Talooyin ka socda Waaxda Caafimaadka Mareykanka iyo Adeegyada Dadka
Bishii Maajo 2014, Waaxda Caafimaadka iyo Adeegyada Dadweynaha ee Maraykanka (DHHS) waxay dib u eegtay xeerarka daweynta HIV-ga, waxayna ku talinaysaa hirgelinta daaweynta antiretroviral therapy (ART) ee dhammaan dadka qaangaarka ah ee lagu sheegay HIV, iyada oo aan loo eegeynin CD4 tirooyinka ama heerka cudurka .
Talooyinka hore loogu yeeray ART ee CD4 ayaa ka hooseeya 500 unug / mL, iyada oo talobixin dhexdhexaad ah loogu talagalay ART oo lagu tirinayo in ka badan 500 unug / mL.
Mucaawin loogu talagalay Daaweynta HIV
Go'aanka DHHS waxa taageersan caddaynta in daaweynta hore ay la xiriirto dhowr natiijo oo wanaagsan, oo ah:
- dhimista khatarta dhimashada iyo cudurada la xidhiidha horumarka cudurka HIV.
- yareynta khatarta gudbinta hooyada ilaa ilmaha.
- yareynta khatarta gudbinta qof qaba HIV.
Talo-bixinta ugu dambeysa waxaa lagu taageeraa caddaynta isticmaalka ART si weyn u yareeyn karto infakshanka qofka qaba HIV, istiraatiijiyad caan ah oo loo yaqaan ' Treatment as Prevention' (TasP)
Waxaa kale oo lagu muujiyey in dadka ay bixiyaan ART degdeg ah 53% ay u badantahay in ay ku dhacaan cudur halis ah , labadaba HIV-ga oo aan la xiriirin, marka loo eego qof ay ART dib u dhigto.
Intaa waxaa dheer, horaantii ART waxay ku koobnayd oo keliya natiijooyinka ka soo rayn, laakiin nolol dheer. Sida laga soo xigtay cilmi-baarayaasha oo la shaqeynayey Ururka Wadajirka Cudurka AIDS-ka ee North American Research & Design (NA-ACCORD), qof 20 jir ah oo HIV qaba ayaa hadda rajeynaya inuu ku noolaado 70-kii sano ee hore haddii lagu daaweeyo waqtiga cudurka.
Taas bedelkeeda, dib u dhigidda ART illaa qofkii CD4 ee ka hooseeya 200 unug / mL wuxuu hoos u dhigi karaa muddada uu qofku nool yahay celcelis ahaan 15 sano.
Talooyin loogu talagalay Daaweynta Hore ee Qalabka ee Dadka waaweyn ee aan la daaweyn
Bukaannada aan horey loo daaweyn ("daaweyn aan caadi ahayn"), guddiga Mareykanka hadda wuxuu ku talinayaa mid ka mid ah lixda daaweeyn ee daroogada sida doorashadooda ay doorbidayaan daaweynta koowaad:
- Triumeq (dolutegravir + abacavir + lamivudine), hal mar ayaa la qaadaa
- Tivicay (dolutegravir) + Truvada (tenofovir + emtricitabine), waxay qaadataa hal mar maalintii
- Stribild (elvitegravir + cobicistat + tenofovir + emtricitabine), hal mar ayaa la qaadaa
- Genvoya (elvitegravir + cobicistat + tenofovir AF + emtricitabine), ayaa hal mar qaatay
- Isir-barar (ratelgravir) + Truvada (tenofovir + emtricitabine), waxay qaadataa hal mar maalintii
- Prezista (darunavir) + Norvir (ritonavir) + Truvada (tenofovir + emtricitabine), ayaa hal mar qaatay
Sababta asaasiga ah ee DHHS-da waxay ka mid tahay culeyska kiniiniga hoose ee nidaamka, jadwalka daaweynta fudfudud, habka saamaynta dhinacyada oo hoos u dhacda, iyo xannibnaanta sare ee dawada adkaynta.
Sababtoo ah shuruudo gaar ah ayaa laga yaabaa inay qaar ka mid ah ka qaataan qaadashada ikhtiyaarka la door biddo (sida Truvada ee bukaannada qaba laf-dhabarka), DHHS waxay liis-celinaysaa lix daweyn oo kala duwan oo loogu talagalay daaweyn-koowaad sida soo socota:
- Atripla (efavirenz + tenofovir + emtricitabine), hal mar ayaa la qaadaa
- Complera (rilpivirine + tenofovir + emtricitabine), oo la qaado hal mar maalin kasta
- Evotaz (atazanavir + cobicistat) + Truvada (tenofovir + emtricitabine), waxay qaadataa hal mar
- Reyataz (atazanavir) + Norvir (ritonavir) + Truvada (tenofovir + emtricitabine), ayaa hal mar qaatay
- Prezcobix (darunavir + cobicistat) OR Prezista (darunavir) + Norvir (ritonavir) oo lala yeeshay Epzicom (abacavir + lamivudine), hal maalin
Ilaha:
Waaxda Caafimaadka iyo Adeegyada Dadka (DHHS). "Tilmaamaha Isticmaalka Aaladaha Antiretroviral ee dadka qaba HIV-1-Infekshan Dadka waaweyn iyo Dhalinyarada." Rockville, Maryland.
Hogg, R .; Althoff, K.; Samji, H .; et al. Kordhinta rajada nolosha ee ka dhex jirta shakhsiyaadka qaba HIV-ga ee ku nool Maraykanka iyo Kanada, 2000-2007. "Shirweynaha Caalamiga ah ee AIDS-ka (IAS) ee loo yaqaan 'Pathogenesis, Treatment and Prevention' Kuala Lumpur, Malaysia June 30-July 3, 2013; Abuuro TuPE260.
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.
Lasry, A; Sansom, S .; Wolitski, R .; et al. "Khatarta gudbinta HIV ee ka dhexaysa labada lamaane ah: qiimaynta saamaynta isku dhafka xeeladaha ka hortagga ah." AIDS . Juun 14, 2014; 28 (10): 1521-1529.
Kitahata, M .; Gange, S .; Abraham, A., et al. "Saameynta horay loo daweyn jiray daaweynta antiretroviral ee daaweynta HIV ee badbaadada." Somali Journal of Medicine. Abriil 30, 2009; 360 (18): 1815-1826.