Lokho Esikufundile Nendlela Abacwaninga Ngayo Ngempumelelo
Kusukela ezinsukwini zokuqala zesifo se-HIV, ososayensi bebelokhu bebona abantu abanegciwane lesandulela ngculazi abangazange baqhubekele egazini futhi bakwazi ukugcina izibalo ze-CD4 ezinzile kanye nemithwalo yegciwane elingenakutholakali ngaphandle kokulashwa, ngokuvamile emashumini eminyaka.
Eminyakeni yamuva nje, njengoba isayensi ye-HIV isiqalile ukuthuthuka kakhulu, kuye kwabonakala ukuthi kunezinsiza eziningi zokwelashwa eziye zaba nethonya elifanayo (noma elifanayo) kubantu abane-HIV eyaziwa-ngisho nakakhulu "ngokucacile" igciwane ngokuphelele emzimbeni wabo.
Lokho esikufundile-futhi siyaqhubeka sifunda-kusuka kulaba bantu ngabanye kungase kube ngolunye usuku lunikeze ososayensi ngemininingwane edingekayo yokuguqula inkinga yokutheleleka nge-HIV noma ukuqeda i-HIV ngokuphelele.
Nansi ukubuka okufushane kwamaqembu noma abantu abaye "bakhohlise" i-HIV futhi basiza ukuqhubela phambili isayensi ye-HIV phambili:
UStephen Crohn, "Umuntu Ongakwazi Ukuthola I-AIDS"
UStephen Crohn, obizwa ngokuthi "Indoda engakwazi ukubhekana ne-AIDS" iphephandaba lase-UK elizimele, litholakala ukuthi lalinomzimba obizwa ngokuthi "i-delta 32" ekuguquleni kwe- CCR5 yamaseli akhe e-CD4, ukuguqulwa okuvimbela ngokuphumelelayo I-HIV yokungena kumaseli okuvikela omzimba. UCrohn wabona kuqala uDkt. Bill Paxton we-Aaron Diamond AIDS Research Centre ngo-1996 emva kokuhlola okwakungabonakali lutho lwezandulela ngculaza naphezu kokuba nabalingani abaningi bezocansi, bonke ababulawa yi-AIDS. Ukuguqulwa kwesimanje kuye kwabonakala ngaphansi kwezingu-1% zabantu.
Ukutholakala kokuthiwa yi-CCR5-delta-32 "ukuguqulwa kwaholela ekwakheni kokubili umuthi we-CCR5 wokuvimbela izidakamizwa uSelententry (maraviroc) , kanye nenqubo yokufakelwa kwesisindo se-stem esetshenziselwa" ukuphulukisa ukusebenza "isiguli se-HIV uThimothy Ray Brown ngo-2009 ( bheka ngezansi ).
Wazalwa ngo-1946, uCrohn wazibulala ngo-Agasti 23, 2013, eneminyaka engu-66 ubudala.
UTimothy Ray Brown, "Isiguli EsiseBerlin"
UThimothy Ray Brown, owaziwa nangokuthi "uMgulane waseBerlin," ungumuntu wokuqala okholelwa ukuthi "uphilisiwe" nge-HIV.
Wazalelwa e-US, uBrown wanikezwa ukufakelwa komnkantsha wamathambo ngo-2009 ukuze aphathe i-leukemia yakhe. Odokotela e-Charité Hospital eBerlin, eJalimane bakhetha i-stem cell donor ngamakhophi amabili e-CCR5-delta-32 mutation, eyaziwa ukuthi iphikisana ne-HIV. Ukuhlola okujwayelekile kwenziwa ngokushesha ngemva kokuba ukufakelwa kwembulani ukuthi amasosha omzimba we-HIV anciphile ukuze afake ukuqedwa kokuphela kwegciwane kusuka ohlelweni lwakhe.
