Kukhona izidakamizwa ezisetshenziselwa ukwelashwa kwegciwane lesandulela ngculaza elingakwandisa ukuhlushwa kwe-plasma yezidakamizwa ezithile zama- antiretroviral (ama-ARV) lapho zisetshenziselwa ukwelashwa okuhlangene. Eyaziwa ngokuthi "izifo," izidakamizwa zivumela odokotela ukuba banciphise umthamo kanye nokuvama kwe-ARV yomlindi ngenkathi kunciphisa amandla okuba nemiphumela emibi ephathelene nezidakamizwa.
Izithuthukisi ze-HIV, ezaziwa nangokuthi i-pharmacokinetic enhancers, akufanele zididaniswe namavithamini noma izithako ezithengiswa ngokuthi "izifo zokuvikela amagciwane," ezingenalo izindawo ezaziwayo zokuvimbela noma ukulwa nokutheleleka nge-HIV.
Isingeniso se-HIV Boosters
Lapho i-HIV protease inhibitors (i-PIs) iqala ukutholakala maphakathi nawo-1990, enye yezinselelo ezinkulu kubacwaningi kwakuyijubane elisheshayo lapho izidakamizwa zafakwa khona esibindi futhi zahlulwa ukusuka egazini. Ngenxa yalokho, ama-PI adingeka kabili- ukulandelwa kathathu-kwansuku zonke. Akukona kuphela ukuthi amanani aphezulu akhulisa ingozi yokudakwa kwezidakamizwa, umthwalo ophezulu wepilisi wenza ukunamathela kunzima kakhulu ( nokuthuthukiswa kokumelana konke okungenzeka).
Ngo-1996, isidakamizwa se-Norvir (ritonavir) savunyelwa ukusetshenziswa kwe-HIV yi-US Food and Drug Administration (FDA). Ngenkathi isidakamizwa saziwa ukuthi sinempahla yokulwa ne-antiviral, ngokushesha kutholakale ukuthi, ngisho nangokwezinga eliphansi kakhulu, lingalimaza le-enzyme (CYP3A4) kwakudingeka ukuba ihlanganise ama-PIs.
Ukutholakala ngokushesha kwathonya indlela iPI ebekiwe ngayo. Namuhla, i-Norvir ayisetshenziselwa ukuthi isetshenziswe yisandulela ngculazi, kodwa kunalokho ukwandisa ukusebenza kwe-PI yabasebenzi, kuyilapho kunciphisa imiphumela emibi ehambisana nokuphathwa.
Lesi sidakamizwa siyingxenye yenhlanganisela yokulinganisa i-PI, i-Kaletra (lopinavir + ritonavir).
(Sicela wazi ukuthi i-Norvir ingaphazamisa izixazululo ze-plasma zezinye izidakamizwa ongase uthathe, ngezinye izikhathi zibe nomthelela omkhulu ekuxhumaneni okukhulu. Sicela ucebise udokotela wakho nganoma yiziphi izidakamizwa ezisebenzayo uma usebenzisa i-Norvir noma i-Kaletra.)
Ikusasa lezikhukhula ze-HIV
Eminyakeni yamuva, kuye kwagxila kakhulu ekuthuthukiseni amanye ama-HIV. Kucatshangwa ukuthi ama-ejenti afanayo angeke akhulise kuphela ukuphumelela kwama-PIs, kodwa enza okufanayo nakwamanye amakilasi ama-ARV-angase enze ukuhlanganiswa okulinganayo, kanye nansuku zonke, ngenkathi ivumela "ukuthethelelwa" okukhulu kufanele kuphuthelwe noma i-gap yokwelapha kwenzeka.
Ngonyaka ka-2012, iminyaka engu-16 egcwele ngemuva kokungeniswa kukaNorvir, isikhulu sesibili sezidakamizwa ekugcineni samukelwa yi-FDA. I-Tybost (i-cobicistat) , ingxenye ye-dose fixed-dose combination drug Stribild (elvitegravir + cobicistat + tenofovir + emtricitabine) , iboniswa ukuvimbela kokubili i-enzyme ye-CYP3A4 namaprotheni amathumbu emathumbu awaziwayo ukuphazamisa ukuxakwa kwezidakamizwa.
Ngenkathi ingenayo i-antibodies, i-Tybost iyakwazi ukwandisa ukusebenza kwe-elvitegravir, i-HIV integrase inhibitor, ngenkathi kufinyelela imiphumela efanayo nama-PIs Reyataz (atazanavir) ne-Prezista (darunavir) ne-nucleotide analogue Viread (tenofovir).
Ekuqaleni kuka-2015, i-FDA ivume izidakamizwa ezimbili ezihlanganisiwe ezihlanganisa i-Tybost, kuhlanganise no- Evotaz (atazanvir + cobicistat) no- Prezcobix (i-darunavir + cobicistat) .
Amanye ama-boosters ahlolwayo aphethwe uphenyo, kuhlanganise ne-novel CYP3A4 inhibitor ethuthukiswa yi-Sequoia Pharmaceuticals.
Imithombo:
I-National Institute of Allergy and Infectious Diseases (NIAID). "Amabili amabili ase-protease inhibitors avunywe yi-FDA. Ukuphathwa Kwezokudla Nezidakamizwa. "I- NIAID AIDS Agenda. I-Bethesda, e-Maryland; Mashi 1996; 4-5.
I-US Food and Drug Administration (FDA). "I-FDA ivumela iPilisi Enhlanganisela Entsha Yokuthola I-HIV Kwezinye Iziguli." I-Silver Spring, eMadrid; ukushicilelwa okukhishwe ngo-Agasti 27, 2012.
I-Gallant, i-J .; I-Koenig, E .; I-Andrade-Villanueva, i-J .; et al. "I-Cobicistat Versus Ritonavir njenge-Pharmacoenhancer of Atazanavir Plus Emtricitabine / Tenofovir Disoproxil Fumarate Endabeni Yokunakekelwa-I-HIV Enama-HIV Aphethwe Ngama-1: Iveki 48 Imiphumela." I- Journal of Infectious Diseases. NgoJulayi 1, 2013, 208 (1): 32-39 .
I-Bristol-Myers Squibb. "I-Evotaz (Atazanvir + cobicistat) - ULWAZI LOKUPHILA OKUQHELEKILE." ENew York, eNew York.
I-Bristol-Myers Squibb. "PREZCOBIX - ULWAZI LOKUPHILA OKUQHELEKILE." ENew York, eNew York.