuguqulwa kweziguli zaseBerlinUThimothy Ray Brown, u-"Isiguli SaseBellin," kubhekwa njengomuntu kuphela oye waphulukiswa nge-HIV. Ngemuva kokuzama ukufakelwa kwe-stem cell ukuhlolwa okuvela emuntwini owayengavumelani nesandulela ngculazi, uBrown waphuma ngo-2008 kungekho bufakazi begciwane kulesisampuli segazi noma izicubu.
Izindaba zezokwelapha zikaBrown zaholela ezifundweni ezalandela zithemba ukuphindaphinda imiphumela kwabanye. Konke okwamanje kuhlulekile.
Phakathi kwabo, amadoda amabili eBoston athi "waphulukiswa" ngo-2013 aphindaphindiwe ngemva konyaka owodwa ngemuva kokufakelwa ukufakelwa. Abanye baye basikisela ukuthi le nqubo yokugcina "yayibukhali kakhulu" kunabakwaBrown futhi ingase ilandise ukuthi kungani leli gciwane lingasusiwe ngokuphelele kumasistimu abo.
Akukhona ukuthi ukuguqulwa kwe-stem cell kwakucatshangwa ukuthi kuyindlela ekwazi ukuphilisa i-HIV. Naphezu komlando we-Berlin Patient case, inqubo ngokwalo ibhekwa njengenani elikhulu kakhulu futhi eyingozi ukuqaliswa ngaphandle kwamacala obudakamizwa kakhulu kakhulu.
U-Brown uyaqhubeka ehlala engabonakali futhi engelapheki, nakuba kusekhona impikiswano yokuthi ngabe igciwane laqedwa ngokuphelele noma lilawulwa yinkambiso yokufakelwa.
Ucwaningo oluqhubekayo luthemba ukukhomba izindlela ezithile zosizo lweBrown, ngokufanele ukuthuthukisa amathuluzi angasetshenziswa esikalini esikhulu, esisezingeni labantu.
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Izithiyo ze-HIV MicrobicideI-HIV microbicides yenza kahle. Cabanga ngalokhu: Uma ngabe ukhathazeke ngokuthola igciwane lesandulela ngculaza kumlingani womlingani, konke okumele ukwenze ukubeka i-gel noma ukhilimu wokubulala i-HIV ekuthintaneni naye. Kungaba nzima kanjani?
Kodwa ngemva kweminyaka engaphezu kwengu-15 yokucwaninga okujulile, asikaze sibone ukuthi ozobhapathizwa akwazi ukunikeza uhlobo lokuvikelwa oludingekayo ukuze afinyelele le migomo.
Esinye isilingo esinjalo, i-CAPRISA 004, sathathwa ngokuthi "yimpumelelo" emuva kuka-2010 lapho kuboniswa ukuthi i-gel eline-concentration ye-1% ye- tenofovir yezidakamizwa inganciphisa ingozi yokudlulisela ingozi kwabesifazane ngamaphesenti angu-39. Kulabo abasebenzisa i-gel njalo, ukuphumelela kungaba ngaphezu kwamaphesenti angu-54.
Kodwa cishe ngemva konyaka, amaNational Institutes of Health ayeka isilingo esikhulu e-Afrika naseNdiya lapho kuboniswa ukuthi i-gel microbicidal efanayo ayinayo inzuzo evikelekile ngokuphelele uma kuqhathaniswa ne-placebo version.
Abacwaningi kusukela ngaleso sikhathi banikeze izizathu zemiphumela, kubandakanya ukusabalala okuphezulu kwezifo ezithathelwana ngocansi phakathi kwabahlanganyeli bezocwaningo kanye nomthwalo ophezulu wegciwane lesandulela ngculaza phakathi kwamadoda anesandulela ngculaza.
Ekugcineni, leli qhinga-elibheka isinyathelo esibalulekile ekunikeni amandla abesifazane nabasemantombazini abasengozini-lahluleka ngenxa yento eyodwa umcwaningi ahluleka ukucabanga ngayo: ubuntu bomuntu.
