Waxaa jira daroogo loo isticmaalo daaweynta HIV-ga kaas oo kordhin kara xajmiga plasma ee wakiilada daawooyinka antiretroviral (ARVs) marka loo isticmaalo daaweynta isku dhafan. Caanaha loo yaqaan "dhiirrigeliyeyaasha," daroogadu waxay u oggolaanayaan dhakhaatiirta in ay yareeyaan qiyaasta iyo inta jeer ee ARV-ta u adeegta iyada oo hoos u dhigeysa suurtogalnimada saameynta daawooyinka la xiriira daroogada.
Horumarinta HIV, oo sidoo kale loo yaqaanno xayeysiinta daawooyinka farmaajada, waa in aan lagu jahwareerin fitamiinada ama suuqgeynta suuq-geynta sida "dhiirrigelin difaaceed," oo aan laheyn qalab loo garan karo si looga hortago ama looga hortago infekshanka HIV.
Hordhaca HIV
Markii la baaray HIV-ga la yiraahdo proteins-ka (PI) ayaa markii hore laga helay bartamihii 1990-meeyadii, mid ka mid ah caqabadaha ugu muhiimsan ee cilmi-baarayaasha ayaa ahaa xawaare deg-deg ah kaas oo daawooyinka loo qoondeeyey beerka oo laga nadiifiyay dhiigga. Natiijo ahaan, PI ayaa loo baahan yahay laba jeer - qiyaasta sadex-jeer ah. Maqnaanshaha oo keliya qiyaasta sare waxay kordhinaysaa khatarta sunta daroogada, culeyska kiniinka ee kiniinka sare ah oo adkaada oo dhan adkeynaya (iyo horumarinta caabbinta dhammaantiisba).
Sanadkii 1996, Norvir (ritonavir) ayaa loo ogolaaday inuu isticmaalo HIV isaga oo adeegsanaya Maamulka Cuntada iyo Dawooyinka ee Maraykanka (FDA). Iyadoo daroogada loo yaqaano inay leedahay guryaha lidka ku ah fayraska, waxaa si dhakhso ah loo ogaaday, xitaa qiyaasta aadka u hooseysa, waxay xakameyn kartaa xayndaabka ugu badan (CYP3A4) ee loo baahan yahay si loo yareeyo PI.
Baadhitaanku wuxuu si deg-deg ah u saameynayaa habka PI loo soo qoray. Maanta, Norvir marar dhif ah ayaa loo isticmaalaa ficilka fayraska, laakiin si loo kordhiyo waxtarka PI-ga ee adeegaha, iyadoo yareyneysa saameynta xun ee la xariirta daaweynta.
Daawada sidoo kale waa qayb ka mid ah isku-darka isku-darka ah ee PI, Kaletra (lopinavir + ritonavir).
(Fadlan ogow - Norvir waxay faragalin kartaa daawooyinka kale ee laga yaabo inaad qaadatid plasma ee aad qaadan kartid, mararka qaarkood waxay keenaan isdhexgalka daran ee fara badan. Fadlan kugula tali dhakhtarkaaga wixii daawooyin ah ee aad isticmaasho marka Norvir ama Kaletra la qoro.)
Mustaqbalka HIV-ga
Sanadihii ugu dambeeyay, waxaa jiray xoogaa diiradda lagu saaray horumarinta kuwa kale ee dhiirigeliya HIV. Waxaa loo maleynayaa in wakiillada la midka ahi aysan sii kordhin karin waxqabadka PI-ga, laakiin sameeya noocyada kale ee ARVs-ay suuragal tahay in ay isku mid noqdaan, qiyaasta maalinlaha ah, iyada oo loo oggolaanayo "cafis" in ay tahay in la qaato qiyaaso daaweyn ama farqi u dhexeysa daaweynta dhacaan.
Sannadkii 2012, 16 sanno oo buuxda ka dib markii la soo bandhigay Norvir, daroogada labaad ee xoojinta ayaa ugu danbayntii ansixisay FDA. Tybost (cobicistat) , oo ah qayb ka mid ah daroogo isku dhafan oo la isku daro Stribild (elvitegravir + cobicistat + tenofovir + emtricitabine) , ayaa lagu muujiyay in la joojiyo labadaba CYP3A4 enzyme iyo qaar ka mid ah borootiinka mindhicirrada qaarkood oo loo yaqaano inay farageliyaan nuugista daroogada.
Inkastoo aysan laheyn sifooyin liddi ku ah unugyada, Tybost wuxuu awoodaa inuu kordhiyo waxtarka elvitegravir, HIV-ga isdhexgalka, iyadoo la helayo natiijooyin isku mid ah PI Reyataz (atazanavir) iyo Prezista (darunavir) iyo analogga Vakiad (tenofovir).
Horraantii 2015, FDA waxay ogolaatay laba dawo dose isku dhafan, oo lagu daray Tybost, oo ay ku jiraan Evotaz (atazanvir + cobicistat) iyo Prezcobix (darunavir + cobicistat) .
Kobcinayaal kale oo tijaabo ah ayaa la baadhayaa, oo ay ku jiraan naqshad CYP3A4 ah oo ay soo saareen Pharmaceuticals Sequoia.
Ilaha:
Machadka Qaran ee Xasaasiyadda iyo Cudurada faafa (NIAID). "Laba barood oo cusub ee protease ee ay ansixisay FDA. Maamulka Cuntada iyo Maandooriyaha. " Agenda NIAID AIDS. Bethesda, Maryland; March 1996; 4-5.
Maamulka Cuntada iyo Dawooyinka Maraykanka (FDA). "FDA waxay ogolaatay kiniinka cusub ee isku-dhafka ee loogu talagalay daaweynta HIV ee bukaan-socodka qaar." Silver Spring, Maryland; saxaafadeed ay soo saartay August 27, 2012.
Gallant, J .; Koenig, E .; Andrade-Villanueva, J .; et al. "Cobicistat Versus Ritonavir oo ah Pharmacoenhancer of Atazanavir Plus Emtricitabine / Tenofovir Disoproxil Fumarate ee Daaweynta-Naif HIV Nooca 1- Cudurada qaba: Toddobaadka 48 Natiijooyinka" Journal of Cudurrada faafa. Julaay 1, 2013, 208 (1): 32-39 .
Bristol-Myers Squibb. "Evotaz (Atazanvir + cobicistat) - MACLUUMAAD KU QORAN MACLUUMAAD". New York, New York.
Bristol-Myers Squibb. "PREZCOBIX - MACLUUMAAD KU QORAN MACLUUMAAD". New York, New York.