Sidee Daaweyn Saddexleh Loo Soo Celiyey Xanuunka HIV-ga
HAART waa qormo loogu talagalay "daaweyn firfircoon oo firfircoon", "ereyga wuxuu ku daboolay dabayaaqadii 1990-yadii si loo sharaxo waxtarnimada dawooyinka isku dhafka ah ee loo isticmaalo daaweynta HIV.
Ka hor HAART, isticmaalka hal ama laba daroogo antiretroviral ah ayaa guud ahaan ku-guuleestay bukaannada qaba HIV, taasoo keentay daaweyn degdeg ah oo degdeg ah iyo sidoo kale awood la'aanta in ay si buuxda u xakameyso dhaqdhaqaaqa fayraska.
Waxay ahayd iyada oo la hirgelinayo borotiinka joojinta ee protease ee 1996-kii in dhakhaatiirtu ay awoodaan in ay isku daraan seddex ama in ka badan wakiilada daroogada si ay si wax ku ool ah u joojiyaan HIV-ga in ay ka tarjumaan meelaha kala duwan ee noloshooda. Iyada oo ay soo baxday HAART, dhakhaatiirta iyo saynisyahannadu waxay awoodaan inay markhaati ka noqdaan hoos u dhac ku yimid 50% oo ah tirada dhimashada AIDS-ka ee Maraykanka iyo Yurub muddada saddexda sano gaaban (1995-1999).
Marka lagu daro HAART, habka daawada badan ayaa sidoo kale loo yaqaan 'seddexleh daaweyn' ama 'seddex kakan oo daroogada'.
Maanta, ereyga waxaa si weyn loogu foorarsaday monikers kale, oo ay ku jiraan cART (daaweynta antiretroviral ee isku-dhafan) ama, xitaa si fudud, ART (daaweynta antiretroviral).
Sidee HAART u Shaqeyneysaa?
Marka laga soo tago daawooyinka hal-daawada ah ama dawooyinka labadaba, isku-darka saddex ama kabadan ee antiretroviral ayaa ka shaqeyn kara koox tixraac ah, si wax ku ool ah u xakameynaya noocyo kala duwan oo HIV ah kuwaas oo ka jiri kara hal qof oo fayras ah.
Haddii hal daroogo uusan awoodin in uu xakameeyo nooca fayraska ah, mid ama labaduba mid kale oo ka mid ah wakiilka kale waxay u badan tahay in uu sidaas sameeyo.
Marka la eego, iyadoo la ilaalinayo dadka fayraska ah ee la xakameynayo ( aan la ogaan karin ), waxaa jira dhowr fayras oo wareegaya dhiigga iyo fursado yar oo fayruusku u badalayo cadaadis iska caabin ah.
Waa sababta daawooyinka pre-HAART u dhaceen si aad u dhakhso badan u dhacaan: dadka mutate-yada yaryar waxaa loo oggolaaday inay sii wataan oo ugu dambeyntii kor u qaadaan tirada si ay u noqdaan cadaadiska fayruuska ee sarreeya. Marka tani dhacdo, maandooriyayaashu mar dambe ma awoodaan in ay joojiyaan HIV-ka si ay wax uga beddelaan, xaalad aan ku sharxeyno inay tahay "daawo u adkaysata."
Daroogooyinka loo isticmaalo HAART
Waxaa jira shan nooc oo ah daroogada antiretroviral , mid kasta oo ka hortaga marxalad gaar ah ee wareegga nolosha ee HIV:
- gelitaanka ama naqshadeeynta fiyuusyada (oo ay ka mid yihiin antagonistayaasha CCR5)
- nucleoside iyo nucleotide xanuunka transcriptase dib u celiya (NRTI / NtRTI)
- kuwa nukleosiid-celin-celinta transcriptase (NNRTI)
- isdhexgalayaasha xannibaadda
- protease xannibaadayaasha
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.
