Isbedelku wuxuu ku saabsan yahay wax ka badan kaliya Simantics
ART waa erayga ugu badan ee loo isticmaalo maanta oo lagu sharaxo HIV. Markii hore, kiliinikada iyo saynisyahanku waxay isticmaali karaan ereyga " CART" (daaweyn isku-dhafan oo la isku dhafan), horeyna u ahayd erayga caanka ah ee HAART waxaa loo isticmaalay in lagu sharxo "daaweynta firfircoon ee firfircoon ee firfircoon."
Isbeddelka sanadaha soo socda wuxuu ka tarjumaa wax ka badan munaasabadda kaliya, laakiin isku dayga dhabta ah ee saraakiisha caafimaadka dadweynaha si dib-u-habeyn loogu sameeyo qaabka aan ula xiriirno waxtarka daaweynta HIV ee dadweynaha.
Mar dambe ma waxaan isku dayi doonaa inaan ku qancino dadka isticmaala in daawooyinka ay yihiin "aad u firfircoon" tan iyo markii ay dhab ahaantii ka badan. Maanta waxay u oggolaadaan nolol caadi ah, tayada nolosha, halka ikhtiyaarrada cusub ee kiniiniga ah ay isticmaalaan ereyga "isku-dhafan" oo dhan oo aan ka badnayn.
Fahminta ART
Wax kastoo la soo gaabiyey loo isticmaalo, ereyga ayaa tilmaamaya isticmaalka saddex ama in ka badan daawooyinka antiretroviral , midkoodna si gooni ah loo qaato ama qiyaas goynta go'an. Ujeedada daaweynta waa in la hubiyo joojinta HIV-ga si loogu magacaabo "aan la garan karin" heerarka micnaha micnaheedu yahay in fayrusku uusan si buuxda u tirtirin, laakiin wuxuu hoosta ka xariiqayaa heerarka baaritaanka imtixaannada iminka socda.
Marka laga soo tago daawo hal dawo ah ama dawo labadaba, isku-dar ah saddexda ama in ka badan oo daawooyinka firfircoon ayaa la ogyahay inay si wax ku ool ah u xakameynayaan noocyada kala duwan ee HIV-ga oo adkaysi leh kaas oo ka jiri kara dad fara badan. Dhab ahaantii, haddii hal daroogo uusan awoodin in uu xakameynayo isbadal fayras ah, kuwa kale waxay u badan tahay inay awoodaan sidaas.
Heerarka sare ee u hoggaansanaanta ayaa loo baahan yahay si loo ilaaliyo heerarka daaweynta ee daaweynta ee dhiigga. Haddii heerarkan ay hoos u dhacaan xuddunta daaweynta, noocyada adkaysiga leh waxaa la siiyaa fursad ay ku koraan . Tirada dadkaas u adkaysata, daawooyinka waxtarkoodu yar yahay ee daroogada waxay noqon doonaan kuwo xakameynaya is-beddelidda HIV-oo ay ugu dambeyntii keento fayruska dib-u-dhiska iyo daaweyn la'aanta .
Laga soo bilaabo 2009, erayga CART wuxuu si bareer ah u siiyay HAART inta badan la yaqaan, gaar ahaan cilmi-baarayaasha iyo dhakhaatiirta. Inkasta oo shuruudaha ay yihiin kuwo isbedelaya, HAART badanaa waxaa loo tixgeliyey inaysan ku filneyn inay sharaxdo waxtarka xoogga leh ee daaweynta isku dhafan.
Dabadeed, ART waxaa loo tixgeliyey inay ku habboon tahay, iyada oo loo eegayo suurtagalnimada in daaweynta isku dhafan ay isbeddesho sanadaha soo socda. Cilmi baaris hadda ah ayaa baaraya isticmaalka laba meelood halkii saddex daawo antiretroviral ah, sida ripilvirine iyo dolutegravir, oo ku jira maaraynta cudurada HIV-ga ee joogtada ah.
Fasallada ART
Waxaa jira shan nooc oo daawooyinka antiretroviral ah , mid kasta oo ka hortagga marxaladda gaarka ah ee wareegga nolosha ee HIV :
- Ka hortagayaasha galitaanka
- Nucleoside celinta transcriptase
- Kaabayaasha dib u celinta transcriptase aan-nukleoside
- Xoojinta isdhexgalka
- Kaadi-saareyaasha xaddidan
Qeybaha kale ee daawooyinka antiretrovirals ayaa la baarayaa, halka daroogooyinka cusub ee jiilka ujeedadoodu ay tahay inay hagaajiyaan dulqaad, yareynayaan saameynta xun iyo fududeeysa daaweynta daaweynta kuwa daaweynta.
Si loo dhammaystiro, tirada sii kordhaysa ee daawooyinka isku dhafan (FDC) ayaa hadda la heli karaa, oo isku daraya laba ama in ka badan daroogada kiniin ama kiniin keliya. Qaar ka mid ah, oo ay ka mid yihiin Atripla ((tenofovir + emtricitabine + efavirenz), Triumeq (abacavir + lamivudine + dolutegravir) iyo Stribild (tenofovir + emtricitabine + elvitegravir + cobicistat) waxay bixiyaan shey kasta oo isku mid ah oo loogu talagalay qiyaasta maalinlaha ah.
Mustaqbalka ART
Horumarinta horumarinta maandooriyeyaasha HIV, ART ayaa hadda loo adeegsanayaa sidii looga hortagi lahaa cudurada faafa ee dad badan oo HIV-ga ah. Istaraatiijiyada loo yaqaan ' Treatment as Prevention (TasP)' , ayaa lagu muujiyay inay yareyso halista gudbinta HIV iyadoo lagu xakameynayo fayraska dhaqdhaqaaqa heerarka aan la ogaan karin. Marka sidaas la sameeyo, khatarta gudbinta waxaa hoos u dhacaya boqolkiiba 96%.
Iyada oo la hubinayo bixinta daroogada baahsan, ART waxay hoos u dhigi kartaa midka loo yaqaan "viral load community" (qaybta dhexdhexaadka ah ee dhexdhexaad ah ee beesha dhexdeeda) illaa heerkee suurtogalnimada in gudbinta ay si weyn u tahay, xitaa qoto dheer, hoos u dhac.
Cilmi-baarayaashu waxay hadda baadhayaan horumarinta walxaha antiretroviral-dheer , qaar ka mid ah oo laga yaabo inay u baahdaan daaweyn daroogo bilo ah ama saddexda bilood ah.
Ilaha:
Delaney, M. "Taariikhda HAART - sheekada runta ah ee ku saabsan sida daaweynta badan ee daawada loo isticmaalo loogu talagalay daaweynta cudurka HIV." Retrovirology. Diisambar 21, 2006; 3 (Sahay 1): S6.
Skarbinski, J .; Furlow-Parmley, C .; iyo Frazie, E. "Qaran ahaan Qaran ee Tirada Cudurka HIV + Dadka Qaadashada Daryeel Caafimaad, Lagu Qoray ART, iyo Mashruuc Korjoogteyn Xeeladaysan - Maqnaanshaha Caafimaadka ee 2009, ilaa 2010-US." Shirka 19aad ee Retroviruses iyo Caabuqyada Fursadaha (CROI); Seattle, Washington; Maarso 8, 2013; sireed afka ah # 138.
Spreen, W; Margolis, D .; iyo Pottage, J .; "Daawooyinka jirka ee mudista dheer leh ee daaweynta HIV iyo ka hortagga." Fikradaha hadda jira ee ku saabsan HIV iyo AIDS. Nofeembar 2013; 8 (6): 565-571.