Isu le-PrEP lingasetshenziswa yini ukuvimbela i-HIV ukusebenza nge-herpes?
I-Valtrex (i-valacyclovir) , i-Zovirax (i-acyclovir), ne-Famvir (famciclovir) imishanguzo emithathu evame ukusetshenziselwa ukwelapha i- herpes yomzimba . Abantu abane-herpes ephindaphindiwe bayovamise ukuba basondelane nabo ukuze kuthi uma izici ezibuhlungu nezibuhlungu ziqala, bangaqala izifundo ngokushesha bese bevala noma banciphisa ubukhulu besiqephu.
Njengoba ingozi yokudlulisa isiphezulu uma kunezilonda ezibonakalayo, kubalulekile ukuvimbela iziqhumane ukugwema ukudlula igciwane kwabanye.
Kodwa, ngisho noma kungekho izimpawu ezibonakalayo, ukudluliselwa kusengenzeka. Lokhu kungenye yezinselele izibhangqwana ezibhekene nazo uma omunye umlingani enamakhemikhali kanti omunye akwenzi.
Kungenxa yalesi sizathu ukuthi abanye abalingani abangathintekile baye bathatha ukusebenzisa i-Valtrex ngaphambi kocansi, bakholelwa ukuthi ukwenza kanjalo kunganciphisa ingozi yokutheleleka. Kuwumkhuba owaziwa ngokuthi u- pre-exposure prophylaxis (i-PrEP ) lapho umuthi usetshenziselwa ukuvimbela kunokuba uphathe isifo esithathelwanayo.
Kuwumkhuba oqashwe kabanzi ukuvimbela i-HIV , kodwa ingabe izimiso ezifanayo ziyasebenza ku-herpes?
Ukuqonda i-Pre-Exposure Prophylaxis
Nge-HIV PrEP, ukusetshenziswa kwansuku zonke komuthi weTruvada (i-tenofovir plus emtricitabine) kunganciphisa ingozi yomuntu yokuthola i-HIV ngamaphesenti angu-90 noma ngaphezulu. Ukwenza lokhu ngokugcina i-Truvada egazini egazini egazini ukuze kuthi uma i-HIV ivela, isidakamizwa singasilula ngokushesha esiteshini sokuchayeka.
Ukwenza uhlelo lusebenze, noma kunjalo, umuntu udinga ukuthatha lesi sidakamizwa ngokuqhubekayo, izinsuku eziyisikhombisa ngokufanele ngesonto.
Kodwa kukhona ubufakazi obuningi bokuthi amadoda alala madoda angathola ukuvikelwa okuphelele ngokulingana okulinganiselwe kwamasonto amathathu ngesonto. Ngakolunye uhlangothi, abesifazane bangadinga ukunamathelana okuseduze-ukufeza izinga elifanayo lokuvikelwa. (Ucwaningo lwelabhu lubonise ukuthi izidakamizwa zitholakala kakhulu emathangeni angama-rectal kunezicubu zomlomo, echaza ukungalingani ekuvikeleni.)
Nokho, kusukela ekubukeni kwe-herpes, kuye kwaba nokucwaninga okuncane ngezinzuzo zangaphambi kokuvezwa kwezidakamizwa ezilwa no-herpes. Lokhu kungenxa yokuthi, ngokwengxenye, ukuthi i-herpes ayinayo ingozi efanayo yokufa nokugula njenge-HIV. Kodwa ingabe lokho yedwa kuchaza ukuthi kungani singakaze sibheke ngokwengeziwe umbono?
Izinselele ezibhekene ne-Herpes Pre-Exposure Prophylaxis
Kusukela ngo-2003, umenzi we-Valtrex wenza izifundo ukuze ahlole ukuthi ukusetshenziswa komuthi wansuku zonke ngumlingani olelekile kunganikeza ukuvikeleka kokungena kumuntu ongathintekile. Lokho abathola, ngokungaqiniseki, kwaba yilokho, esikhathini esingaphezu kwezinyanga eziyisishiyagalombili, umthamo wansuku zonke we-500 mg we-Valtrex unciphisa ingozi ngamaphesenti angu-48.
Kuze kube manje, akukho cwaningo olunjalo olwenziwe ukuze kubone ukuthi luzokwenzeka yini uma isimo siphenduka, kanti umlingani ongathintekile wathatha iValtrex esikhundleni segciwane. Futhi isizathu salokhu silula: kungabi yisimiso sokwenza kanjalo. Uma isisindo sasizohluleka, umlingani othelelekile ubeyobe engekho ngokungadingekile abekwe ngendlela eyingozi, futhi lokho bekungeke kwenzeke.
