Sidee Xitaa Hirgalinta Daraasad-Horumarinta Horumarinta HIV
"Breakthrough" waa erey la isticmaalo marar badan-qaar ayaa laga yaabo inay dhammaantood si joogta ah u tiriyaan-markay sharxayaan horumarka HIV-ga. In kasta oo ay jirto, haddana, ayaa ah tiro isbaddal ah oo isbeddeley sannadihii la soo dhaafay , erayga badanaa wuxuu soo jeedinayaa in aanu ku dhowaanayno daaweyn ama xal in aynu run ahaantii nahay.
Tani waxay dhici kartaa marka cilmi-baaristu ay tahay mid aan loo tarjuntay ama wariyuhu ku guuldareysto in uu sayniska u dhigo macnaha saxda ah. Taasi waa xishood, marka la eego waxa la soo sheegay waa inta badan runti muhiim ah.
Si cad, hype waa inaanay noqon qayb ka mid ah warbixinta sayniska, wax aan dib u soo ceshnay 1984-kii kadib markii Xoghayaha Adeegyada Caafimaadka iyo Adeegga Aadanaha Margaret Heckler uu ku dhawaaqay inaan qaadan karno tallaalka HIV "laba sano gudahood."
Ma aha oo kaliya astaan khaldan sida sidan oo kalsooni loo qabo kalsoonida dadwaynaha, waxay badanaa leeyihiin saameyn toos ah caafimaadka bulshada. Daraasado farabadan ayaa muujiyay in shakhsiga khatarta khatarta ah - inta qofku ama uu yareeyo khatarta - waxaa si toos ah saameyn ugu yeelan kara tayada iyo ilaha warbaahinta ay raadsadaan.
Tani waxaan aragnay sannadka 2016 markii nin ka tirsan HIV-ga horey loo soo ogaaday (PrEP) loo soo sheegay in uu ku dhacay cudurka inkastoo uu qaato daaweynta maalin kasta. Warbixin aan sax ahayn, warbixinnada si qalad ah ayaa soo jeediyay in "naadir" oo ah mid aan loo adkeynin daroogada u adkeysiga ay ku wareegayaan dadweynaha, iyagoo shaki gelinaya in haddii ay tahay in barnaamijka PrEP uu ahaa mid ku habboon istaraatiijiyadeed iyada oo mas'uuliyiinta caafimaadka lagu dhawaaqay.
Waxaan fiirineynaa shanta sano ee ugu dambeysey HIV-ga "ciribtirka" ee cadeeyay inay tahay waxkasta laakiin aan eegno waxa aan ka baranay, labadaba wanaag iyo diidmadii, ka dib markii dib loo dhigay.
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Tallaalka AIDSVAXSannadkii 1995, tallaalka AIDSVAX ayaa la siiyay caymis aad u ballaadhan markii warbaahintu ay jabisay jawaab celin difaac difaaceed ee yar yar, Daraasada Wajiga II ee mutadawiciinta.
Tani waxay keentay soo saaraha tallaalka tallaalka, VaxGen, in uu soo gudbiyo codsi lagu samaynayo maxkamad caalami ah oo marxaladda ku jirta oo Maraykanku ka mid yahay codsi ugu dambeyntii la soo gaabiyay markii la arkay in tiro dad ah mutadawaciin ah ay qaadeen intii lagu jiray tijaabada hore.
Hoggaamiyaha VaxGen wuxuu ugu baaqay beesha caalamka ee cilmi-baarista caalamiga ah iyo ugu danbeyntii degenaa daraasad sannadkii 2002-dii. Taasi waxay ku guuldareysatey in ay joojiso ama daciifiso infekshanka ka qaybgalayaasha daraasadda.
Inkasta oo ay warku baahsan yihiin, shirkaddu waxay si deg-deg ah u soo saartay war-saxaafadeed ay sheegayso in tallaalku muujiyay waxtarka dadweynaha (inta badan madow iyo Aasiya), xitaa waxa ay aad u soo jeediyeen in musharaxa musharaxa ah ee suurtagalka ah la heli karo illaa iyo 2005-kii.
