Uma kushiywe kungalashwa, i-HIV izoqhubeka isandulela ngculaza; lowo ngumthetho jikelele. Kodwa-ke, i-subset encane yabantu abane-HIV ikholelwa ukuthi iyakwazi ukulawula i-HIV ngaphandle kokuqhubeka ne-AIDS-futhi ngaphandle kokusetshenziswa kwezidambisigciwane . Laba bantu, okwake babizwa ngokuthi abahlala isikhathi eside bengekho abaqhubekela phambili , namuhla bavame ukubizwa ngokuthi abaphathi be-HIV abaphakeme .
Ngesikhathi ochwepheshe bebheka isikhathi eside ukucabangela lelizinga lokumelana okungavamile ngemfihlakalo, ubufakazi obuningi namuhla bubonisa ukuthi ukuguqulwa kwezakhi zofuzo ezinikeza lolu "lawulo" lwe-HIV. Ngakho-ke, kugxila kakhulu ekunqumeni ukuthi izindlela ezifanayo zingahle zilingiswe kwabanye abantu, ngenhloso yokugcina umgomo wokugoma i-AIDS noma indlela yokuzivikela nge-immunologic ekulawuleni i-HIV ngaphandle kokusebenzisa izidakamizwa.
Yini Umlawuli Wabaholi?
Abalawuli be-Elite bachazwa ngokubanzi njengabantu abane-HIV abagcina imithwalo engavamile yegciwane lengculaza ngaphandle kokusetshenziswa kwezidakamizwa ze-HIV. Ukukhululeka komthwalo wemisebenzi yokungavimba engalawuleki, abalawuli abakhulu banamasistimu omzimba avikelekile (njengoba kulinganiswa isibalo se-CD4 ), okusho ukuthi ingozi yabo yokutheleleka okubonakalayo iyabhekwa njengephansi.
Kulinganiselwa ukuthi abalawuli abakhulu balinganiselwa ku-1 kwabangu-300 abantu abane-HIV. Lelo nani lingashintsha, noma kunjalo, kunikezwe ukuthi ucwaningo luvame ukuchaza abalawuli abakhulu ngokuhlukile.
Kwezinye izimo, abalawuli abakhulu balichazwa ngokuthi bayakwazi ukugcina igciwane elingenakulinganiswa ngonyaka; abanye bahlanganiswa kuphela emva kokunye kusuka eminyakeni engu-3-15.
Lokhu kuhlukaniswa okubalulekile ngoba asikwazi ukukhuluma ngokuqiniseka ukuthi labo balawuli abaphezulu ngeke baqhubeke besesifo sabo noma bahlangabezane nokusebenza okungazelelwe kwemisebenzi yegciwane.
Kumele sicabange ukuthi abanye balaba bantu bazoba.
Yini Eyenza Umlawuli Wabaholi?
Izifundo zakuqala aziphumelelanga ekutholeni izici ezivamile nezici phakathi kwabalawuli abakhulu. Kwakungakaze kufike ukuhlolwa kobuchwepheshe kanye nobuchwepheshe esasikwazi ukukhomba okufanayo phakathi kwalabo abacatshangwa ukuthi bahloniphekile.
Phakathi kwabacwaningi abalulekile, isazi sesazi seHarvard Medical School uBruce Walker, MD sasiyingxenye yokuqala yokuhlukanisa ukuhlukahluka kofuzo ekubunjisweni kwalesi sibalo, okudweba ubufakazi obuvela eqenjini labalawuli abangu-1,100 abalingana nabantu abangu-800 abane-AIDS.
Esikhathini sesimiso sokuzivikela esijwayelekile, amasosha omzimba akhethekile, okuthiwa "umsizi" T-cells , aqaphele amagciwane akhipha isifo futhi athi "bathathe" ukuze bangathathi i-neutralization. "Umbulali" T-amaseli bese evala igciwane kumaphuzu athile okunamathiselwe futhi abulale igciwane ngaphakathi ngaphakathi.
Kodwa-ke, i-HIV iyakwazi ukuzivumelanisa nokuhlaselwa komzimba, ukuguqula ukuvimbela isinamathisela "se-killer" yeseli, ngenkathi kubhidliza amaseli "omsizi" adingekayo ukukhombisa ukuhlasela kuqala.
