Cilmi-baadhayaashu waxay xirtaan xiritaanka xallinta muddada dheer ee daaweynta HIV, PrEP
Mid ka mid ah caqabadaha ugu weyn ee lagu guuleysto daawada HIV-ga waa heerka sare ee loo baahan yahay si loo gaaro ujeedooyinka daaweynta ee daaweynta . Qaar ka mid ah, hawsha maalinlaha ah ee qaadashada daawooyinka antiretrovovirus waxay noqon kartaa mid aad u adag, gaar ahaan marka ay la socdaan arrimaha dareenka ama hawlaha kuwaas oo si xun u saameyn kara noloshooda-iyo raacitaanka - dadka qaba HIV.
Sidaa daraadeed waa arrimo qoto dheer oo ah arrimahan, Maraykanka, maanta, in ka badan 20% dadka ku jira daaweynta antiretrovoviral ayaa awood u leh inay ilaaliyaan xaddiga fayruska aan la ogaan karin , cabbirka lagu guuleysto daaweynta.
Jawaab ahaan, saynisyahanadu waxay hadda bilaabeen inay sahamiyaan daawooyinka muddada dheer, iyo sidoo kale nidaamka daaweynta maandooriyaha, taas oo ugu dambeyntii u oggolaan karta hal mar-ama xitaa hal mar hal mar qiyaas ah, si loo daaweeyo cudurka HIV ama looga hortago.
Maandooriyeyaasha Baaritaanka Dheerka ah
Sannadkii 2013, laba wakiilo antiretroviral ah ayaa lagu soo bandhigay shir sannadkii 7aad ee Ururka Caalamiga ee AIDS-ka (IAS) ee Kuala Lumpur. Daawooyinka baadhitaanka ayaa labadaba loo sameeyay sidii nanosuspespeps, oo ay ku jiraan kaniiniyada yar yar ee daroogada firfircooni ah ayaa lagu duray dareeraha, taas oo u oggolaanaysa sii-deynta iyo daaweynta habka daaweynta nidaamka.
Markii hore, cabotegravir (oo sidoo kale loo yaqaan GSK1265744) ayaa iska leh daroogada daroogada loo yaqaan " integrase inhibitors" , taas oo xannibaysa enzme oo loo yaqaanno isdhexgalka ee HIV-ga u baahan yahay in lagu dhufto. Dhinaca labaad, TMC278-LA , waa qaab-dejin dheer oo ah daawada Edurant (ripilvirine) oo hadda lagu isticmaalo daaweynta HIV.
Qaar ka mid ah tijaabooyinka 'Phase II' ayaa muujiyay cabirka loo yaqaan 'cabotegravir' kaas oo loo gudbiyo gebi ahaanba guud ahaan si u dulqaadan leh celcelis ahaan nus ah inta u dhexeysa 21 illaa 50 maalmood (marka la barbar dhigo 40 saacadood ka dib hal qiyaasta afka ah). Daraasad la mid ah ayaa muujisay in daroogada ay sidoo kale hubiso daroogada joogtada ah ee unugyada malawadka iyo unugyada, taas oo soo jeedinaysa in loo adeegsan karo sida habboon oo wax ku ool ah oo loo yaqaan 'PREP' .
Marka la barbardhigo, baadhitaan Wajiga I ayaa muujisay in TMC278-LA ay awood u laheyd inay ilaaliso daawooyinka loo yaqaan 'plasma drugs' ee laga soo bilaabo 12 illaa iyo toddobaad. Daawada ayaa sidoo kale muujisay balanqaad sida PrEP, oo leh xoogaa xoog leh oo lagu arko unugyada malawadka marka la barbar dhigo unugyada siilka.
Baaritaanada joogtada ah ayaa la qorsheynayaa iyada oo hadafka lagu ballaarinayo cilmi-baadhista tijaabooyinka wajiyada labaad iyo III.
Qalabka Antiretroviral ee Qabiilka ah
Cilmi-baarayaasha Machadka Oak Crest Institute ee Sayniska ee Pasadena, California ayaa sheegey in ay sameynayaan maqaar-gacmeed isdabajoog ah oo keeni kara daaweyn joogto ah oo daawooyinka antiretroviral ah marka la geliyo maqaarka.