Laga soo bilaabo wakhtigaas, AIDSVAX ayaa la isku darey iyada oo la isku daray tallaal kale, illaa 2009kii, isku-darka isku-jirka ahi wuxuu gaadhay 31 boqolkiiba waxtarka ka hortagga HIV.
Natiijooyinkaasi waxay ku dhowaad isla markiiba ku dhawaaqeen "istiraatiijiyadii taariikhiga ahayd" ee ay bixisay Isbahaysiga Udoodidda ee Tallaalka ee Tallaalka (Vaccine Advocacy Coalition). Tani waxay keentay bakhtiyaa-nasiib ah oo muujinaya warar sheegaya in cilmi-baarayaashu ay qarka u saaran tahay "daaweyn ficil" oo loogu talagalay HIV (micnaheedu waa in fayrusku kantarooli karo tallaal halkii kaniiniyada).
Talooyinkan ayaa si aad ah hoos ugu dhacay tan iyo markaas, iyada oo caddayn yar oo lagu taageerayo sheegashada. Si kastaba ha ahaatee, tijaabo marxaladda Phase III ah ayaa bilowday si aad ah ugu sahlan Koonfur Afrika sannadka 2016, mar kale iyada oo la isticmaalayo AIDSVAX iyo isku tallaal isku mid ah ayaa loo isticmaalaa 2009.
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Mississippi BabyQaar ka mid ah "hirgelinta" ayaa ka warramay feejignaan dheeraad ah oo ah in ilmaha yar ee Mississippi , oo ah ilmo aan la magacaabin oo loo maleynayay in laga daaweeyay cudurka HIV ee 2013.
U dhashay hooyada HIV-ga qabta, cunuga waxaa lagu daaweeyay habka gardarada ah ee daaweynta antiretroviral 30 saacadood ka dib dhalmada. Markuu ilmuhu ahaa 18 bilood, hooyadu si lama filaan ah ayey uga tagtay daryeel waxayna ka tagtay cunug iyada oo aan daweyn muddo ka badan shan bilood.
Marka hooyada iyo ilmuhu ugu dambeyntii soo noqdaan, dhakhaatiirtu waxay la yaabeen si ay u ogaadaan in ilmuhu aanu lahayn fayraska la ogaan karo ee ku jira shaybaarka dhiiga ama unugyada. Tani waxay keentay warar qarsoodi ah oo daaweynta la bixiyo waqtiga cudurka uu si wax ku ool ah u joojin karo infekshankeeda.
Sidaa daraadeed waa ay yaraatay caqiidooyinka, in daadad ka timid warbixinnada wargeysyada si dhakhso ah ay u raaceen, iyaga oo sheeganaya in carruurta kale ay heleen natiijo la mid ah natiijada daaweynta ka dib. (Dhab ahaan, si ka duwan sida ilmaha Mississippi, midkoodna carruurtu weligood ma daaweynin sababaha anshaxa.)
Ilaa julaay 2014, heerka sare ee warbaahinta, dhakhaatiirta ayaa sheegay in fayruusku, dhab ahaantii, uu soo laabtay (dib u soo celiyey) ilmaha Mississippi. Tani waxay soo jeedinaysaa in fayraska aan la tirtirin sida qaar ka mid ah ay rumaysteen laakiin waxay ku qarsoonayd kaydadka gacanta oo diyaar u ah inay dib ugu soo baxaan maqnaansho daweyn joogta ah.
Daraasado dheeraad ah oo lagu baaro daweynta HIV ee dawaynta HIV-ga ee dhalaanka cusub ayaa dib loo dhigay.
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Joojinta daaweynta bukaanka ee BerlinTimothy Ray Brown, aka "Berlin Patient," waxaa loo tixgeliyaa qofka keliya ee lagu daaweeyay HIV. Ka dib markii lagu sameeyay xubin baaritaan oo qotodheer ah oo laga sameeyay xubin ka mid ah HIV, Brown ayaa soo ifbaxay 2008dii iyada oo aan jirin caddayn ku saabsan fayruska shaybaarka dhiiga ama unugyada.
