Nazarin Ya Yi Gargaɗi game da Rigakafin Rigakafin Magunguna masu yawa

Rashin ƙaddamar da lalacewar baya zai haifar da mutuwar mutane 425,000

A cikin shekaru 10 da suka shige, hukumomin kiwon lafiya na duniya sun yi tasiri sosai wajen samar da kwayoyin cutar HIV a kan mutanen da suke zaune a duniya. Bisa ga shirin hadin gwiwar Majalisar Dinkin Duniya game da cutar kanjamau (UNAIDS), kimanin mutane 21 ne aka sanya su a kan maganin rigakafi a ƙarshen shekara ta 2017, daidai da kashi 43 cikin dari na yawan mutuwar cutar HIV tun 2003.

Amma kamar yadda UNAIDS da wasu hukumomin kiwon lafiya na duniya suka tura don kawo ƙarshen annoba ta 2030, wani batu mai ban tsoro yana barazana ga ragowar wadannan kokarin: bunkasa kwayar cutar HIV da ta rigaya ta dauka ta zama rare ga masana kimiyya.

Wannan matsala ne ba kawai shafi kasashe masu iyakoki ba (kamar wadanda ke Afirka wanda ke dauke da nauyin kamuwa da cutar HIV) amma kasashe masu tasowa wadanda yawancin kudaden da suka shafi jigilar cutar .

Dalilin kwayoyin cutar HIV-resistant

Yawancin magungunan jigilar magungunan abu ne wanda aka gani a wasu yanayi na kiwon lafiya, kamar tarin fuka (TB) da cututtuka na staphylococcal , wanda wanda ya kamu da kwayar cutar ya kasa karbar maganin hanyoyin maganin miyagun ƙwayoyi. A wasu lokuta, juriya na iya zama matsananci, irin su tare da TB (XDR TB) mai yawan miyagun ƙwayoyi wanda aka gani a wasu sassan kudancin Afirka, wanda yawancin ƙwayoyin mutuwa ke da yawa kuma yawancin maganin magani.

Kamar dai sauran nau'i na juriya , fitowar kwayar cutar HIV mai yawan miyagun ƙwayoyi ya fi dacewa da rashin iyawar mutum don ɗaukar magungunanta ko dai kamar yadda aka umarce su.

Lokacin da aka dauki daidai, kwayoyi zasu shafe ayyukan aikin hoto a wani wuri inda ake dauke da kwayar cutar ta HIV "ba tare da damu ba. " Lokacin da aka dauki kuskure, ayyukan bidiyo mai sauri zai iya ci gaba da matakan da maye gurbin miyagun ƙwayoyi ba zai iya cigaba ba sai dai ya bunƙasa.

Yawancin lokaci, yayin da rashin lafiya ya faru kuma mutum ya bayyana ga magunguna da yawa, ƙarin maye gurbin zai iya ci gaba, gina ɗaya a gaba na gaba.

Idan mutumin nan zai cutar da wani, tozarin maganin miyagun ƙwayoyi zai wuce, yadawa cikin yawan jama'a ta hanyar sadarwar jima'i ko yin amfani da miyagun ƙwayoyi .

Siffar Crisis

A cewar Hukumar Lafiya ta Duniya (WHO), wadda ta sake nazarin bayanai daga kamfanonin kamfanoni 12,000 a kasashe 59, an samu kimanin kashi 20 cikin 100 na likitoci na maganin rigakafi da suka kamu da cutar ba tare da shekara guda ba. Daga cikin wadanda suka ci gaba da farfadowa, yawanci kashi 73 cikin dari sun yi jituwa ba tare da bata lokaci ba, yayin da kusan ɗaya daga cikin uku bai kasa cimma burin kyakwalwa mai ƙyama ba daidai da nasara.

Wannan matakin na bidiyo mai hoto a cikin yawan jama'a yana ƙaruwa da juriya da yawa, musamman ma a cikin kasashe masu tasowa wanda yawanci daya daga cikin mutane biyar ke fama da cutar. Sakamakon halin da ake ciki shi ne sauye-sauyen miyagun ƙwayoyi, wanda ke barin marasa lafiya ba tare da magunguna ba kuma yana tasiri kusan kashi 36 cikin dari na asibiti a cikin kasashe masu tasowa.

Ko da a ƙasashe kamar Amurka, yawan ƙwayar cutar da ba a sani ba (kashi 20 cikin dari) da ƙananan kudaden haƙuri (kashi 40) sun fassara zuwa ƙananan ƙananan kudaden maganin hoto (kashi 28).

"Rashin amincewa da ƙwayoyi masu yawa" wanda ba zai iya yiwuwa ba "ya damu

Nazarin shekara ta 2016 daga Jami'ar Jami'ar London (UCL) ya nuna damuwa da damuwa tsakanin masana kimiyya wadanda suke tsoron cewa ci gaba da jigilar kwayoyi masu yawa na iya canzawa da yawa daga cikin abubuwan da aka samu a yakin duniya na kan HIV.