Sidoo kale naqshadeynta qalabka ka hortagga uur-qaadista mudada dheer, qalabka ayaa lagu muujiyay baaritaankii hore si uu u bixiyo kantaroolka, oo sii deynaya daawada tenofovir alafenamide (TAF) ilaa 40 maalmood.
[Tiro ka duwan tifaftirka tifaftirka (TDF), oo si xawli ah u iibsada Viread oo ku jirta daawooyinka Truvada iyo Atripla , TAF ayaa loo tixgeliyaa inay tahay maaddooyinka hormuudka ah ee awoodda u leh in ay gaaraan daawooyinka ku habboon daawooyinka qiyaasta yar ee TDF.
Inkastoo cilmi-baarista hadda ay diiradda saarayso qalabka loogu talagalay barnaamijka PrEP, waxaa la soo jeediyay in wakiillada kale ee dheeriga ah ay ugu dambeyntii la isticmaali karo si loogu bixiyo daaweyn antiretroviral (CART) oo loogu talagalay dadka la nool HIV.
Rajada mustaqbalka cilmi-baarista ee furitaanka albaabka si ay u kobciso muraayadaha oo socon kara illaa hal sano ama ka badan.
Rootiyada Micavicidal Intravaginal
Cilmi-baadhayaashu waxay muddo dheer ku dadaalayeen in ay haweenka khatarta ugu jira ka hortagaan is-difaaca HIV-ga, gaar ahaan gobollada haweenka awoodda galmadu ay sareeyso. Istaraatiijiyooyin badan oo ka mid ah habka PrEP ee afka ama microbicides ee haweenka , ayaa badiyaa ku fashilantay cilmi-baaris sababtoo ah la'aanta adeenta iyo sidoo kale heerarka hooseeya ee daroogada loo yaqaan 'biomavailability' ee unugyada siilka , xitaa haweenka qaba heerarka sare.
Si wax looga qabto xaaladahan, dhowr kooxood oo cilmi-baaris ah ayaa sahamaya in la isticmaalo baallooyinka ka soo baxa kuwaas oo si wanaagsan u deyn kara daawooyinka antiretroviral ilaa bil gudaheed.
Giraanta, naqshad jajab ah oo lagu xakameynayo daroogada firfircoon, waxay u oggolaaneysaa in gabadhu ay xirto qalabka aan muuqan muddada isticmaalka.
Natiijooyinka hore waxay muujiyeen dulqaad ay ku sameeyeen giraanta ka soo horjeeda oo ay ku jirto daawada dapivirine ee tijaabada ah (TMC120 ) iyada oo si guul leh loo qeybiyo daroogada ilaa habka hoose ee maskaxda mudo ah 33 maalmood.
Labo siman oo tijaabo ah oo marxaladda III ah, Rugta Daraasadda iyo ASPIRE, ayaa la socda si loo qiimeeyo ammaanka taleefanka iyo sidoo kale dadaalkeeda ilaalinta muddada dheer ee dhexdhexaadka ah ee 4,500 oo haween ah oo HIV-ga ah.
Ilaha:
Xarumaha Xakamaynta iyo Kahortagga Cudurrada Maraykanka (CDC). "Warqada Xaqiiqda CDC | HIV-ga ee Mareykanka: Heerarka Daryeelka." Atlanta, Georgia; la daabacay July 2012.
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Margolis, D .; Brinson, C; Eron, J .; et al. "744 iyo rilpivirine oo ah daaweyn afka ah oo laba dawo leh: LAI116482 (LATTE) toddobaadkii 48 natiijadood." Shirka 21aad ee Retroviruses iyo Infekshinka Fursadaha (CROI 2014); Boston, Massachusetts; Maarso 3-6, 2014; abstract 91LB.
Gunawardana, M .; Remedios-Chan, M .; Miller, C .; et al. "Pharmokinetics ee Tobankii Actarka Toban Dhimirka ah ee Alofenamide (GS-7340) Implant Subdermal Implantis." Walxaha Antimicrobial iyo Chemotherarpy. Abriil 20, 2015; doi: 10.1128 / AAC.00656-15.
Nel, A; Smythe, S .; Young, K .; et al. "Ammaanka iyo farmasokokinetics ee dhalidda nukliyeerka oo ka sameysan matrix iyo kaydka gudaha ee haweenka ku jira haweenka HIV-ga." Wargeyska Ciladda Immune Deficiency Syndrome. 2009; 51 (4): 416-423.