Idan an bar shi ba tare da an hana shi ba, HIV za ta ci gaba da cigaba da cutar AIDS; wannan shine doka ta gaba ɗaya. Duk da haka, an yi la'akari da ƙananan ƙarancin masu dauke da kwayar cutar HIV da zasu iya magance cutar HIV ba tare da cigaba da cigaba da cutar AIDS ba - kuma ba tare da amfani da kwayoyin cutar ba . Wadannan mutane, wanda ake kira dadewa marasa ci gaba , a yau ana kiran su masu kula da cutar HIV .
Duk da yake masana sun dade suna dauke da wannan matsala ta rikice-rikice, yawancin shaidu a yau suna nuna cewa wasu maye gurbin kwayoyin halitta sun ba da wannan "kulawa" ta HIV. Don haka, ana mayar da hankali ga ƙaddara idan za'a iya amfani da irin wannan tsari a wasu mutane, tare da manufar kyakkyawar zane na maganin cutar AIDS ko wasu hanyoyin rigakafi don magance kwayoyin cutar HIV ba tare da amfani da kwayoyi ba.
Mene ne Mai Gudanarwa na Elite?
Kwararrun masu kula da kudancin suna nuna cewa mutane masu cutar HIV ne masu kula da kwayar cutar HIV ba tare da amfani da kwayoyin cutar HIV ba. An cire shi daga nauyin ayyukan bidiyo mai ban dariya, masu kula da kwarewa suna da tsarin kiyayewa (kamar yadda aka ƙidaya ta CD4 ), ma'anar haɗarin kamuwa da ƙwaƙwalwar kamuwa da ƙyatarwa yana dauke da ƙananan.
An kiyasta cewa mai kula da masu kula da tsararren asibiti na kimanin 1 cikin 300 masu cutar HIV. Wannan adadi zai iya bambanta, duk da haka, an ba da wannan bincike a lokuta daban-daban ma'anar masu jagoranci.
A wasu lokuta, masu lura da manufofin suna nuna cewa suna iya kula da kwayar cutar maras tabbas na shekara guda; wasu sun hada da bayan ko'ina daga shekaru 3-15.
Wannan wata muhimmiyar mahimmanci ne saboda ba za mu iya amincewa da cewa waɗanda masu kula da ka'idodin ba za su ci gaba da cutar ba ko kuma su shawo kan aikin hoto.
Dole ne mu ɗauka cewa wasu daga cikin wadannan mutanen zasu.
Menene Yake Neman Gudanarwa Mai Sauƙi?
Binciken farko ba su da nasaba wajen gano dabi'un da halaye na yau da kullum tsakanin masu jagoranci. Ba har sai zuwan binciken kwayoyin halitta da fasahar da muka iya nunawa a tsakanin wadanda suke da ikon kulawa.
Daga cikin masu bincike mai zurfi, Masanin kimiyya na Makarantar Harvard Bruce Walker, MD ya kasance daga cikin na farko don ware bambancin jinsin da aka yi a cikin wannan jama'a, yana nuna hujjoji daga gungun mutane 1,100 masu kulawa da kuma mutane 800 da cutar AIDS.
A cikin tsari na yau da kullum, ƙananan kwayoyin halitta, wadanda ake kira "masu taimakawa" T , suna gane ƙwayoyin cututtukan cuta da "tag" su don neutralization. "Killer" T-cell sa'an nan kuma kulle da cutar a wasu takamaiman maki da kuma yadda ya kamata kashe cutar daga cikin.
Duk da haka, HIV yana iya daidaitawa da mummunar tashin hankali, mutating don hana "kisa" cell da aka makala, yayin da lalata "mataimaki" sel da ake buƙatar sigina harin a farkon wuri.
A cikin bincikensa na kungiyar, Walker ya iya ƙayyade cewa ƙwayoyin T-"kisa" a cikin rukuni mai kula da kullun sun iya aiki ba tare da ɓangaren T-sakan "mataimaki" ba.
