Kayan Halitta, Harkokin Gudanarwa da Koda Kayan Kayan Kayan Layi Sanya Sashe na Zaɓin Kwarewa
Tare da gabatar da sababbin ƙwayoyin cuta , zabar dabarun maganin kwayar cutar HIV sau da yawa sauƙaƙe kamar zaɓar ɗayan yau da kullum, kwamfutar hannu ɗaya da wani yau da kullum, kwamfutar hannu ɗaya. Kuma a mafi yawan sababbin marasa lafiya, yana da sauƙi kamar haka-yana buƙatar ƙananan gwaje-gwajen jini da kuma nazari na ainihin tarihin likita don gano ko wane haɗin likitoci zaiyi aiki mafi kyau a gare ku a matsayin mutum.
Duk da haka, yin zabi mai kyau ba koyaushe ba game da saukakawa. Duk da yake samun maganganu daya kamar Atripla , Complera ko Genvoya tabbas zai sa rayuwa ta fi sauƙi daga ra'ayi, tsinkaye, na asibiti ko ma abubuwan sirri sukan bayar da shawarar hanyoyin da za a magance su.
Ƙarshen manufar magani shine maganin farfadowa don yin amfani da kwayoyin ku har tsawon shekaru masu yawa tare da ƙananan sakamako masu illa da kuma maganin cututtukan hoto (kamar yadda kwayar cutar HIV ta ɗauka ). Don yin haka yana buƙatar kimanta abubuwan da ke biyo bayan waɗannan maganganu:
Dabbobi iri-iri da aka fi so a Farfesa na Farko
Harkokin magani sun canza da yawa a cikin shekaru goma da suka wuce, suna motsawa daga wasu kwayoyi (ko kuma wasu nau'o'in kwayoyi) da aka sani sun zama masu guba ko kuma sun fi dacewa wajen bunkasa magunguna .
A cikin sharuɗɗan Amurka na yanzu , an fi mayar da hankali akan yin amfani da masu haɗin gwiwa (ISTIs) a cikin farfadowa na farko, tare da hudu daga cikin likitattun fannoni guda shida da suka haɗa da ƙwayoyin ISTI da ke cikin Tikiyya (samo a Triumeq da Tivicay ), raltegravir (Isentress) ko elvitegravir (a cikin Vitekta , Stribild , da Genvoya ).
Dalilin da ya fi dacewa ya fi dacewa da haƙurin haƙuri, rashin sakamako masu illa maganin, da kuma ingantattun bayanan juriya (ma'anar cewa sun fi iya rinjayar duk wani magungunan maganin rigakafi wanda ya rigaya ya kasance). Dukkan hanyoyin da aka fi so a kan sau ɗaya a kowace rana, ƙwarewa cewa sauƙi na amfani yana da muhimmiyar mahimmanci wajen kiyaye daidaito mai kyau .
Kayan Halitta Kwayoyin Kwayoyinku
Babu irin wannan nau'in kwayar cutar HIV. Yayinda kwayar cutar ta HIV ke ci gaba, cutar za ta ci gaba da maye gurbinta, wasu daga cikinsu suna ba da shawara ga magunguna. Yayinda wannan kwayar cutar ta shige daga mutum zuwa mutum, an kuma jure juriya (yanayin da ake magana da ita kamar yadda ake kawowa ko samu juriya).
Dukkanin daya daga cikin sababbin kamuwa da cutar Ebola guda shida a Amurka za su samu juriya a kalla kashi daya na kwayoyin cutar HIV. Samun maganin magunguna da yawa da aka samo asali.
Domin tabbatar da farfadowar farko ɗinka zai iya cin nasara akan irin wannan shinge, gwaje-gwajen kwayoyin (wanda ake kira genotyping) an yi don gano abin da maye gurbin da kwayar cutar ta ke da kuma ko waɗannan maye gurbin bada juriya. Maganin ƙwayoyi suna dogara ne akan bincike mai kyau game da sakamakon jinsin kwayar cutar.
A cikin iyakoki marasa iyakacin albarkatun da ba a aiwatar dashi ba, zabin mai magani ya dogara akan binciken ilimin (a) sanannun bambance-bambancen da aka sani ko a cikin yanki na musamman da kuma (b) kayan da ake amfani da su sun fi nasara da irin wannan juriya.
Ayyukan Kwayoyin Jiki da Harkokin Kimiyya
A bayyane yake, lafiyar lafiyar mai haƙuri tana jagorancin yadda ake kula da lafiyar mutane da ke dauke da HIV.
Matsayi na rashin lafiya (wanda aka kiyasta ta CD4 ) zai iya motsa yin amfani da miyagun ƙwayoyi daya akan ɗayan. Wasu yanayi na kiwon lafiya na iya ƙyale amfani da wasu magunguna, ko dai saboda maganin miyagun ƙwayoyi na iya haifar da yanayin da ya rigaya ya kasance ko ya haifar da bayyanar cututtuka.