Warbaxinta Brown ee daaweynta waxay keentay daraasado dambe oo rajeynaya in ay dib u soo celiyaan natiijooyinka dadka kale. Dhamaan ilaa taariikhda ayaa ku fashilmay.
Waxaa ka mid ah, laba nin oo Boston ah oo ku dhawaaqay "in la daaweeyo" 2013-kii oo dib loo soo celiyay hal sano ka dib markii la sameeyay beerka. Qaar ka mid ah ayaa tan iyo markii ay soo jeediyeen in nidaamkii dambe uu ahaa mid aad u sarreeya "Brown" oo laga yaabo inuu sababo sababta fayruusku uga gaabsanayn nidaamyadooda.
Maahan in unugyada unugyada unugyada unugyada unugyada unugyada unugyada unugyada loo yaqaan 'transplanted cells' ay weligood tixgelinayaan istiraatiijiyad waxtar leh oo lagu daweeyo HIV Inkasta oo dabeecadda taariikhiga ah ee bukaanka Berlin, nidaamka laftiisa ayaa loo tixgeliyaa inay tahay mid aad u qaali ah oo khatar ah si loo fuliyo marka laga reebo xaaladaha caafimaad ee ugu daran.
Dhiniciisa, Brown ayaa weli sii wadi doona in aan la ogaan karin oo la daaweyn karo, in kasta oo ay jiraan doodo laga yaabo in fayraska si buuxda loo tirtiro ama si fudud loo xakameeyo habka tallaalka.
Hadafka cilmi-baarista dheeraadka ah ee lagu ogaanayo hababka khaaska ah ee daaweynta Brown, oo habboon in la horumariyo qalabka loo isticmaali karo cabir weyn, oo ku saleysan dadweynaha.
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Dib-u-Celinta Hiv-ga MicrobicideMicrobicides HIV waxay samaysaa dareen macquul ah. Ka fakar: Haddii aad weligiin ka walwalsan tahay in HIV lagaa qaado lamaanahaaga galmoodka, dhammaantiin waa inaad sameysid jel ama kareem si aad HIV-ga ula xiriirtid. Sidee ayey u adkaan kartaa?
Laakiin ka dib in ka badan 15 sano oo ah cilmi-baaris degdeg ah, weli wali ma aragno musharaxa awood u leh inuu sameeyo nooca ilaalinta loo baahan yahay si loo gaaro yoolalkaas.
Mid ka mid ah tijaabooyinka noocaas ah, CAPRISA 004, ayaa loo qoondeeyey "dib u soo laabasho" sannadkii 2010 marka la muujiyay in jeel ay ku jirto miisaankeedu yahay boqolkiiba 1 dhibcood ee tenofovir daroogada ayaa hoos u dhigi kara khatarta halista gudbinta haweenka ilaa 39 boqolkiiba. Kuwa isticmaala jelka si joogta ah, waxtarkiisu wuxuu noqon karaa mid aad u sareeya 54 boqolkiiba.
Laakiin sannad ka dib, Machadyada Qaranka ee Caafimaadka ayaa joojiyay tijaabo ballaadhan oo Afrika iyo Hindiya ah markii la muujiyay in jeelka isla microbicidal uusan laheyn wax faa'iido ah oo la ilaaliyo marka la barbar dhigo nooca xuddunta.
Cilmi-baadhayaashu waxay tan iyo markii ay bixiyeen sababaha natiijooyinka, oo ay ku jirto baahsanaanta cudurada galmada ee ka-qaybgalayaasha ee ka-qaybgalayaasha iyo culeys fara badan oo bulshada ka dhexjira HIV-da.
Ugu dambeyntii, istaraatijiyad-mar ayaa loo arkay talaabo muhiim ah oo ku aaddan xoojinta haweenka iyo gabdhaha nugul- waxay ku dhaceen wax yar sababtoo ah cilmi-baadhuhu wuxuu ku fashilmay in uu tixgeliyo: dabeecada aadanaha.
