Kamuwa da cuta a cikin maza biyu a kan rigakafin rigakafi don kawo damuwa
An sanar da shi a ranar 25 ga Fabrairu, 2016 cewa wani mutum dauke da kwayar rigakafi na kwayar cutar HIV, Truvada , ya yi kamuwa da cutar duk da cewa yana bin cikakken tsarin likitancin yau da kullum. Rahotanni sun nuna damuwa ga wasu game da yadda tasirin da aka fi sani da kwayar cutar ta HIV ( PrEP ) -a yadda yake tabbatar da cewa marasa lafiya na cutar HIV ba su da lafiya.
A cikin rahotonsu, masu bincike da Magani Leaf Medical Clinic (MLMC) a Kanada sun tabbatar da cewa wani mutum mai shekaru 43 mai shekaru 43 ya gwada kwayar cutar HIV yayin da yake kan PrEP, da kuma nazari akan takardun magani guda biyu da gwajin maganin likita ( da aka yi amfani da shi don auna ƙwayar miyagun ƙwayoyi a cikin jini) ya ba da tabbaci ga matakin da mutum yayi.
Ƙarin gwajin kwayoyin ya nuna cewa mutumin ya samu kwayar cutar HIV mai wuya, wadda ta kasance tsayayya ga magungunan miyagun ƙwayoyi guda biyu wanda ke dauke da Truvada.
Don haka tambaya ta kasance: shin wannan yanayin shine "rare" kamar yadda wasu a cikin kafofin yada labarai suka ruwaito? Ko kuma abin da ya faru, a gaskiya, ya nuna yiwuwar yin amfani da makamai na wannan shirin rigakafin HIV?
Ƙarƙashin Ƙarƙashin Ƙarƙashin Ƙaƙwalwar Harkokin Kwarewa
Yawancin kamfanonin HIV a yau za su ba ku shawara cewa PREP, idan aka ɗauki daidai a cikin kwamfutar hannu yau da kullum, zai iya rage yawan mutum na samun HIV ta kashi 90 ko fiye.
Haka kuma za su yi amfani da masu yin amfani da hankali, musamman wadanda ke da haɗari mai tsanani , cewa ba za a yi amfani da miyagun ƙwayoyi ba ne a kan bazuwa amma a matsayin wani ɓangare na shirin kare rigakafin HIV (ciki har da kwaroron roba, iyakance yawan jima'i, da dai sauransu)
Amma sakon sau da yawa yana saukewa ga jama'a yana da hanyoyi daban-daban, tare da kafofin watsa labarun da kuma labarun labarai akai-akai akai-akai ko kuma skewing ainihin shaida.
Yau ba wani abu bane na jin cewa PrEP shine "tasiri 99" a hana rigakafin HIV, ko don ganin binciken da ke tattare da bincike don bayyana cewa PrEP "kashi 100 cikin dari" daga cikin mazaunin gayuwa mai girma ba sa amfani da kwaroron roba .
Kuma yayin da yake da gaskiya cewa wasu nazarin tsakanin mazaunan gayayyaki masu yawan gaske sun bayar da rahoton rashin cututtuka a tsakanin waɗanda ke da cikakkun maganin, waɗannan irin sakamakon ba dole ba ne su fassara yanayin da ke faruwa na ainihi, inda masu yawa masu rikitawa zasu iya rage tasirin PrEP matakin mutum.
Yana da yawa daga cikin wadannan masu rikici wanda ke sanya yanayin Kanada a cikin haske mai haske.
Abubuwan da ke Shafan Ƙwarewar Ƙwarewa
A cikin binciken su, masu bincike na MLMC sun nuna cewa mai cutar kanjamau ya kamu da mutumin Kanada wanda ke da nasaba da cutar antiretroviral. Bayan gwajin gwajin gwajin kwayar cutar, an nuna cutar ta abokin gaba ga magunguna biyu da emtricitabine (magungunan kwayoyi na Truvada), ta yadda za a kawar da amfanin PREP.
Yayinda wasu majiyoyi sun tabbatar da cewa irin wannan jigilar kwayoyi ba abu ne mai sauƙi ba-tare da rage yawan kasa da kashi daya cikin dari-wasu bincike sun nuna hoto daban-daban. Mun sani, alal misali, juriya 10ofovir na gudana a ko'ina daga kashi 20 cikin dari (a Turai) zuwa kashi 57 cikin dari (a Afrika) tsakanin marasa lafiya marasa lafiya, a cewar wani rahoto na shekara ta 2016 daga kungiyar nazarin TenoRes.
A lokuta irin wannan, koda kuwa maɓallin emtricitabine ya kasance mai dorewa, ikonsa na hana rigakafi, ya kasance mafi kyau, ƙananan zuwa rashin cancanta. Wannan shi kadai ya yi tambaya ko yanayin yanayin kamuwa da cuta a cikin Kanada ya kasance "maras kyau," yayin da yake nuna matsalolin da al'ummomin ke fuskanta lokacin da tsayayyar gwagwarmayar tenofovir ta yi girma.