Emcwaningweni weqembu lakhe, u-Walker wakwazi ukucacisa ukuthi amaseli "we-killer" e-group elite control akwazi ukusebenza ngokuzimela ngaphandle kwamaseli "Tsizi" T.
Ngaphezu kwalokho, ithimba lakhe lithole ukuthi amangqamuzana "ababulali" akwazi ukwehlisa ukuhlukahluka kwe-HIV, hhayi nje i-subset ecacile njengoba kunjalo njalo.
Njengoba ucwaningo lukaHatcher lushicilelwa, ososayensi baye bakwazi ukuhlukanisa ukushintshashintsha kwezakhi zofuzo ezitholakala ku-genome ye-elite control population. Phakathi kwazo:
- Ukuguqulwa kwesakhi sofuzo se- FUT2 , esitholakala kuma-20% wezwe laseYurophu futhi liyaziwa ukunikeza ukumelana okuqinile kwezinye izinhlobo zegciwane.
- Ukuba khona kwezakhi zofuzo ezikhethekile ezibizwa ngokuthi i- leukocyte antigen B (HLA-B) yabantu , etholakala kwinani elikhulu labalawuli abakhulu.
- I-genetic mechanism evumela abalawuli be-elite ukuthi bakhiqize okuthiwa ama-antibodies (ne-bNAbs) ngokubanzi okusheshayo kunezilawuli ezingekho abalingani. I-bNAbs, ngencazelo, iyakwazi ukubulala uhlobo olubanzi lwe-HIV. Ngokujwayelekile, umlawuli ongeyena onobuhle angathatha iminyaka ukukhiqiza la maseli, ngaleso sikhathi i-HIV isivele isungula izigcawu ezifihlekile ezifihlekile ezingenakukwazi ukuhlasela. Abalawuli be-Elite, ngokuphambene, kubonakala bekwazi ukuvuselela i-bNAbs ngokushesha, ukuvimbela (noma okungenani ukunciphisa) ukusungulwa kwamagumbi okugcina.
Ngokuhlonza lezi zindlela zofuzo, ososayensi banethemba lokuphindaphinda izinqubo nge-gene therapy, i-immunologic vaccine, noma inhlanganisela yezindlela eziphilayo.
Ngaphansi kwe-Elite Control
Naphezu kokulindela okuphathelene nokulawulwa kwe-elite nokucwaninga okuphathelene nokugoma, ubufakazi obandayo buveze ukuthi ukulawulwa kwabantu abakhulu kufike ngentengo. Uma kuqhathaniswa nabangewona abalingani abaphethe imishanguzo ye-antiretroviral (ART) , abalawuli abakhulu bavame ukuba nokuphindwe kabili inani lezibhedlela, ikakhulukazi ezifweni ezingenalo i-HIV eziyaziwa ukuthi ziphazamisa kakhulu abantu bonke abane-HIV.
Uma kuqhathaniswa nabangewona abalingani-abalawuli be-ART abanezinsizakalo ezingavamile ezingavamile, abalawuli abakhulu babe nama-hospitali angu-77% ngaphezulu. Ngisho nabangewona abalingani ababhekene negciwane ebonakalayo bahamba kangcono, okuphakamisa ukuthi i-ART ikwazi ukunciphisa ukuvuvukala okungapheli kwesikhathi eside esiyazi ukuthi kungakwandisa ingozi nokuthuthukiswa kusengaphambili kwegazi elingenalo i-HIV , izifo zenhliziyo, nezifo ze-neurological .
Imithombo:
UMarkowitz, M .; "Isifundo se-HIV Elite Controller (MMA-0951)." IYunivesithi yaseRockefeller; ENew York, NY; NgoFebruwari 9, 2011.
Olson. A .; Ummeli, uL .; I-Prins, i-M .; et al. "Ukuhlolisiswa kwezincazelo ze-HIV Elite Controller ngaphakathi kwe-Seroconverter Cohort Collaboration." I-PLoS | Eyodwa. NgoJanuwari 28, 2014; I-DOI: 10.1371 / iphephandaba.pone.0086719
I-Crowell, T .; I-Gebo, K .; Blankson, J .; et al. "Izindleko zezibhedlela nezizathu phakathi kwabaphathi be-HIV abasha kanye nabantu abane-HIV elawulwa ngamademeshe." Izifo Ezithathelwanayo Emitholampilo. Disemba 15, 2014; doi: 10.1093 / infdis / jiu809.