Nazarin da ke Afirka da Turai suna da mahimman ra'ayi
A cikin watan Disamba na shekarar 2014, binciken biyu da ke bincikar cutar ta HIV a kudancin Afirka da Turai, ya nuna ra'ayi biyu daban.
Na farko, wanda aka gudanar a Botswana da Afirka ta Kudu, ya nuna cewa cutar ta hanyar magance kwayoyin cutar HIV da ake kira 'yan adam (BLA-B) da ke dauke da kwayar cutar ta HIV-yana haifar da rauni ga cutar ta hanyar yin amfani da kwayar cuta, saboda haka ci gaba da ci gaba da cutar.
Na biyu, wanda ya biyo bayan wani ɓangare na marasa lafiya na Turai a shekaru da dama, ya duba musamman a matsanancin nauyin hoto da kuma adadin CD4 bayan bayanan muni na kamuwa da cuta kuma ya tabbatar da cewa, game da ci gaba da cutar, kadai kwayar cutar ta HIV ta fi sauri ci gaba da cutar.
Yaya za'a iya yiwuwa binciken biyu ya ƙare tare da irin fassarori daban-daban? Shin kawai batun yanayin bincike ne mai ban mamaki, ko kuwa yana iya yiwuwar saurin cutar daga nahiyar zuwa nahiyar - ko da ƙasa zuwa ƙasa - ya jagoranci ƙungiyoyin masana kimiyya a gaba ɗaya?
Yaduwar cutar HIV a Botswana da Afrika ta Kudu
A cikin binciken farko, masana kimiyya a Jami'ar Oxford, jagorancin mai binciken Rebecca Payne, sun yi tambaya ko bayyanar wasu kwayoyin HLA-B-hade da haɗari da ci gaba da ciwon hankali da kuma ci gaba da maganin kwayar cuta-sun iya haifar da maye gurbin HIV wanda zai iya raunana ta "maganin maganin hoto."
Binciken da aka yi a baya ya nuna cewa wasu al'ummomi suna da karuwar yawan mutane tare da wannan mummunar maye gurbin cutar HIV, daga kashi 75% a Japan zuwa kashi 20% a Afirka ta Kudu. Lokacin da suke kallo gazawar, masu binciken sun fara mamaki ko wannan zai iya taimakawa, a wani ɓangare, ga bambancin bambanci a cikin annoba a tsakanin kasashen da ba su da yawa kamar Japan da kuma yankuna masu cike da jini kamar yankin kudu maso Sahara.
Tun da yake yawan kwayoyin cutar HIV ba su da yawa a kasar Japan, masu bincike sun mayar da hankali ga binciken da aka yi a kan wani ɓangare na marasa lafiya a Botswana, kasar da cutar ta kamu da cutar ta HIV a shekarar 2000, kuma idan aka kwatanta da wata ƙungiya mai kama da juna a Afirka ta Kudu, wanda kawai ya isa yawanta a 2010.
Binciken farko ya nuna cewa yawancin kwayar cutar hoto a cikin marasa lafiya marasa lafiya a Botswana, inda cutar ta "tsufa," ya kasance ƙasa da na Afirka ta Kudu, inda cutar ta kasance shekaru goma "ƙarami" (15,350 kofe / ML zuwa 29,350 kofe / ML, bi da bi). Bugu da ƙari kuma, duk da ciwon CD4 count / 50 m fiye da na Afirka ta Kudu, Botsansans tare da kwayar cutar HIV suna so su rayu tsawon lokaci, suna nuna ƙananan ƙarancin ƙira.
Tare da wannan shaida a hannunsa, masu binciken sun kalli tsarin tsarin kwayoyin cutar HIV da marasa lafiya suka gano cewa mafi yawan mutanen Botswanans suna da maye gurbin HLA-B na "kubuta" (ma'anar cewa cutar ta dace da kasancewar lamarin HLA don gujewa gano). A cikin haka, masana kimiyya sun yi imanin cewa "lafiyar" kwayar cutar ta iya raunana, ta jinkirta damar iyawa da kuma iyawarsa ta lalata tsarin kulawa da marasa lafiya.
Dukkanin sun ce, kashi 46 cikin 100 na 'yan kungiyar Botswana sunyi mahimmancin maye gurbin HLA-B idan aka kwatanta da kashi 38% na' yan Afirka ta kudu.
Magungunan gwajin gwaji sunyi amfani da maganin, tare da kwayar cutar HIV daga Botswanan samfurin da yayi daidai da 11% a hankali fiye da wannan daga Afirka ta Kudu.
Bisa ga bayanan kididdiga daga dakunan shan magani, Payne da ƙungiyarta sun kara nuna cewa cutar ta HIV ta fara farawa a Afrika ta Kudu, tare da nauyin haya mai nauyin hoto a tsakanin matan da ba a hana su ba daga 13,550 a 2002-2005 zuwa 5,750 a shekarar 2012- 2013.
Ana auna kwayar cutar HIV a cikin Chorus CASCADE na Turai
Binciken na Turai ya ɗauki tsarin da ya fi sauƙi, wanda ya dace, wanda ya samo bayanan da aka samu na haƙuri daga kwanan nan, kungiyar ta CASCADE ta rukuni na Turai ta yi nazari daga 1979 zuwa 2002.