Sida laga soo xigtay falanqaynta kaddib, dumarka (gaar ahaan haweenka dhalinyarada ah) waxay ku fashileen isticmaalka jelka sida loo qoray, badanaa sababtoo ah diidmada xubinaha qoyska ama cabsida ah helitaanka xaaska ama lamaanayaasha.
Baadhitaano dhowaan la sameeyey oo lagu sameeyay isticmaalka qoryaha casriga ah ee ku jira miyir-beelka ayaa muujiyey kaliya ilaalin dhexdhexaad ah guud ahaan, iyada oo aan ku guul daraysnayn in la siiyo ilaalin wax lagu qiyaaso haweenka 18 illaa 21 sano.
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Kick-Kill oo deenish ahTusaalooyinka laga helay ballanqaadyada HIV-ga ee hoos u dhacay, wax yar baa soo jiitay, oo ka mid ahaa jaamacadda Aarhus, markii lagu dhawaaqay sannadkii 2013, in dawo la filayay "bil gudaheed."
Saacadaha lagu dhawaaqay, warbaahintu waxay gashay shaki ah, oo ay daabacday warar sheegaya, in kooxda deenishku aanay awoodin inay iska nadiifiyaan HIV-gu, oo laga yaabo inay ka ilaaliyaan goobaha xayawaanka ah (oo lagu magacaabo kaydadka qashinka ), laakiin waxay sidoo kale awood u leeyihiin inay fayruska ku dhejiyaan. Istaraatiijiyadda, oo loo yaqaan 'kick-kill,' ayaa qabatay fikradda dadwaynaha soo jiidashada ah ka dib markii la soo wariyay wargeysyada ku saabsan ilmaha Mississippi.
Inkastoo cilmibaadhista Aarhus, dhab ahaantii, tallaabo rajo leh oo lagu gaarayo "gujinta dilka," waxay ku guuldareysatay inay qirato hal arrin oo wiiqday sharafteeda: weli wali ma ogaanno xitaa intee in le'eg kaydadahan.
Dhowr saacadood ka hor warka ayaa yimid, in daraasadda Aarhus ay aad u yarayd ballanteeda, oo ku guulaysatay hawlo firfircoon oo fayruusyo hayn leh, laakiin aan meelna u dhowayn heerarka loo baahan yahay, inay noqdaan "kick-kill".
Waxaa intaa dheer, weli ma jiraan wax caddayn ah in wakiil kasto, ha ahaato daawooyinka ama immunological, si buuxda u cirib tiri karaan HIV haddii la sii daayo oo laga sii daayo meesha ay ku yaalliin meel qarsoodi ah.
Baaritaano dheeraad ah ayaa loo qabtaa si loo eego in isku-dar ah daroogooyinka iyo / ama wakiillada tallaalka ay kor u qaadi karaan natiijooyinkan hore.
> Ilo:
> Rerks-Ngarm, S .; Pitisutithurm, P .; Nitayaphan, S .; et al. "Tallaalka ALVAC iyo AIDSVAX si looga hortago Hurgunka HIV-1 ee Thailand." Somali Journal of Medicine. Diisambar 3, 2009; 361: 2209-2220.
> Ledford, H. "Dib-u-soo-kabashada HIV-ga Dashes Rajada '' Mississippi Baby ''. Dabeecadda; la daabacay July 10, 2014.
> Hutter, G. "Qalinka unugyada unugyada qanjirada 'ee xeeladaha lagu daaweeyo HIV / AIDS." Cilmi-baarista iyo Daaweynta AIDS-ka. Sebtembar 13, 2016; 30:13.
> Xarumaha Cilmi-baarista Barnaamijka AIDS-ka ee Koonfur Afrika (CAPRISA). "Daraasad cusub oo saliida ah ee tenofovir ma muujineyso wax saameyn ah oo ka-hortagga HIV-ga: Dhimista saameynta isticmaalka gelitaanka gelitaanka natiijooyinka tijaabada ah". Warbaahinta sii deynta February 24, 2015.
> United Press International (UPI). "Daawaynta HIV ayaa la filayaa bil gudaheed," ayay tiri cilmibaadhayaasha deenishka. La sii daayay May 1, 2013.