A halin yanzu, wasu masu rikitarwa na iya haifar da inganci na PrEP. Babban daga cikinsu:
- Rashin gazawar samun nasara da kuma kula da matakan da ya dace na Truvada a cikin jini. Duk da yake maganin da ya saba da shi ya fi sau da yawa dalilin wadannan lalacewar, an kuma san cewa marasa lafiya da ke fara PrEP dole ne a yi musu magani a kimanin kwanaki 20-30 kafin a iya daukar magungunan da tasiri. Da zarar an samu matakan miyagun ƙwayoyi, a wasu lokuta an rasa asibiti ya zama ƙasa da batun - a kalla a cikin mazaunin maza da mata.
- Ƙaruwa a cikin tasirin PrEP a cikin mazaunin maza da mata maza da mata. Akwai shaidu kuma yanzu suna nuna cewa PREP bazai zama tasiri a cikin mata ba, kuma har ma tare da cikakkiyar haɗin kai, amintaccen kariya zai iya fadi a kasa da kashi 90 cikin dari na kofa da ake gani a maza.
A cikin cikakkiyar waɗannan abubuwa, waɗannan bayanan sun nuna abubuwa biyu: cewa tasirin PrEP a wasu al'ummomi zai kasance ƙasa da sauran, kuma cewa bukatar buroron roba da sauran magance rigakafi ya kasance kamar yadda ya dace.
Abubuwa da yawa da Abokan Hulɗa
Da wannan aka ce, inganci na PrEP ba ya zama alaƙa da yawancin halayen haɗakar da ke tattare da kamuwa da cuta ba. Yayin da yake amfani da kwaroron roba ba tare da abokiyar jima'i ba, alal misali, an san su don kara yawan cutar HIV, ba lallai ba lallai su inganta tasirin PrEP a cikin mutane masu haɗari.
A gaskiya ma, tsakanin gay da aka ga sun kasance cikin mafi girman haɗari, yin amfani da PrEP har yanzu yana da alaƙa da kimanin kashi 86 cikin 100 na kare lafiyar waɗanda ba su yi amfani da PrEP ba. Amfanin kawai ana gani shine kara yawan wadanda suke yin amfani da kwakwalwa ta jiki, kuma suna iyakance yawan abokan aure (musamman ma wadanda ba a san su ba ko matsakaicin hali).
Da wannan aka ce, har yanzu ba a iya la'akari da PREP a matsayin "magungunan sihiri" wanda ya sabawa amfanin wasu nau'i na kariya, kamar su roba ba. A watan Fabrairun 2017, wani mutum na uku ya gwada tabbatacce yayin da yake a kan PrEP. A wannan yanayin, duk da haka, masu bincike sun yi imanin cewa watsa ya faru ne a cikin babban bangare saboda yawan "matukar mahimmanci" yawan abokan jima'i da yake da su.
Dan shekaru 50 mai suna Hollande ya halarci nazarin PEP na Turai kuma ya bada rahotanni game da nau'in jima'i na jima'i da kuma fiye da 100 nau'in jima'i na jima'i a cikin jarrabawar makonni 12. Yayin da yake a kan PrEP, an gano mutum sau biyu tare da gyaran gonarrhea kuma sau ɗaya tare da chlamydia.
Duk da yake irin yanayin da ake ciki ya haifar da gaskantawa cewa wannan lamari ne guda daya, wasu ba su da tabbas. A gwada kwayar cutar mutum, sun gano cewa babu wani maye gurbin cutar HIV da kowane nau'i kuma wannan kwayar cutar tana dauke da "mai launi".
Abin da ake nufi shi ne, idan aka ba da rikodin sa, to, magungunan ya kamata su tanadar kariya sai dai idan wasu dalilai sun taimaka wa kamuwa da cuta. Idan haka ne, waɗannan abubuwan da ba a san su ba ne na iya sanya wasu a hadarin. Har sai masu bincike sun sani, ya kamata a ci gaba da yin aikin jima'i da aminci idan dai don samar da ƙarin kariya na kariya.
Sources:
> Hoornenborg, E. da de Bree, J. "Mutuwar Cututtuka Tare da Dabba-irin kwayar cutar HIV-1 a FATA mai amfani da Matsanancin TDF." Taron kan Magunguna da Hanyoyin Ciki; Seattle, Washington; Fabrairu 13-16, 2017; m 953.
> Molina, J. Ma'aikatar, C .; Spire, B .; et al. "Abubuwan da ake kira Prophylaxis a cikin maza a Babban Haɗarin HIV-1 Cutar." New England Journal of Medicine. Disamba 1, 2015; An wallafa shi a layi a gaban bugu; DOI: 10.1056 / NEJMoa1506373.
> Labaran POZ. "PrEP ya raunana Gay Man Adhering to Daily Truvada, Ya Kwayar da kwayar cutar HIV." Fabrairu 25, 2016.
> Rukunin 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 yanar gizo; DOI: 10.1016 / S1473-3099 (15) 00536-8.
> Kwamitin Gudanarwa na Birtaniya. "TAMBAYOYI nazarin bincike na lokaci-lokaci ya gano prephylaxis prophylaxis (PrEP) yana da kariya ga kwayar cutar HIV ga maza da mata da maza da suka yi jima'i da maza a Birtaniya." London, Ingila; sakin watsa labaran Oktoba 16, 2014.