Ngesikhathi uBrown eqhubeka engabonakali izimpawu ze-HIV, ukuguqulwa kwe-stem cell elandelayo eyenziwa odokotela eBrigham naseBlinikweni Yabesifazane akuphumelelanga ukufeza imiphumela efanayo, kokubili iziguli ezithola ukuguqulwa kwamagciwane emva kwezinyanga ezingu-10 nezi-13 zokuhlolwa okungenakulinganiswa. Lezi ziguli azizange zitshalwe kabusha nge-Delta 32, kodwa.
"Umnikezeli 45"
Ngo-2010, owesilisa wase-Afrika-waseMelika, owaziwa ngokuthi "uMnikeli 45," watholakala enesandulela esinamandla sokuvikela i-HIV ebizwa nge-VRC01 ngabacwaningi be-Vaccine Research Center ye-National Institute of Allergy and Infectious Diseases (NIAID).
Okwakunzima kakhulu ukutholakala yiqiniso lokuthi i-VRC01 iyakwazi ukubophezela ku-90% yazo zonke izinhlobo ze-HIV zomhlaba wonke, ngokuvimbela ngokutheleleka ukutheleleka ngisho noma igciwane liyashintsha.
Ngenxa yezinhlobonhlobo eziphezulu ze-HIV , ama-antibodies amaningi avikelayo akakwazi ukufeza leveli yomsebenzi.
Ukutholakala kwasiza ukukhulisa ucwaningo ngokugqugquzela ama-antibodies amaningi , okungahle kuvimbele usuku olunye noma ukuphuza ukuqhuma kwesifo ngaphandle kokusetshenziswa kwezidambisigciwane.
Ucwaningo oluqhubekayo ngonyaka ka-2011 lwaqhamuka abantu ababili abane-HIV abanesandulela ngculazi abanezifo ezifanayo ze-VRC01.
I-Visconti Cohort
Ngo-Ephreli 2013, indaba yomntwana we- Mississippi "ophulukisiwe" we-HIV wathatha isihloko sezwe. Ingane, inikwe imishanguzo ye-antiretroviral ngesikhathi sokuzalwa, kubikwe ukuthi isuliwe igciwane futhi "ilashwa ngendlela efanele" ye-HIV .
Ngenkathi umntwana ekugcineni ezobhekana nesifo segciwane lesandulela ngculazi ngo-2014 , ebeka emuva izimangalo zanoma yiluphi ukwelashwa okunjalo, kwasala iziphakamiso zokuthi ukungenelela kokudakwa kwezidakamizwa kungase kube nezinzuzo zayo ngokuvimbela i-HIV ukuthi ingafihli emanzini amaningi okugcina emzimbeni.
Ukulandela isisindo secala lezingane zaseMississippi kwakungumbiko ovela eFrance lapho kuthiwa iziguli ezingu-14 kwazingu-70 ezifundweni eziqhubekayo zoThisholo lweVisconti zikwazi ukugcina imithwalo yemithi ekhungathekile ngokugcwele ngaphandle kokwelashwa ngemuva kokubekwe imishanguzo yegciwane lesandulela ngculaza kungakapheli amasonto ayishumi okutheleleka.
Kuzo zonke izimo, ukwelashwa kwamiswa ngaphambi kwesiguli. Ezingu-14 ezikwazi ukuqhubeka nokucindezelwa kwegciwane lesandulela ngculazi (ezinye eziphezulu eminyakeni engaphezu kwesikhombisa), izibalo ze-CD4 zanda ukusuka ku-500 kuya ku-900 amaseli / mL ngenkathi ukulayisha kwe-viral kwehla kusuka ku-500,000 kuya ngaphansi kwama-cell angu-50 / mL. Ucwaningo oluqhubekayo luqhutshwa ukuze kuqinisekiswe ukuthi ezinye izici, izakhi zofuzo noma i-virological, zinegalelo emiphumeleni.
