Ososayensi Abahlela Ngokusondela Kuzo Izixazululo Zesikhathi eside Zokwelashwa Kwe-HIV, PrEP
Esinye sezivimbelo eziyinhloko empumelelweni yezidakamizwa ze-HIV yisilinganiso esiphakeme sokubambelela okudingekayo ukuze kufinyelelwe imigomo yomtholampilo yokwelapha . Kwabanye, umsebenzi wansuku zonke wokuthatha imishanguzo yegciwane lengculaza ingaba yinkimbinkimbi, ikakhulu uma ihambisana nezinkinga ezingokomzwelo noma ezisebenzayo ezingaba nomthelela omubi empilweni- nokunamathela- kubantu abane-HIV ephilayo.
Ngakho-ke lezi zimpikiswano ezinkulu, e-US namuhla, abantu abangaphezu kuka-20% abanomuthi wokwelapha ama-antiretroviral bayakwazi ukugcina umthamo wegciwane elingenakulinganiswa, isilinganiso sokuphumelela kokwelashwa.
Ephendula, ososayensi sebeqale ukuhlola izidakamizwa ezisebenza isikhathi eside, kanye nezinhlelo zokulethwa kwezidakamizwa, okungenzeka ekugcineni zivumele ukuphindaphinda kanye nenyanga-noma ngisho nokukodwa kwenyanga, noma ukuphatha ukutheleleka nge-HIV noma ukuyivimbela.
Izidakamizwa Zesikhathi Esiqhubekayo Zokuphenya
Ngo-2013, ama-antiretroviral amabili asebenza isikhathi eside asetshenziselwa iNkomfa ye-International AIDS Society (IAS) yonyaka wesi-7 e-Kuala Lumpur. Izidakamizwa zokuphenya zazakhiwa njengama-nanosuspensions angenayo, lapho amakristalu amancane omuthi osebenzayo enqanyuliwe ketshezi, okuvumela ukukhululwa kwemithi kancane kancane nokuqhubekayo ohlelweni.
I-first, i- cabotegravir (eyaziwa nangokuthi i-GSK1265744) ingokwesigaba sezidakamizwa ezibizwa nge- integrase inhibitors , okuvimbela i-enzyme ebizwa ngokuthi i-integrase ukuthi i-HIV idinga ukwanda. Owesibili, i- TMC278-LA , ukubunjwa okudala isikhathi eside kwe-drug Edurant (ripilvirine) okwamanje esetshenziselwa ukwelashwa kwe-HIV.
Izilingo eziningana zezigaba ze-Phase II zibonise ukuthi i-cabotegravir ethunyelwe nge-intramuscularly ivame ukubekezelelana kahle nengxenye yokuphila phakathi kwezinsuku ezingu-21 kuya kwezingu-50 (uma kuqhathaniswa namahora angu-40 ngokulandela umthamo owodwa, ngomlomo). Ucwaningo olufanayo lubonisa ukuthi lesi sidakamizwa saqinisekisa nokuxilongwa kwezidakamizwa ezinomsoco emathanjeni angama-rectal and vagin, okuphakamisa ukuthi kungenziwa njengendlela esebenzayo, esebenzayo isikhathi eside ngaphambi kokushisa i-pre-exposure prophylaxis (i-PrEP) .
Ngokuqhathanisa, isifundo seSigaba I sibonise ukuthi i-TMC278-LA yakwazi ukugcina ukubhekwa kwezidakamizwa ze-plasma ezivela emavikini angu-12-26. Lesi sidakamizwa sabuye sabonisa isithembiso njenge-PrEP, ngokugxila okunamandla okubonwa ezinhlotsheni zamaconsi uma kuqhathaniswa nezicubu zangasese.
Uphenyo oluqhubekayo luhlelwe ngenhloso yokwandisa ucwaningo olwaluvivinywa ukuhlolwa kweSigaba II no-III.
Izimpindiselo ezithathelwanayo nge-Antiretroviral
Ososayensi e-Oak Crest Institute of Science ePasadena, eCalifornia babika ukuthuthukisa ukutshala okulingana nomdlalo okungaholela ekugxilweni okunamandla kwemishanguzo ye-antiretroviral uma kuhlanganiswa ngaphansi kwesikhumba.
