Izincomo ezivela eMnyangweni wezeMpilo waseMelika kanye nezinsizakalo zabasebenzi
NgoMeyi 2014, uMnyango wezeMpilo kanye noHulumeni baseMelika uvuselele iziqondiso zawo zokwelashwa kwe-HIV, ukhuthaza ukuqaliswa kwe- antiretroviral therapy (ART) kuwo wonke umuntu omdala one-HIV, kungakhathaliseki ukuthi yi- CD4 count noma isigaba sesifo .
Izincomo ngaphambilini zabiza i-ART kuma-CD4 izibalo ngezansi kwamaseli angu-500 / mL, ngesincoma esilinganiselwe sama-ART ekubalweni kwamangqamuzana angaphezu kuka-500 / mL.
Isizathu sokuthola ukwelashwa kwegciwane lesandulela ngculaza ekuxilongweni
Isinqumo se-DHHS sisekelwa ubufakazi bokuthi ukwelashwa kokuqala kuhlotshaniswa nemiphumela eminingi emihle, okungukuthi:
- ukunciphisa ingozi yokufa kanye nezifo ezihambisana nesifo se-HIV.
- ukunciphisa ingozi yokudluliselwa kusuka kumama kuya kwengane.
- ukunciphisa ingozi yokudluliselwa kumuntu one-HIV.
Izincomo zokugcina zisekelwa ubufakazi bokuthi ukusetshenziswa kwe-ART kunganciphisa kakhulu ukutheleleka komuntu onesandulela ngculazi, isu elibizwa ngokuthi iTraction as Prevention (TasP)
Kuye kwaboniswa ngokuqhubekayo ukuthi abantu abanikeza ama-ART asheshayo bangama- 53% amathuba okuthuthukisa ukugula okungathí sina , kokubili okuhlobene ne-HIV nokungahlobene naye, kunomuntu oye wephulwa yi-ART.
Ngaphezu kwalokho, i-ART yokuqala ayinikezi kuphela imiphumela emihle kepha impilo eminingi. Ngokusho kwabacwaningi abambisene neNorth American American Cohort Collaboration Research and Design (NA-ACCORD), umuntu oneminyaka engu-20 ubudala onesandulela ngculazi manje ungalindela ukuhlala eminyakeni yakhe engama-70s uma ephathwa ngesikhathi sokuhlungwa.
Ngokuphambene, ukuhlukanisa i-ART kuze kube yilapho inani le-CD4 yomuntu liwela ngaphansi kwama-200 amaseli / mL linganciphisa isikhathi salowo muntu ngokuphila okungenani iminyaka eyi-15.
Izincomo zoKwelashwa Kwemigqa Yokuqala Emadodeni Angakhulumi
Ngenxa yeziguli ezingaphathwa kabi ("izifo ezingenayo imithi"), iphaneli lase-US liphakamisa okwamanje imithi eyisithupha yezidakamizwa njengezinketho zabo ezikhethwa kukho yokwelashwa kokuqala:
- I-Triumeq (dolutegravir + abacavir + lamivudine), ethathwa kanye ngosuku
- I-Tivicay (i-dolutegravir) + iTruvada (i-tenofovir + emtricitabine), ithathwa kanye nsuku zonke
- I-Stribild (elvitegravir + cobicistat + tenofovir + emtricitabine), ithathwe kanye nsuku zonke
- I-Genvoya (elvitegravir + cobicistat + i-tenofovir AF + emtricitabine), ethathwe kanye ngosuku
- I-Isentress (ratelgravir) + i- Truvada (i-tenofovir + emtricitabine), ithathwe kanye nsuku zonke
- I-Prezista (i-darunavir) + i- Norvir (i-ritonavir) + i- Truvada (i-tenofovir + emtricitabine), ithathwa kanye nsuku zonke
Isizathu esiyinhloko sesimo esithandwayo se-DHHS sifaka umthwalo ophansi wepilisi, isimiso sokulinda esilula, iphrofayli yempembelelo enciphise, kanye nokuvinjelwa okuphezulu kokumelene nezidakamizwa.
Njengoba izimo ezithile zingase zingabandakanyi abanye ngokuthatha izinketho ezikhethwayo (ezifana neTruvada ezigulini ezinokukhubazeka kwezinso), i-DHHS ibeka izinhlawulo eziyisithupha zokulungisa ukwelashwa kokuqala njengokulandela:
- I-Atripla (i-efavirenz + tenofovir + emtricitabine), ithathwe kanye ngosuku
- I-Complera (rilpivirine + tenofovir + emtricitabine), ithathwe kanye ngosuku
- I-Evotaz (atazanavir + cobicistat) + i- Truvada (i-tenofovir + emtricitabine), ithathwa kanye nsuku zonke
- I-Reyataz (atazanavir) + Norvir (ritonavir) + iTruvada (i-tenofovir + emtricitabine), ethathwa kanye ngosuku
- I-Prezcobix (i-darunavir + cobicistat) OR Prezista (i-darunavir) + no- Norvir (i-ritonavir) ethathwe ngokuhlanganyela no- Epzicom (abacavir + lamivudine), kanye ngosuku
- I-Prezcobix (i-darunavir + cobicistat) + i- Truvada (i-tenofovir + emtricitabine), kanye ngosuku
Imithombo:
UMnyango wezeMpilo kanye nezinsizakalo zabasebenzi (DHHS). "Imihlahlandlela yokusetshenziswa kwama-Antiretroviral Agents ku-HIV-1-Adult Adult and Adolescents." I-Rockville, e-Maryland.
I-Hogg, R .; I-Althoff, K .; I-Samji, H .; et al. Ukwandisa isikhathi sokuphila phakathi kwabantu abathintekayo abane-HIV e-United States naseCanada, 2000-2007. "I-7th International AIDS Society (IAS) Conference on Pathogenesis, Treatment and Prevention. Abstract TUPE260.
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.
I-Lasry, A; Isihlengo, S .; Wolitski, R .; et al. "Ingozi yokudlulisela ucansi nge-HIV phakathi kwemibhangqwana ye-serodiscordant: ukuhlola imiphumela yokuhlanganisa amasu okuvimbela." AIDS . Juni 14, 2014; 28 (10): 1521-1529.
Kitahata, M .; Gange, S .; U-Abraham, A., et al. "Umthelela we-antiretroviral we-antiretroviral we-antiretroviral ophikisana nayo ekuqaleni kokusinda." I-New England Journal of Medicine. Ngo-Ephreli 30, 2009; I-360 (18): 1815-1826.