Bugu da ƙari kuma, tawagarsa ta gano cewa '' kisa '' '' '' '' '' '' '' 'sun iya kawar da bambancin kwayar cutar HIV, ba kawai wani takamaiman tsari ba kamar yadda yawanci yake.
Tun da aka wallafa binciken da Walker ya yi, masana kimiyya sun iya raba yawancin maye gurbin da aka samu a cikin jinsin mahalarta masu rinjaye. Tsakanin su:
- Juyawa na FUT2 , wanda aka samu a cikin kashi 20 cikin dari na yawan mutanen Turai kuma an san shi don samar da karfi mai karfi ga wasu nau'in cutar.
- Kasancewar kwayoyin musamman sune ake kira antigen B (HLA-B) , wanda aka samo a cikin babban ɓangaren masu jagoranci.
- Hanyar kwayoyin da ke bawa masu bada izini damar samar da abin da ake kira jujjuyawar ƙwayoyin cuta (bNAbs) da sauri fiye da wadanda ba su da jagoranci. BNAbs, da ma'anarsa, suna iya kashe kwayar cutar HIV da yawa. Yawancin lokaci, wanda ba shi da jagoranci zai iya ɗaukar shekaru don samar da waɗannan kwayoyin halitta, wanda lokacin da kwayar cutar HIV ta riga ta kafa wuraren da ba a rufe ba, waɗanda ba su da mahimmanci don kai farmaki. Masu jagorancin Elite, da bambanci, suna nuna su iya kunna bNAbs kusan nan da nan, suna hana (ko kuma akalla rage) kafa dakunan tafki.
Ta hanyar gano wadannan nau'o'in halittu, masana kimiyya suna fata su sake aiwatar da matakai ta hanyar jinsin kwayar cutar, maganin rigakafin rigakafi, ko haɗuwa da hanyoyin maganin halittu.
Ƙarƙashin ƙasa zuwa Elite Control
Duk da kyakkyawan fata da ke tattare da kulawar kwarewa da kuma maganin alurar rigakafi, shaidar da ta fi ƙaruwa ta nuna cewa iko mai sauƙi ya zo a farashin. Idan aka kwatanta da masu kula da marasa lafiya a kan maganin antiretroviral (ART) , masu kula da kullun suna da fiye da sau biyu adadin asibitoci, musamman daga cututtukan da ba a ɗauke da HIV ba, waɗanda aka sani da rashin rinjaye suna shafi dukan mutanen da ke dauke da kwayar cutar HIV.
Idan aka kwatanta da waɗanda ba a yarda da su ba a kan ART tare da nauyin da ke dauke da kwayoyin cutar bidiyo ba tare da damu ba, masu kula da kwarewa sun samu karin asibiti 77%. Koda masu kulawa da marasa lafiya wadanda suka kamu da kwayar cutar sun fi dacewa, suna nuna cewa ART tana kula da rage wasu ƙananan ciwon da zafin jiki da muka sani zai iya kara yawan hadarin da kuma ci gaba da ci gaban marasa ciwon HIV , cututtuka na zuciya da jijiyoyin zuciya, .
Sources:
Markowitz, M .; "Nazarin Gudanar da Ƙwararren Masarautar HIV (MMA-0951)." Jami'ar Rockefeller; New York, NY; Fabrairu 9, 2011.
Olson. A .; Meyer, L .; Prins, M .; et al. "Wani Bayani na Ma'aikatan Gudanar da Harkokin Kwayoyin cuta na HIV da ke Cikin Gudanar da Ƙungiyar Tattalin Arziƙi." PLoS | Daya. Janairu 28, 2014; DOI: 10.1371 / journal.pone.0086719
Crowell, T. Gebo, K .; Blankson, J .; et al. "Harkokin Harkokin Kulawa da Dalilai a tsakanin masu dauke da kwayoyin cutar HIV da mutanen da ke kula da kwayar cutar HIV." Cututtuka na cututtuka na asibiti. Disamba 15, 2014; Doi: 10.1093 / infdis / jiu809.