Ukufunda ukuthi unesandulela ngculazi kungaba yinto emangalisayo. Inhlamba ehambisana negciwane ingaba yinkimbinkimbi, futhi abantu abaningi banenkinga yokucubungula izindaba ukuthi banesandulela ngculazi. Kodwa-ke, uma bekwenzile, ngokuvamile okunye kokuqala okucatshangelwayo yizinketho zabo zokwelapha i-HIV. Lokhu kuqondakala ngokuqondile kubantu abahlukunyezwayo , kepha ukukhetha imithi yokwelapha imishanguzo ye-antiretroviral (MAP) kungaba nzima nakakhulu ezigulini ezinezinkinga ezingagwiliswa izidakamizwa ze-HIV.
Indlela Ukuphikiswa Kwemithi Yezidakamizwa Okuthuthukisiwe
I-HIV ishintsha futhi iguquke ngesivinini esheshayo. Njengoba kunjalo, ukwelapha igciwane akulula ngaso sonke isikhathi. Eminyakeni yokuqala yesifo , kwakukhona izinketho ezimbalwa kakhulu zokwelapha. Abantu babekwe umuthi owodwa kuphela ngesikhathi, futhi ukuphikisana nalawo mithi ngezinye izikhathi kwanda ngokushesha.
Njengoba kunezinye izidakamizwa ze-HIV - kanye namakilasi wezidakamizwa ze-HIV - zakhiwe, odokotela batshintshela emiphakathini eminingi yezidakamizwa eyaziwa ngokuthi ukwelashwa kwama-antiretroviral kakhulu noma i-HAART. Lezi zinhlobo ngokuvamile zaziqukethe imithi emibili ye-antiretroviral ezivela emakilasini ahlukene wezidakamizwa.
Eminyakeni yamuva, lesi sigama sishintshile. Manje odokotela bavame ukukhuluma ngegciwane - ukwelapha okulwa negciwane lesandulela ngculaza. Kodwa-ke, inhloko-nkulu isesenjalo. Isigaba ngasinye sezidakamizwa sisebenza ukuphazamisa ingxenye ehlukile yokujikeleza kwegciwane, futhi ngokuhlanganisa izidakamizwa eziningi kwenza kube nzima ukuthi igciwane liguquke futhi libe umelana nomuthi owodwa we-HIV.
Ukunciphisa Ukuphikiswa Kwezidakamizwa
Ngenxa yenani elikhulayo lezokwelapha ezintsha ze-HIV, inani lokuphikisa izidakamizwa liye lahla ngokuhamba kwesikhathi. Ukushintsha amafomula yokwelapha ukwenza amaphilisi kulula ukuwuthatha, nokwandisa ukulandelwa, uye wakusiza kakhulu. Lezi zinguquko, ngezindlela ezithile, zihle kakhulu ekuboniseni ukuthuthukiswa kwemigomo eyodwa yepilisi yokuphathwa kwegciwane lesandulela ngculazi.
Lezi zinhlobo ziqukethe izidakamizwa ezintathu noma ezine kuphilisi elilodwa elithathwa kanye ngosuku.
Lokhu kulula kakhulu iziguli eziningi ukubhekana nokuhlela inani elikhulu lamaphilisi ngezikhathi ezahlukene kulo lonke usuku. Uma ukutheleleka kwesiguli kulawulwa kahle emithini yabo yegciwane lesandulela ngculaza, futhi balondoloza imithwalo engavamile engavamile engaphezu kwesikhathi, cishe akunakwenzeka ukuhlaselwa kwezidakamizwa.
Indlela igciwane lesandulela ngculaza eliba ngayo ukulwa nemithi eyodwa noma ngaphezulu
Abantu abanegciwane lesandulela ngculaza bangaqeda imishanguzo ye-HIV emelana nezidakamizwa ngezindlela ezimbili. Okokuqala ukuthi bangenwe isifo sengculaza. Okwesibili ukuthi igciwane lawo lingase likwazi ukumelana nemithi eyodwa noma ngaphezulu ngokuhamba kwesikhathi. Ezinye izici ezingase zandise amathuba okuthi i-HIV ithuthukise ukumelana nezidakamizwa zibandakanya:
- Ukwenza okungekho emthethweni / ukubambelela : Abantu abangahlali ngokuphuza imishanguzo yabo ngendlela efanele, njengoba kunqunyiwe, amathuba okuthuthukisa igciwane elimelana nemithi. Lokhu kuyiqiniso ikakhulu kubantu abanenkinga yokuhambisana ngokuhamba kwesikhathi eside.