A cikin binciken su, masu binciken na CASCADE sun mayar da hankali ga dalilai biyu:
- matsakaicin adadin CD4 bayan rikice-rikice (wanda ya ƙayyade yadda cutar ta HIV ta raunana tsarin mutum na rigakafi), kuma;
- magungunan hoto mai mahimmanci "zane-zane" (inda kamuwa da kwayar cutar ta fara bayan ƙananan mataki na kamuwa da cuta, tare da ƙwayar maganin cututtukan hoto wanda yafi dacewa wajen inganta ci gaba).
A cikin nazarin binciken su na bincike, masu binciken sun gano cewa adadin CD4 ya ragu daga kwayoyin 770 a cikin 1979 zuwa 570 sel / mL a shekarar 2002, yayin da kwayar cutar tazarar ta kai kusan kusan uku daga 11,200 a 1979 zuwa 31,000 a 2002.
Har ma fiye da shi shine irin gudunmawar da cutar ta yi ta ci gaba, a kowace shekara, a cikin mutanen da ke dauke da kwayar cutar HIV. Bisa ga binciken, tsawon lokacin da ya ɗauka na CD4 ya kamu da ƙananan 350 - matakin da aka bada shawarar maganin cutar antiretroviral - ya karu daga shekaru bakwai a 1979 zuwa kusan shekaru 3.4 da 2002.
Differences Mahimmanci a cikin Bincike
Dukkanin bincike guda biyu suna da iyakokin su, tare da zane-zane na binciken wanda zai iya jayayya tsakanin masana kimiyya da mahimmanci. Daga cikin bambance-bambance:
- Yayinda binciken da aka yi a Afirka ya yi nazari akan kimanin marasa lafiya 2,000 a Botswana da Afirka ta Kudu, ainihin adadin marasa lafiya da aka haɗa a cikin samfurin samfurin ba da ƙananan ba ne kawai (16 daga Afirka ta Kudu da 63 daga Botswana) amma an ɗauka a lokaci daya a lokaci . A bambanta, kusan marasa lafiya 16,000 sun haɗa su a cikin ƙungiyar CASCADE, waɗanda aka bincika su duka tsawon lokaci.
- Duk da yake Payne da ƙungiyarta suka mayar da hankalinsu game da tasiri na maye gurbin HLA a kan abin da ke dauke da kwayar cutar ta mutum mai haƙuri, ba su iya nuna cewa kasancewar wadannan maye gurbi ba tasiri a kan ragowar CD4. A bambanta, masu bincike na CASCADE sunyi la'akari da tsaka-tsakin CD4 / viral load na tsakiya don kafa kwayar cutar HIV. Sun kuma ƙayyadewa kawai ga marasa lafiya wadanda aka gano a cikin watanni uku na kamuwa da cuta, suna samar da mafita mai haske wanda zai iya auna ci gaban cutar / CD4.
- Yana da muhimmanci a lura da cewa, ƙungiyar CASCADE kawai ta gudanar da nazari na hankali a kan fararen fata, maza da mata maza (don tabbatar da tabbatarwa ta kowa a cikin tarihin jiyya da kuma maganin bidiyo). Duk da yake bincike ya nuna cewa ƙwayar ƙarancin jiki zai iya zama a cikin Turai kamar yadda yake gaba daya-tare da ɗakin da ke dauke da kwayar cutar hoto daga 31,000 a shekarar 2002 zuwa 25,500 a shekara ta 2008 - ba za'a iya bayyana wannan ga maza ba. Tun da aka sani cewa yaduwar cutar ta HIV ta hanyar yawan maza na maza (tare da matakan karuwar maganin cutar) ya haifar da bambancin kwayoyin da kuma jigilar juriya , yana yiwuwa yiwuwar maganin da ke shafi wannan ƙungiya na iya, a gaskiya, kasancewa virulent.
- Ya bambanta, ana gudanar da nazarin Afirka a kasashen da ba a jima'i jima'i ba kawai hanyar hanyar watsa ba, amma inda, har zuwa kwanan nan, mutane da yawa sun kamu da cutar HIV . A sakamakon haka, bambancin kwayoyin cutar HIV a cikin kudancin Afrika an yi la'akari da shi, tare da wasu bincike da ke nuna cewa canjin yanki na cutar zai iya ba da dama ga bambance-bambance a kan cutar ta HIV.
A takaice dai, duk da rashin kuskuren binciken binciken Afirka da ƙuntataccen bincike na CASCADE, duka ƙaddara zai iya zama daidai. Ana buƙatar karin bincike daga bangarorin biyu.
Sources:
Payne, R .; Muenchhoff, M .; Mann, J. et al. "Hanyoyin cutar HLA da ke dauke da kwayar cutar HIV a kan ƙauyuka masu yawa a kan cutar HIV." PNAS. Disamba 16, 2014; 111 (50): E5393-5400.
Pantazis, N .; Porter, K .; Costagliola, D .; et al. "Yanayin lalacewa a cikin alamomi na kwayoyin cutar HIV-1 da kuma yiwuwar sassaukarwa. A L tsofaffin HIV. Disamba 2014; 1 (3): e119-126.