Masana kimiyya da Ma'aikatan Ma'aikata sun amince da Kwayar cutar HIV ga kowa
An yi ta muhawara tsakanin masu tsara manufofin, masu binciken, da kuma likitoci don sanin ko fara cutar HIV a lokacin ganewar asali zai iya samun mahimmanci ga mai haƙuri, dukansu biyu game da kiwon lafiya mafi tsawo da kuma kauce wa cutar ta HIV- kuma ba -Hassan haɗuwa.
Wani bincike mai zurfi da New England Journal of Medicine ya fitar a ran 20 ga Yuli, 2015 ya sa muhawarar ta huta ta hanyar kammalawa da cewa maganin gaggawa ba kawai zai rage rashin lafiya da mutuwa ta 57% ba, amma ba tare da la'akari da shekarun mutum, tsere, jima'i, nau'in hoto mai hoto , yanki na duniya, matsayi na tattalin arziki ko matsayi na rashin rinjaye (kamar yadda aka auna ta CD4).
Kafin binciken, maganin antiretroviral (ART) an bada shawarar idan adadin CD4 na mutum ya sauka a ƙarƙashin wani kofa (kullum a kasa 500 Kwayoyin / ML ko, a wasu ƙasashe, a kasa 350 sel / mL).
Sabuwar bincike-da ake kira Tsarin Gwaninta na Farfesa na Farko (START) - an tsara shi ne don tabbatar da lafiyar mafi girma a CD4 na iya ba da damar inganta lafiyar jiki ba tare da yaduwar cutar mai cututtukan zuciya ba, koda ko sauran cututtukan da ba a ɗauke da HIV ba.
Binciken Sakamako na START da Sakamako
Sakamakon farko na gwaji na START, wanda aka gabatar a taron na AIDS a shekara ta 2015 a birnin Vancouver da Dokta Jens Lundgren na shirin HIV, ya yi tsammanin bayan an sanar da shi a watan Mayu cewa za a dakatar da binciken nan ba tare da dadewa ba saboda dalilai masu yawa. daga gare ta amfani mai kyau.
Binciken da aka fara a shekara ta 2009 ya tara mutane 4,685 maza da mata daga mazauna 215 a cikin kasashe 35, dukansu suna da CD4 masu daraja fiye da 500 / ML. Yawan shekarun shekaru 36 ne, yayin da kashi 27 cikin 100 na mahalarta mata ne.
An raba marasa lafiya zuwa kungiyoyi biyu: daya daga cikinsu wanda aka fara samo ART kuma wani wanda aka dakatar da ART har sai dai yawan CD4 na mutum ya sauko a kasa 350 kwayoyin / ML ko akwai ci gaban cutar rashin lafiya da cutar AIDS ko mutuwa.
A lokacin da aka kammala karatun, an gano abubuwa 50 da suka shafi cutar kanjamau a cikin bangarorin da aka jinkirta binciken, kimanin sau hudu fiye da wadanda suka kamu da su a cikin ART (14). Bugu da ƙari, kusan kusan sau biyu ne da yawa wadanda suka faru da cutar AIDS (29) fiye da yadda aka gani a nan gaba (ARM).
Tarin fuka, lymphoma da Kaposi sarcoma (KS) sune abubuwa uku da suka shafi abubuwan da ke fama da cutar kanjamau da aka gani a cikin mahalarta nazarin, da kashi 62 cikin dari na waɗannan ke faruwa a mahalarta Afirka. Abubuwa masu tsanani da suka shafi cutar ta AIDS ba su da ciwon daji , cututtukan zuciya (CVD) da mutuwa.
Ta hanyar rukuni, yawancin abubuwan da suka faru da aka gani a cikin marasa lafiya marasa lafiya, wanda zai iya yiwuwa ya ba da karfin yawan ciwon daji da CVD a tsakanin mazan tsofaffin jama'a. Abin mamaki shine, shan taba bai bayyana ya canza sakamakon ba, ya nuna cewa ART ta kasance mai amfani sosai ga masu shan taba fiye da masu shan taba.
Wata kila mafi mahimmanci ganowa, shi ne cewa abubuwa masu ban sha'awa suna faruwa ba a tsakanin marasa lafiya da ƙananan CD4 ba, kamar yadda za a sa ran, amma daga waɗanda ke da ƙididdigar CD4 mafi girma . Duk da yake masu bincike ba su iya cikakken bayani game da sakamakon ba, binciken da ya nuna a baya binciken da ya nuna cewa CD4 yana ƙidayar shi kadai bazai iya ba da cikakkiyar hoto game da rashin lafiyar mutum ba.
A jawabinsa, Dokta Lundgren ya bukaci bincike a cikin matakan da za a yi don ba da kulawa da hankali don fahimtar hanyoyin da wadannan abubuwan da ke faruwa ba tare da cutar AIDS ba.
START Yayi la'akari da Mahimmancin Mahimmancin Bayanan Cutar AIDS
An fara gudanar da gwajin farko a shekarar 2011, lokacin da wani binciken, HPTN 052, ya nuna cewa yin amfani da ART ta haɓaka ya rage haɗarin cutar da cutar daga kwayar cutar HIV a wani abokin tarayya maras lafiya - wata hanyar da aka fi sani da magani kamar rigakafi, ko TASP .
Dangane da wadannan sakamako biyu, shugabannin a taron na IAS na 2015 sun ba da sanarwa da ake kira Vancouver Consensus, inda ya bayyana cewa "dukkanin mutanen dake dauke da kwayar cutar HIV dole su sami damar samun maganin rigakafin maganin cutar."
Duk da yake shugabannin sun amince da yawancin shinge ga aiwatarwa - ba tare da komai ba daga ciki har da karin kudaden biliyan biliyan 8-10 na kudade daga abokan hulɗar duniya da kasashe masu ba da taimako-sun dage cewa wannan shirin zai iya "kawo ƙarshen" annoba kamar yadda muka sani da wuri kamar 2030.
Da yake sharhi game da sakamakon START, Kate Thomson na Asusun Duniya ya bayyana cewa fitinar ya nuna "lokacin da ya dace" a yakin duniya na yaki da cutar HIV, wanda har yanzu yana ganin sama da miliyan biyu da cututtuka da kuma mutuwar mutane miliyan 1.2 kowace shekara.
Sources:
Ƙungiyar Nazarin Sake Farawa. "Gaddamar da farfadowa da maganin cutar kanjamau a Early Asymptomatic HIV infection." New England Journal of Medicine. Yuli 20, 2015; DOI: 10.1056 / NEJMoa1506816.