Daga cikin misalai:
- Ana amfani da amfani da tenofovir a cikin mutane tare da koda mai tsanani (ƙananan ruɓaɓɓu) kamar yadda zai iya haifar da gazawar koda a wasu marasa lafiya. Irin wannan yanayin zai iya cire amfani da kwayoyin tenofovir dauke da kwayoyi Viread, Truvada, Stribild, Complera, da Atripla.
- Ana iya yin gargadin marasa lafiya da cututtukan zuciya, damuwa, cututtuka, cututtuka, ko wani mummunan cututtuka na zuciya da cututtuka na yin amfani da efavirenz, magani wanda aka sani da shi ya shafi ainihin tsarin jiki (haifar da mafarkai, matsalolin matsalolin da tashin hankali) . Duk wani daga cikin waɗannan ka'idoji zai iya ware amfani da Sustiva da miyagun ƙwayoyi na Avila.
- Mutanen da aka sani ko hasara na hanta (ciki har da wadanda ke tare da hepatitis) ya kamata su guji duk wani kwayoyi wanda zai iya tsananta yanayin. Wannan ya haifar da ƙwayar maganin waɗannan kwayoyi a cikin hanta, wanda zai haifar da gina wasu sunadarai masu guba (yanayin da ake kira hepatotoxicity). An yi amfani da Aptivus (tipranavir) a cikin irin waɗannan lokuta, kamar yadda wasu wasu magungunan antiretroviral ke nunawa a cikin abubuwan da suka fi tsanani daga rashin hanta.
Drug-Drug Interactions
Amfani da maganin miyagun ƙwayoyi ne na al'ada a cikin marasa lafiya kan cutar HIV, tare da wasu hulɗar da ake buƙatar canje-canje a kashi kuma wasu na buƙatar dakatar da ko kwayar cutar HIV.
Ɗaya daga cikin hulɗar da ta fi dacewa ita ce amfani da kwayoyi da ake amfani dasu don magance tarin fuka, tare da ba a kasa da kwayoyin maganin ƙwayar cuta ba 13 da aka haramta don amfani da kwayoyi TB da rifapentine.
Hakazalika, ba za a yi amfani da kwayoyi kwayoyin cutar HIV ba tare da wasu kwayoyin cutar hepatitis C , haɗin haɗin da suke haɗuwa don rage tasirin da kuma sakamakon kowane ɗaya ko duka kwayoyi. Haka kuma ya shafi magungunan ƙwayoyin lipid din Mevacor (lovastatin) da Zocor (simvastatin), wadda ba za a dauka da yawancin magunguna na HIV protease ba. S.
Abin mamaki, watakila, maganin magunguna na St. John's Wort an haramta shi don amfani tare da dukan magunguna na HIV kamar yadda aka sani cewa rage yawan ƙwayar miyagun kwayoyi a jini.
Yana da mahimmanci a koya wa likitanka koyaushe game da duk wani kwayoyi, wadanda aka tsara da wadanda ba a ba da umurni ba, cewa kana shan ko akai-akai ko a'a.
Abubuwan Dajiyar Rayuwa da Sauran Ƙididdiga
Sanin maganin cutar HIV ya kula da rayuwar mutum da kuma yadda magani zai iya tasiri irin wannan salon. Kuma lokuta ba sauki ba ne. Koda a cikin shari'ar "mai sauƙi" -a ina, alal misali, aikin gyare-gyare na rashin daidaituwa na iya haifar da rashin lafiyar kwayar cutar da ba za a iya bawa - karin kulawa don tabbatar da cewa an tsara maganin lafiya ga lafiyar mai haƙuri a kan da sakamakon binciken asibiti.
Dole ne a yi la'akari da matan da suke haifar da haihuwa, alal misali, game da hadarin efavirenz a kan ci gaban tayi da kuma tsara wani farfadowa mai mahimmanci idan akwai yiwuwar daukar ciki.
A cikin tsofaffin marasa lafiya, wadanda a matsayin yawancin suna da ƙananan rashin lafiyar koda, za'a iya maye gurbin tenofovir domin ya kauce wa yiwuwar gazawar gawar.
Magunguna a kan maganin jijiyar (wanda ake amfani da su na maganin maganin opioid) ana iya ba da shawara don kauce wa efavirenz, da Viramune (nevirapine) da kuma Kaletra (lopinavir / ritonavir) , domin suna iya rage tasirin hanyoyin biyu. A daidai wannan numfashi, dole ne a yi la'akari game da yin amfani da zaɓuɓɓukan maganin zazzage a cikin yawan jama'a inda daidaitattun daidaito ya kasance matsala.
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; isa ga Fabrairu 15, 2016.
Li, J. Kim, D .; Linley, L .; et al. "Zane-zane mai hankali ya nuna rashin fahimtar rashin lafiyar kwayar cutar HIV." Taron taron na 2014 game da Rikici da Hanyoyin Ciki (CROI); Boston, Massachusetts. Maris 3-7, 2014; m 87.