Ngokufanayo ekuklanyeleni izimpande zokuvimbela ukukhulelwa isikhathi eside, le divayisi yaboniswa ekucwaningeni okuqala ukuze ikwazi ukukhulula okulawulwayo, okuqhubekayo kwe- tenofovir alafenamide (TAF) izinsuku ezingafika ku-40.
Ngokungafani ne-tenofovir disoproxil fumarate (TDF), evame ukudayiswa e- Viread futhi equkethe izidakamizwa i- Truvada ne- Atripla , i-TAF ibhekwa njengengqamuzana yamangqamuzana ekwazi ukufinyeleleka ekuhlungeni kwezidakamizwa ezihle kakhulu kumazinga amancane kakhulu kune-TDF.]
Ngesikhathi ucwaningo lwamanje lugxile kudivayisi ye-PrEP, kuphakanyiswa ukuthi amanye ama-agent asebenza isikhathi eside angagcina asetshenziselwa ukuhlinzeka inhlanganisela yokwelashwa kwe-antiretroviral (ipeni) kubantu abaphila negciwane lesandulela ngculaza.
Ucwaningo lwesikhathi esizayo luthemba ukuvula umnyango ekuthuthukiseni izimila ezingapheli unyaka noma ngaphezulu.
Izindleko ze-Intravaginal Microbicidal
Sekuyisikhathi eside ososayensi bazama ukunikeza abesifazane abasengozini yokuzivikela e-HIV, ikakhulukazi ezindaweni lapho ukuxhobisa abesifazane ngokocansi kuphakeme. Amasu amaningi, kungaba ngendlela ye-PrEP ngomlomo noma ama- microbicides omzimba , ahluleke kakhulu ekucwaningweni ngenxa yokungabi namathelisi kanye namazinga aphansi okutholakala kwezidakamizwa ezingxenyeni zomzimba , ngisho nakwabesifazane abanezinga eliphezulu lokunamathela.
Ukubhekana nalezi zinhlawulo, amaqembu amaningi ocwaningo ahlola ukusetshenziswa kwamagceke angaphakathi okumele akhulule izidakamizwa ezidambisigciwane kuze kube yinyanga ngayinye.
Indandatho, i-elastomer engenakulinganiswa i-scaffold enezidakamizwa ezisebenzayo, ingavumela owesifazane ukuba agqoke idivayisi engabonakali isikhathi sokusebenzisa.
Imiphumela yokuqala ibonise ukubekezelelana kwendandatho yangaphakathi equkethe i-drug test dapivirine (TMC120 ) ngokusabalalisa okuphumelelayo kwesidakamizwa emgqeni ophansi ongokwenyama esikhathini esingama-33.
Izivivinyo ezimbili zezigaba ze-Phase III, i-Ring Ring ne-ASPIRE, ziyaqhubeka ukuhlola ukuphepha kwendandatho kanye nokusebenza kwayo okuvikela isikhathi eside phakathi kwamalungu ama-4 500 abesifazane abangenayo i-HIV.
Imithombo:
Amasevisi aseMelika okuLawula nokuvimbela izifo (CDC). "I-CDC Fact Sheets | I-HIV e-United States: Izinyathelo Zokunakekela." I-Atlanta, Georgia; eshicilelwe ngoJulayi 2012.
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.
UMargolis, D .; Brinson, C; Eron, J .; et al. "U-744 no-rilpivirine njengokwelapha ngomlomo wokwelapha ngomlomo: i-LAI116482 (LATTE) isonto lama-48." Ingqungquthela yesi-21 nge-Retroviruses kanye nezifo ezithinta amathuba (CROI 2014); IBoston, eMassachusetts; NgoMashi 3-6, 2014; abstract 91LB.
I-Gunawardana, M .; Remedios-Chan, M .; Miller, C .; et al. "I-Pharmokinetics ye-Tenofovir Alafenamide (GS-7340) Yokufakelwa Kwe-HIV Prophylaxis." Ama-Antimicrobial Agents ne-Chemotherarpy. Ngo-Ephreli 20, 2015; i-doi: 10.1128 / AAC.00656-15.
I-Nel, A; Smythe, S .; Intsha, K .; et al. "Ukuphepha kanye ne-pharmacokinetics yokudilizwa kwe-dapivirine kusuka ematrix nasemagodini amathangeni angena emadodeni abesifazane abangenayo i-HIV." I-Journal Yokuthola Imfutho Yokuzivikela Emzimbeni. 2009; 51 (4): 416-423.