Futhi, ngokusekelwe kulokho esikwaziyo mayelana nomuthi, kungase kuphumelele. Ukuze i-herpes PrEP isebenze, isidakamizwa sidinga ukuhlala egazini ngamanqanaba aphezulu okunikeza isihlangu sokuvikelwa, futhi yilapho imodeli ingase ihlukane khona.
Kuyinto izibalo ezilula. I-Valacyclovir, i-acyclovir, ne-famciclovir ngayinye inesigamu sokuphila kwemithi yamahora angu-2.5 kuya ku-3.3 kanye nengxenye yokuphila engama-10, okusho ukuthi ixoshwa emzimbeni masinyane. Njengoba i-Truvada, i-half-life drug is amahora angu-17 futhi i-intracellular half-life engaphezu kuka-60. I-HIV PrEP isebenza ngoba ukuxilongwa kwezidakamizwa kuhlala isikhathi eside phakathi kwamanani.
Ukuze i-Valtrex yenza okufanayo, umuntu kuzodingeka athathe amanani amaningi nsuku zonke. Lokhu kungeke kwenzeke nje kuphela, kungadingekile ukuthi amakhondomu ahlinzeke ngokuvikeleka ngokumelene ne-herpes yobulili.
Njengethuluzi lokuvimbela, amakhondomu aphelele kakhulu , kepha kulula ukunamathela kunokuba athathe izidakamizwa nsuku zonke.
I-HIV PrEP njenge-Herpes PrEP?
Ngokuthakazelisayo, ososayensi bathola ukuthi, phakathi nokwakhiwa kobuhlobo obuzibophezelekile, abantu abathatha i-HIV PrEP babengamaphesenti angama-33 amathuba okuthola i-herpes yobulili kumlingani othelelekile kunelapho ayengazange khona.
Noma kunjalo, ukuze kufinyelele le nzuzo, lo muntu uzodinga ukulondoloza ukunamathela komuthi oseduze kakhulu, umsebenzi obanzi kunokuba ubonakale . Njengesixazululo esiwusizo sokuvimbela i-herpes, kungakhathaliseki ukuthi i-HIV, ingabe ingabe ingenangqondo inikezwe ingozi yemiphumela emibi yezidakamizwa zesikhathi eside (kufaka phakathi ukulimala kwezinso kanye nokulahleka kwamathambo).
Ngalokhu engqondweni, indlela engcono kakhulu yokugwema i-herpes yangasese ngokobulili iyisisekelo futhi iyasebenza:
- Sebenzisa amakhondomu njalo uma kukhona izilonda noma cha.
- Nciphisa inombolo yakho yabalingani bobulili.
- Gwema ucansi uma kukhona izilonda ezibonakalayo noma izilonda ezizungezile izidakamizwa, i-anus, noma umlomo.
> Imithombo:
> Bonnar, P. "Ukwelashwa kwe-valacyclovir okucindezelayo ukunciphisa ukudluliselwa kwe-genital genital: Inqubomgomo yezempilo yomphakathi omuhle?" UMcGill J Med. 2009; 12 (1): 39-46. I-PMCID: PMC2687913.
> Celum, C .; UMorrow R .: Donnell, D. et al. "I-tenofovir kanye ne-emtricitabine-tenofovir preexposure prophylaxis inciphisa uhlobo lwegciwane le-herpes simplex le-2 ekuthengeni phakathi kwabantu abesilisa nabesifazane abangenalo i-HIV-1-abangenalutho: ukuhlaziywa kwamacembu okuhlola okungahleliwe." U-Ann Intern Med . 2014; 161 (1): 11-9. I-DOI: 10.7326 / M13-2471.
> Heinine, W. no Kashuba, A. "Ukuvimbela i-HIV nge-Oral Preexposure Prophylaxis." I-Cold Spring Harb Perspect Med. 2012; 2 (3): a007419. I-DOI: 10.1101 / cshperspect.a007419.
> Magaret, A .; I-Mujugira, A .; Hughes, J. et al. Ukusebenza kwekhondomu Ukusebenzisa Isenzo Ngesenzo HSV-2 Ingozi yokudluliswa kwe-HIV-1, ama-HSV-2-discordant Couples. " I-Dis Infect Dis. 2016; 62 (4): 456-61. DOI 10.1093 / cid / civ908.
> Marcus, J .; Glidden, D .; McMahan, V. et al. "I-emtricitabine yomlomo nsuku zonke / i-tenofovir pre-exposure prophylaxis ne-herpes simplex virus hlobo 2 phakathi kwamadoda alala namadoda." PLoS One. 2014; 9 (3): e91513. I-DOI: 10.1371 / iphephandaba.pone.0091513.