Mustaqbalka HAART
Marka laga reebo bixinta joojinta joogtada ah ee HIV ee dadka qaba cudurka, HAART waxaa loo isticmaalaa sidii macnaheedu yahay in lagu celiyo heerarka faafa ee dad badan oo khatar sare leh. Istaraatiijiyada, oo loo yaqaano ka-hortagga sida ka hortagga (TasP) , ayaa lagu muujiyay in la yareeyo "faafinta bulshada ee bulshada" ee ku dhex jira dadweynaha, taas oo ka dhigeysa mid aad u adag in laga gudbiyo fayruska qof cudurka qaba qof aan cudurka qabin.
Waxaa intaa dheer, HAART ayaa lagu muujiyey inay yareyso khatarta HIV-ga iyo HIV-ga iyo cudurrada kale ee HIV-ga (oo ay ka mid yihiin kansarrada iyo cudurrada wadnaha) ilaa 58% haddii la bilaabay waqtiga cudurka. Natiijo ahaan, waxaa haatan lagu talinayaa in HAART la bilaabo dhammaan dadka qaba HIV , iyada oo aan loo eegin xaaladda jidhka, dakhliga, gobolka juqraafi, jinsiyadda, ama fayraska HIV.
Fikradda HAART sidoo kale waxay u badan tahay in ay isbeddel ku samayso horumarinta dawooyinka daroogada ee dheeraadka ah ee antiretroviral (laga yaabo in ay u oggolaadaan bilaha ama saddexda biloodba) iyo daroogooyinka soo socda ee ujeedadoodu tahay in ay yareeyaan qaddarka kaneecada ah ee seddexaad ee caadiga ah illaa laba daroogo.
Laba tijaabo oo marmar ah oo loo yaqaan 'SWORD-1' iyo 'SWORD-2', ayaa muujiyey in isticmaalka Tivicay (dolutegravir) iyo Edurant (rilpivirine) ay keentay in la xakameeyo fayraska xajinta 48 wiig oo leh waxyeelo yar. Maxkamad kale oo yar, oo lagu magacaabo LAMIDOL study, ayaa muujisay in Tivicay loo isticmaalo lamivudine (daroogada soo koreysa ee sii jirtey) waxay awood u laheyd inay natiijo isku mid ah sameyso bukaanno hore loo daaweeyay.
Ilaha:
> Sansone, G. iyo Frengley, J. "Saameyntii HAART Sababta Sababta Dhimashada Dadka Qaatay Xilliga Dhibaatada Xanuunka AIDS-ka." Wargeyska Caafimaadka Magaalo. Juun 2000; 77 (2): 166-75.
> Cohen, M .; Chen, Y .; McCauley, M .; et al. "Kahortagga infekshanka HIV-1 oo leh daaweyn antiretroviral ah oo hore." Somali Journal of Medicine. Agoosto 11, 2011; 365 (6): 493-505.
> Kooxda Waxbarashada ee INSIGHT START. "Bilaabidda Daaweynta Antiretroviral ee Hore ee Asymptomatic HIV Infekshinka." Somali Journal of Medicine. Julaay 20, 2015; DOI: 10.1056 / NEJMoa1506816.
> Llibre, J .; Hung, C .; Brinson, C .; et al. "Wejiga III CUTUBKA 1 & 2: u gudub DTG + RPV wuxuu ilaaliyaa xakamaynta fayruuska iyada oo loo marayo 48 wks." 2017 Shirka Retroviruses iyo Caabuqyada Fursadaha (CROI); Febraayo 13-16, 2017; Seattle; abstract 44LB
> Joly, V .; Burdet, C .; Landman, R .; et al. "Natiijooyinka ka soo baxa > dolutegravir > + dayeejinta lamivudine ee ANRS 167 > LAMIDOL > tijaabo." 2017 Shirka Retroviruses iyo Caabuqyada Fursadaha (CROI); Febraayo 13-16, 2017; Seattle; abstract 458.