- Ukungabi nempendulo kulayini lokuqala lwe-line : Uma ukwelashwa kokuqala kungaholela ekucindezelweni kwegciwane kungakapheli izinyanga ezingu-12, cishe kungenzeka ukuthi igciwane lakho, noma seliba, ukumelana nemithi yokwelashwa. Lokhu kuyinkinga ikakhulukazi kwizilungiselelo eziphansi ezisetshenziswayo lapho abantu bephathwa khona ngokuqala nge-nonnucleoside reverse-transcriptase inhibitor (NNRTI) esekelwe ezokwelashwa. Noma kunjalo, kubalulekile ukwazi ukuthi ukungabi nampendulo akusho ukuthi ukwelashwa kokuqala kwembangela kubangele ukuthi igciwane lakho lingamelana nalo. Ukungabi nampendulo okunjalo ngokuvamile kuyisibonakaliso sokuthi odokotela basebenzise ukuphenya ukuthi ngabe unesifo esinomthelela emithi.
- Ukwelapha okuqhubekayo : Lokhu kwenzeka lapho odokotela bengasetshenziswanga ukuthuthukiswa kwamuva kunomuthi we-HIV, noma ngesizathu esithile, ukwelashwa okungcono akutholakali. Kukhona ukulandelana okuqondile kwezokwelapha okunconywa ukunciphisa amathuba okuphikiswa kwezidakamizwa okwenzekayo. Lokhu akubandakanyi nje ukuhlanganisa amakilasi wezidakamizwa ngendlela efanele kodwa ukhethe izidakamizwa ezithile ngaphakathi ekilasini okungenani okungenzeka kubangele ukumelana noma ukwabelana ngezinyathelo zokumelana.
- Ukuntuleka kokuqapha ukumelana nokuvimbela : Uma kunokwenzeka, odokotela kufanele baqaphe njalo umthamo wegciwane lesiguli ngenxa yezibonakaliso zokumelana nokuphikiswa. Lokhu kuvumela odokotela ukuba bashintshe izidakamizwa ngokushesha ukuze babheke lezo ezizosebenza ngokuphumelelayo. Kodwa-ke, kwezinye izindawo, ukuqapha ukuphikiswa akutholakali, noma iziguli azikwazi noma zizimisele ukuhlolwa njalo. Ngokuvamile, ukungabikho kokuqapha ukumelana nakho kuyisibonelo sendlela abahlengikazi abangase bakwenze ngayo ukumelana nokumelana, kunokubangela imbangela.
Ukuthola i-HIV-Resistant HIV
Ezinye izinhlobo zokumelana nezidakamizwa zingatholakala ngokulandelana kwe-genome yegciwane. Kunezinhlobo eziningana zokuguqulwa kwezidakamizwa eziye zabonakala, futhi lezi zinguquko ziye zaxhunyaniswa nokwehlisa ukwelashwa kwezidakamizwa ngabanye noma amakilasi ezidakamizwa. Ulwazi lokuthi yiziphi izinguquko ezitholakala ku-genome ye-viral zingasiza odokotela ukuthi bakhethe imithi efanele yezidakamizwa zesiguli. Kodwa-ke, ukuvivinya nge-HIV-1 ye-genome akuyona into ejwayelekile yokusebenza komtholampilo.
Imithombo:
De Luca A, Hamers RL, Schapiro JM. Ukwelashwa kwe-antiretroviral ukulandelana amasu okunqoba isifo se-HIV 1 ukuphikiswa kwezidakamizwa ezinganeni kanye nabantu abadala emazweni aphansi angenayo. I-Disfect Dis Dis. 2013 Jun 15; 207 Isigaba 2: S63-9.
I-Hosseinipour MC, i-Gupta RK, i-Van Zyl G, i-Eron JJ, i-Nachega JB. Ukumelana nokuphikisana kwezidakamizwa ze-HIV ngesikhathi sokuqala ukwelashwa kwama-antiretroviral emgqeni wokuqala. I-Disfect Dis Dis. 2013 Jun 15; 207 Isamba 2: S49-56.
Kostrikis LG, Hezka J, Antoniadou ZA, Kousiappa I, Mamais I, Skoura L, Pilalas D, Metallidis S, Nicolaidis P, Malisiovas N. Ama-Cellular HIV-1 Amanqanaba e-DNA Alinganayo phakathi kwezinkinga zokulahla izidakamizwa nezinkinga zokulwa nezidakamizwa kuNew Diagnosed and Antiretroviral Iziguli Eziphazamisayo. I-AIDS Res Hum Retroviruses. 2013 Sep 12. [Epub ngaphambi kokuphrinta]
USiliciano JD, uSiliciano RF. Amathrendi wakamuva ku-HIV-1 ukumelana nezidakamizwa. I-Curr Opin Virol. 2013 Sep 7.