Shawara daga Ma'aikatar Kiwon Lafiya ta Amurka da Ayyukan Dan Adam
A watan Mayu 2014, Ma'aikatar Lafiya ta Amurka da Ayyukan Dan Adam (DHHS) sun sake nazarin hanyoyin magance cutar HIV, suna bada shawarar aiwatar da maganin rigakafi (ART) a cikin dukan mutanen da aka bincikar cutar HIV, duk da la'akari da CD4 ko ƙaddamar da cutar .
Shawarar da ake kira ART a CD4 sun ƙidaya sama da 500 Kwayoyin / ML, tare da shawarwari mai kyau don ART a ƙidaya fiye da 500 Kwayoyin / ML.
Sanin maganin cutar HIV a kan ganewar asali
Shaidar DHHS tana goyan bayan shaidar cewa ana jima da jima'i da mahimman sakamako, wato:
- ragewa cikin hadarin mutuwa da cututtuka da suka shafi ci gaba da cutar HIV.
- wani raguwa a cikin hadarin watsa daga uwa zuwa yaro.
- ragewa cikin hadarin watsawa daga mutumin da ke dauke da kwayar cutar HIV.
Bayanin ƙarshe shine shaidar tabbatarwa cewa yin amfani da ART zai iya rage yawan ciwowar mutum mai dauke da kwayar cutar HIV, wata hanyar da aka fi sani da magani kamar rigakafi (TasP)
An kara nuna cewa mutanen da suka ba da kayan aikin ta ART gaba ɗaya ne 53% na kasa da ƙila su sami ciwo mai tsanani , da masu dauke da kwayar cutar HIV da wadanda basu da dangantaka, fiye da wanda aka dakatar da ART.
Bugu da ƙari, ART ta farko ba ta ba da kyakkyawan sakamako ba amma tsawon rai. A cewar masu bincike tare da Cibiyar Nazarin Harkokin Kasuwanci ta Arewacin Amirka kan Bincike da Zane (NA-ACCORD), mai shekaru 20 da ke dauke da kwayar cutar HIV zai iya zama a yanzu ya kasance a farkon shekarun 70s idan aka bi shi a lokacin ganewar asali.
Ya bambanta, yin sulhu da ART har sai yawan CD4 na mutum ya sauke ƙasa 200 kwayoyin / mL zai iya rage yawan rai ta tsawon shekaru 15.
Shawarwari don Farko na Farko a Ƙararrun Matasan
Domin marasa lafiya marasa lafiya (marasa lafiya), marasa lafiya na yau da kullum suna bada shawarar daya daga cikin sababbin kwayoyi guda shida kamar yadda zaɓin su ya fi dacewa don farfadowa na farko:
- Triumeq (dolutegravir + abacavir + lamivudine), dauka sau ɗaya kowace rana
- Tivicay (dolutegravir) + Truvada (tenofovir + emtricitabine), dauka sau ɗaya kowace rana
- Stribild (elvitegravir + cobicistat + tenofovir + emtricitabine), dauka sau ɗaya kowace rana
- Genvoya (elvitegravir + cobicistat + tenofovir AF + emtricitabine), dauka sau ɗaya kowace rana
- Isentress (ratelgravir) + Truvada (tenofovir + emtricitabine), dauka sau ɗaya kowace rana
- Prezista (darunavir) + Norvir (ritonavir) + Truvada (tenofovir + emtricitabine), dauka sau ɗaya kowace rana
Dalilin da ya dace na DHHS ya fi dacewa da matsayi ya ƙunshi nauyin nauyin nau'in kwaya mai sauƙi, sauƙin maganin lissafi, rage tasirin sakamako na gefen, da kuma babban tsangwama ga maganin miyagun ƙwayoyi.
Tunda wasu sharuɗɗa na iya cire waɗansu daga ɗaukar zaɓuka waɗanda aka fi so (kamar Truvada a marasa lafiya tare da ciwon koda), DHHS ya bada jerin tsari guda shida don farfadowa na farko kamar haka:
- Atripla (efavirenz + tenofovir + emtricitabine), dauka sau ɗaya kowace rana
- Kammala (rilpivirine + tenofovir + emtricitabine), dauka sau ɗaya kowace rana
- Evotaz (atazanavir + cobicistat) + Truvada (tenofovir + emtricitabine), dauka sau ɗaya kowace rana
- Reyataz (atazanavir) + Norvir (ritonavir) + Truvada (tenofovir + emtricitabine), dauka sau ɗaya kowace rana
- Prezcobix (darunavir + cobicistat) OR Prezista (darunavir) + Norvir (ritonavir) tare da Epzicom (abacavir + lamivudine), sau ɗaya kowace rana
Sources:
Ma'aikatar Lafiya da Ayyukan Dan Adam (DHHS). "Sharuɗɗa don Amfani da Ma'aikata marasa lafiya a HIV-1-Infected Adults and Adolescents." Rockville, Maryland.
Hogg, R .; Althoff, K .; Samji, H .; et al. Ƙara hawan rai a tsakanin wadanda ke dauke da kwayoyin cutar HIV a Amurka da Canada, 2000-2007. "Taro na 7th na Ƙungiyar Kasashen Duniya na IAEA (IAS) game da Harkokin Kwayoyin cuta, Jiyya da Rigakafin. Kuala Lumpur, Malaysia. Yuni 30-Yuli 3, 2013; Abubuyar TUPE260.
Skarbinski, J. Furlow-Parmley, C .; da kuma Frazie, E. "Rahotanni na Ƙasa na Ƙididdigar yawan kwayoyin cutar HIV + da suka sami lafiyar likitoci, da aka tsara ART, da kuma Cibiyar Kula da Lafiya ta Viral Cyber, 2009 zuwa 2010-Amurka." Taro na 19 a kan Magungunan Tsarin Kasuwanci da Hanyoyi (CROI); Seattle, Washington; Maris 8, 2013; maganganun na baka # 138.
Lasry, A; Sansom, S .; Wolitski, R .; et al. "Harkokin jima'i na HIV ya haddasa matsala tsakanin ma'aurata da ke tattare da cutar ta HIV: tantance abubuwan da zasu haifar da haɗin dabarun rigakafi." AIDS . Yuni 14, 2014; 28 (10): 1521-1529.
Kitahata, M .; Gange, S .; Ibrahim, A., et al. "Hanyoyin maganin cutar kanjamau na farko game da cutar kanjamau." New England Journal of Medicine. Afrilu 30, 2009; 360 (18): 1815-1826.