Ukuguquka Kukhona Okungaphezu Kwama-Semantics Nje
I-ART yisichazamazwi esivame ukusetshenziswa namuhla ukuchaza i-HIV ukuthi isifo sosizo lwe-HIV. Ngaphambi kwalokhu, odokotela kanye nososayensi bangasebenzisa leli gama (inhlanganisela yokwelashwa kwe-antiretroviral), futhi ngaphambi kwalokho igama elithi HAART elisetshenziselwa ukuchaza "ukwelashwa okudambisako kakhudlwana kwama-antiretroviral."
Izinguquko eminyakeni edlule zibonisa okungaphezu nje kwefashini, kodwa umzamo wangempela izikhulu zezempilo zomphakathi ukuhlela kabusha indlela esikukhulumisana ngayo ukusebenza kwe-HIV ukwelashwa emphakathini.
Asisayizama ukuqinisekisa abasebenzisi ukuthi izidakamizwa "zisebenza kakhulu" ngoba empeleni ziningi ngaphezu kwalokho. Namuhla bavumela ukujwayelekile, ikhwalithi yokuphila, kuyilapho izinketho ezintsha zamapilisi ezisha zenza ukusetshenziswa kwegama elithi "inhlanganisela" nakakhulu kakhulu.
Ukuqonda i-ART
Kungakhathaliseki ukuthi isichazamazwi sisetshenzisiwe, leli gama lisho ukusetshenziswa kwezidakamizwa ezintathu noma ngaphezulu, okuthathwa ngokuzithandela noma ngokuhlanganiswa kwezilingo ezihleliwe. Inhloso yokwelashwa ukuqinisekisa ukucindezelwa kwegciwane lesandulela ngculazi okuthiwa "amazinga angabonakali" -kusho ukuthi igciwane aliqedi ngokuphelele, kodwa livele ngaphansi kwamazinga okuhlolwa okuhlolwa kwamanje.
Ngokuphambene nomuthi owodwa-noma ukwelashwa okubili kwezidakamizwa, ukuhlanganiswa kwezidakamizwa ezintathu noma ngaphezulu kuyaziwa ngokuphumelelayo ukucindezela izinhlobo ezihlukahlukene ze- HIV enesifo esingaba khona phakathi kwabantu abanegciwane . Ngokuyinhloko, uma esinye isidakamizwa singakwazi ukuvimbela ukuguquguquka komzimba othile, abanye bazokwazi ukwenza kanjalo.
Amazinga aphezulu wokunamathela adingekayo ukuze agcine amazinga okudambisa izidakamizwa egazini. Uma la mazinga awela ngaphansi kwesigqabhe sokugula, izinkinga eziphikisanayo zinikezwa ithuba lokukhula . Okukhudlwana kulaba bantu abaphikisanayo, izidakamizwa ezingasebenzi kangako zizobe zivimbela ukuphindaphinda kwe-HIV-ekugcineni kuholele ekukhusheni kwegciwane kanye nokuhluleka kokwelashwa .
Kusukela ngo-2009, i-CART yesikhulumi yanciphisa kakhulu i-HAART eyaziwa kakhulu, ikakhulukazi phakathi kwabacwaningi nabahlengikazi. Ngenkathi le migomo ishintshashintsha kakhulu, i-HAART yayingabhekwa njengengenele ekuchazeni ukusebenza kahle komuthi wokuhlanganiswa.
Ngemuva kwalokho, i-ART ibhekwa njengokufanelekile, kunikezwa ukuthi kungenzeka ukuthi ukwelashwa okuhlangene kuzoshintsha eminyakeni ezayo. Ucwaningo lwamanje luphenya ukusetshenziswa kwezidakamizwa ezimbili ezidambisigciwane, hhayi i-ripilvirine ne-dolutegravir, ekulawulweni kwezifo ezingenayo i-HIV.
Amakilasi we-ART
Kukhona okwamanje amakilasi amahlanu omuthi we-antiretroviral , okunye okuvimbela isigaba esithile kumjikelezo wokuphila nge - HIV :
- Ukungena kwe-inhibitors
- I-nucleoside reverse transcriptase inhibitors
- Ama-non-nucleoside reverse transcriptase inhibitors
- Integrase inhibitors
- Ama-protease inhibitors
Ezinye izigaba ze-antiretrovirals ziyaphenywa, kanti izidakamizwa ezintsha zenzalo zihlose ukuthuthukisa ukubekezelelana, ukunciphisa imiphumela emibi futhi lula ukulandelela kulabo abakwelashwa.
Kulokhu, inani leminyango ehlanganisiwe ye-dose (FDC) manje iyatholakala, ukuhlanganisa izidakamizwa ezimbili noma ngaphezulu zibe yipilisi eyodwa noma ithebhulethi eyodwa. Abanye, kuhlanganise ne- Atripla ((tenofovir + emtricitabine + efavirenz), i- Triumeq (abacavir + lamivudine + dolutegravir) ne- Stribild (tenofovir + emtricitabine + elvitegravir + cobicistat) banikeza wonke ama-formulations for dosing lula, nsuku zonke.
Ikusasa le-ART
Ngokuthuthukiswa kokuthuthukiswa kwezidakamizwa ze-HIV, i-ART manje isetshenziswa njengendlela yokuguqula amazinga okutheleleka ekukhuleni kwabantu abanegciwane lesandulela ngculaza. Isu, esaziwa ngokuthi iTranscription as Prevention (TasP) , siboniswe ukunciphisa ingozi yokudlulisa i-HIV ngokuvimbela i-virus umsebenzi emazingeni angafinyeleleki. Ngokwenza kanjalo, ingozi yokudlulisela iyancishiswa cishe ngo-96%.
Ngokuqinisekisa ukusatshalaliswa kwezidakamizwa, i-ART inganciphisa lokho okubizwa ngokuthi "umthamo womthamo womphakathi" (umthamo wegciwane lesandulela ngculaza emphakathini) kumazinga lapho amathuba okudlulisela khona kakhulu, ngisho nakakhulu, anciphisa.
Ososayensi manje bahlola ukuthuthukiswa kwama -antiretroviral ehlala isikhathi eside , okunye okungadinga ukuhlolwa kwesidakamizwa njalo ngenyanga noma ngisho nenyanga.
Imithombo:
U-Delaney, M. "Umlando we-HAART - indaba yeqiniso yokuthi ukwelashwa kwezidakamizwa eziphumelelayo kwenzelwe kanjani ukwelashwa kwesifo se-HIV." I-Retrovirology. Disemba 21, 2006; 3 (I-Suppl 1): S6.
I-Skarbinski, J .; I-Furlow-Parmley, i-C .; kanye ne-Frazie, E. "Izilinganiso Zomphakathi Zenani le-HIV + Abadala abathola Ukunakekelwa Kwezokwelashwa, I-ART Enikezwe Ngayo, kanye neProjekthi Yokuqapha Ngokwemilanguzo Ye-Viral, 2009 kuya ku-2010-US." Ingqungquthela ye-19 yama-Retroviruses kanye nezifo ezivame ukuqhutshwa (CROI); Seattle, Washington; Mashi 8, 2013; isicaciso somlomo # 138.
Spreen, W; UMargolis, D .; no-Pottage, J .; "Izidambisigciwane ezithathelwana isikhathi eside zelashwa nge-HIV nokuvimbela." Izincazelo zamanje nge-HIV ne-AIDS. Novemba 2013; 8 (6): 565-571.