Ucwaningo luye lwasiza ukuqinisa ingxabano "isu lokuhlola nokuphatha", lapho ukwelapha okuqala kungase kuhambisane nokulawula okukhulu kwegciwane. Kungakhathaliseki ukuthi ukungenelela kwangempela kungaba yini ngempela ukuguqula ukutheleleka-njengoba abanye bebasikisela icala lezingane ze-Mississippi-lihlala lingabaza. Iningi iziphathimandla manje ziphakamisa ukuthi "ukukhululwa okuqhubekayo" yisikhathi esifanelekile, ngenxa yezinselelo ezenzweni zokuqala "zokwelashwa".
Ukukhishwa Kwe-HIV Okumangalisayo Kwezingane ZaseFrance
NgoJulayi 2015, ososayensi baseFrance baphinde bamemezela icala lokudluliswa kwe-HIV, okwamanje enentombazane eneminyaka engu-18 ubudala eyayikwazi ukugcina ukucindezelwa kwegciwane lesandulela ngculaza iminyaka engu-12 ngaphandle kokulashwa kwe-antiretroviral. Njengomntwana we-Mississippi ngaphambi kwakhe, lo mfana wanikezwa ukwelashwa okuhlangene ngesikhathi sokuzalwa, okwakunqunywe ngaphezu kweminyaka emihlanu-ngokuvamile ephethe izifo ezibangelwa yi-viral rebound ngenxa yokunamathela komuthi we-HIV.
Ngonyaka wesihlanu, abazali bakhe bamdonsa ohlelweni lokucwaninga futhi banqamula ngokuphelele ukwelapha. Lapho bebuya ngonyaka odlule, bona kanye nabacwaningi bamangala lapho bethola ukuthi ingane iphethe umthamo wegciwane elingenakutholakali, okunye into intombazane eye yakwazi ukuyigcina kusukela ngaleso sikhathi.
Uphenyo lwesikhathi esizayo luzohlose ukukhomba izindlela, izakhi zofuzo noma okunye, ukulawulwa okunjalo kokubili kwentombazane yaseFrance kanye nabalingani bakhe abadala emkhakheni weVisconti.
Imithombo:
Hütter, G .; Manjeak, D .; Mossner, M .; et al. "Ukulawula Kwesikhathi Eside Ne-HIV nge-CCR5 Delta32 / Delta32 Isitembu Sokufakelwa Kwamaselula." I-New England Journal of Medicine. Ngo-February 12, 2009; 360: 692-698.
I-Zhang, i-Z .; I-Wu, i-X .; Longo, N .; et al. Ukulinganisa okujulile ngesampuli eside longu-VRC01-like antibody's response in an individual infections. " I-Retrovirology. Ngo-Septhemba 13, 2012; 9 (2): O36.
I-National Institute ofergy and Infectious Diseases (NIAID). "'Mississippi Baby' manje sesitholile i-HIV, abacwaningi bathola." IsayensiIsiSayensi. Julayi 10, 2014.
I-Sáez-Cirión, A .; Bacchus, C .; I-Hocqueloux, i-L .; et al. "Abaphathi be-Post-Treatment HIV-1 abane-Remote Virological Remission emva kokuphazanyiswa kwe-Antiretroviral Early Early Treatment ANRS VISCONTI." I-PLoS Pathology. Ngo-Mashi 14, 2013; 0 (3): e1003211.
I-Frange, i-P .; Faye, A .; Avettand-Fenoëll, et al. "Ukuxoxwa kwe-HIV-1 nge-HIV kweminyaka engaphezu kwengu-11 ngemuva kokuphazamiseka kwe-antiretroviral ekuqaleni kokuqala kwe-anti-infectious virus." Ingqungquthela ye-IAS ye-HIV ye-HIV Pathogenesis, Ukwelashwa Nokuvimbela; Julayi 20, 2015; Vancouver, British Columbia; I-oral abstract MOAA0105LB.