A cikin binciken su, masana kimiyya na UCL sun gudanar da bincike kan lamarin marasa lafiya 712 da suka samu maganin rigakafi a tsakanin shekarun 2003 da 2013 kuma sun kasa gadon farko.

Daga cikin wadannan, marasa lafiya 115 (16%) suna da ciwon kwayar cutar HIV tare da juriyar analog na thymidine, nau'in da ke hade da kwayoyin tsara ta farko kamar AZT da 3TC. Abin mamaki shine, kashi 80 cikin 100 na wadannan marasa lafiya sunyi tsayayya da tenofovir, wanda ake amfani da miyagun ƙwayoyi da dama a fadin duniya.

Wannan ya zama abin mamaki ga mutane da yawa a cikin 'yan bincike, wadanda suka yi la'akari da irin wannan nau'i na magunguna da yawa, idan ba zai yiwu ba.

Yayin da aka sani cewa lokaci na ƙarfin tenofovir ya karu ne - daga 20% a Turai da Amurka zuwa fiye da kashi 50 cikin sassa Afrika - mutane da yawa sunyi imani cewa wadannan nau'i biyu na maye gurbi ba zasu iya kasancewa ba.

Idan tayin ya ci gaba, kamar yadda mutane da yawa suna tsammanin, sakamakon zai iya zama babban. Wasu nazarin sun nuna cewa maganin cututtukan kwayoyin cutar HIV zai iya sa mutane da dama su mutu kamar 425,000 da 300,000 sabon cututtuka a cikin shekaru biyar masu zuwa.

A halin yanzu, fiye da kashi 10 cikin dari na mutanen da ke fara cutar HIV a tsakiya da kudancin Afirka suna da tsayayya ga kwayoyi na farko, yayin da kashi 40 cikin dari zasu sami irin wannan juriya na maganin likitanci da na gaba. Haɗuwa da tenofovir da kuma maganin analog na thymidine kawai ya haifar da batun ta hanyar ƙayyadad da hankali ga mutum ba kawai daya ko biyu magunguna ba, amma dukkanin kwayoyi.

Kashewar Yanayin

Yayinda yake fadada kwayar cutar HIV - tare da tsarin Majalisar Dinkin Duniya 90-90-90 - yana da mahimmanci don kawo karshen annoba, daidai yake da bukatar mu zuba jarurruka a fasaha da kuma gano hanyoyin magance matsalolin tsarin da aka saba wa magunguna adherence. Wani gargadi ne da jami'an da ke kula da WHO suka dauka, wanda ya bayyana cewa ba tare da wata hanya ba don tabbatar da kulawa da lafiyar mai haƙuri, yaduwar fadada shirye-shiryen miyagun ƙwayoyi ba za ta isa ya dauke da annoba ba.

Ana sa ran ana yin amfani da kwayar gwaji da ake kira ibalizumab, wanda aka ba da izinin nasara ta US Food and Drug Administration a shekara ta 2015. Dandalin da ake yiwa rigakafi ya hana HIV daga shiga cikin tantanin halitta kuma an nuna shi ya shawo kan yawan miyagun kwayoyi- damuwa masu tsayayya a gwajin mutum. Yayinda FDA ba ta samu lasisi ba, hanyar samun nasara ta hanyar yin amfani da hanyoyi na sauri daga ko'ina daga watanni shida zuwa shekara.

Wasu bincike sun nuna cewa sabon sabon nau'i na tenofovir (wanda ake kira tenofovir AF) zai iya rinjayar juriya da ke hade da magungunan miyagun ƙwayoyi (mai suna tenofovir DF).

Daga wani hangen nesa, rigakafin kasancewa mahimmanci don guje wa ƙara yawan yaduwar maganin kwayoyi. Yana buƙatar matakan biyu na kulawa da lafiyar mutanen da ke zaune tare da kwayar cutar HIV da kuma ci gaba da ragowar lalacewa na kowa don hana duka sayen da kuma watsa kwayar cuta mai guba.

> Sources:

> Gregson, J; Kaleebu, P .; Marconi, V. et al. "Kwayar cuta ta HIV-1 na maganin analogues na thymidine bayan rashin cin nasara na tenofovir na farko da aka haɗa tare da analogic cytosine da nevirapine ko efavirenz a ƙasashen Saharar Afirka: binciken da aka yi a tsakanin kungiyoyi masu yawa." Lancet cututtuka na cututtuka. Nuwamba 30, 2016; S1473-3099 (16) 30469-8.

> Kungiyar Nazarin TenoRes. "Ciwon duniya na maganin magungunan miyagun ƙwayoyi bayan rashin nasarar WHO ya bada shawarar tsarin tsarin farko don cutar HIV-1 mai girma HIV: wani bincike mai mahimmanci na binciken kundin tsarin mulki." Lancet cututtuka na cututtuka. Janairu 28, 2016; buga a kan layi.