Ngokusho kokuhlaziywa kwesilingo, abesifazane (ikakhulukazi abesifazane abasebasha) bahlulekile ukusebenzisa i-gel njengoba kunqunyiwe, ngokuvamile ngenxa yokungavumi kwamalungu omndeni noma ukwesaba ukutholakala ngabashade noma abalingani bobulili.
Uphenyo olwedlule olwenziwe ekusetshenzisweni kwamagceke ezincane ezincane eziboniswa ngamagciwane amakhulu lubonisa ukuvikelwa okulinganiselwe jikelele, ngenkathi ehluleka ukuhlinzeka noma yikuphi ukuvikelwa okungenakuqhathaniswa kwabesifazane abaneminyaka engu-18 no-21 ubudala.
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I-Danish Kick-Kill CureKulezi zibonelo zezithembiso ze-HIV ezifinyeleleka, bambalwa abathinteka kakhulu njengeyaseDenmark yase-Aarhus University yaseDenmark lapho kumenyezelwa ngo-2013 ukuthi kulindeleke ukuthi ukwelashwa "kungakapheli izinyanga."
Ngamahora angakapheli kwesimemezelo, abezindaba baqala ukungena, ukushicilela imibiko ithi ithimba laseDenmark lalingakwazi ukukhipha igciwane lesandulela ngculazi emangcwabeni angama-cellar (abizwa ngokuthi ama- reservoirs angenalutho ) kepha yakwazi nokunciphisa igciwane. Isu, esaziwayo ngokubizwa ngokuthi "ukubulala," sithatha umcabango womuntu otholwe ngumphakathi ngokuphumelela kokulandela imibiko yezindaba mayelana nomntwana we-Mississippi.
Ngenkathi ucwaningo lwe-Aarhus luyiqiniso, isinyathelo esithembisayo sokufinyelela "ukubulala, ukubulala," kwahluleka ukwamukela into eyodwa eyanciphisa ukuziqhenya kwayo: asikaze sakwazi ukuthi lezi zinqolobane zikhulu kangakanani.
Akubanga nje isikhathi eside ngaphambi kokuba izindaba zifike ukuthi isifundo se-Aarhus siphumelele kakhulu esithembisweni sazo, senze ukusebenza ngokulinganayo kwama-virus aphelile kodwa akukho ndawo eduze kwamazinga adingekayo ukuze enze "umsebenzi wokukhahlela".
Ngaphezu kwalokho, akusekho ubufakazi bokuthi noma yimuphi ummeleli, noma ngabe imithi noma i-immunological, ingaqeda ngokuphelele i-HIV uma ikhishwa endaweni yayo yokucasha indawo yeselula.
Uphenyo oluqhubekayo luqhutshwa ukuze ubone ukuthi inhlanganisela yezidakamizwa kanye / noma ama-agent okugoma angathuthukisa kule miphumela yokuqala.
> Imithombo:
> Izintambo-Ngarm, S .; I-Pitisutithurm, i-P .; I-Nitayaphan, iS .; et al. "Ukugonywa ne-ALVAC ne-AIDSVAX ukuvimbela ukutheleleka kwe-HIV-1 eThailand." I-New England Journal of Medicine. Ngo-Disemba 3, 2009; 361: 2209-2220.
> I-Ledford, H. "I-HIV ivuseleleka i-Dashes Hope ye 'Mississippi Baby' Cure." Imvelo; ishicilelwe ngoJulayi 10, 2014.
> I-Hutter, G. "Ukufakelwa kwe-Stem cell kususelwa kumasu okuphulukisa i-HIV / AIDS." I-AIDS Research and Therapy. Ngo-September 13, 2016; 30:13.
> Amasevisi we-AIDS Program Research ku South Africa (CAPRISA). "Ucwaningo olusha lwe-tenofovir gel alukho umphumela ekuvinjweni kwegciwane lesandulela ngculaza: Okuphansi kunalokho okulindelwe ukusetshenziswa kwegelisi imiphumela yemiphumela ye-FACTS." Ukukhululwa kwemidiya ngoFebhuwari 24, 2015.
> I-United Press International (UPI). "Ukwelashwa kwegciwane lesandulela ngculaza kulindeleke 'ezinyangeni,' kusho ososayensi baseDenmark." Kukhishwe ngo-Meyi 1, 2013.