Mushumo weHIV Progress: Tave Pedyo Nemushonga?

Zvemukati

• Mushonga
• Kudzivirira kwekutanga
• Pre-exposure prophylaxis (PrEP)
• Post-exposure prophylaxis (PEP)
• Kunyatsoongorora
• Matanho ekurapwa
• Isingawanikwe yakaenzana isingachinjiki
• Zviitiko zvikuru mukutsvaga
• Majekiseni emwedzi nemwedzi
• Kutarisa matura eHIV
• Kuputsa hutachiona hweHIV
• ‘Kushanda pabasa’
• Kwatiri ikozvino

Mhedziso

HIV inonetesa immune system uye inotadzisa kugona kwemuviri kurwisa zvirwere. Pasina kurapwa, HIV inogona kutungamira padanho rechitatu HIV, kana AIDS.

Denda reAIDS rakatanga muUnited States muma1980. Zvinofungidzirwa kuti vanhu vanopfuura mamirioni makumi matatu nemashanu vafa nechirwere ichi.

Parizvino hapana mushonga weHIV, asi zvidzidzo zvekiriniki zvakawanda zvakatsaurirwa kutsvaga mushonga. Mishonga yazvino yemaARV inobvumidza vanhu vanorarama neHIV kudzivirira kufambira mberi kwayo uye kurarama hupenyu hwakajairika.

Mafambiro makuru akaitwa mukudzivirira uye kurapwa kweHIV, nekuda kwe:

• masayendisiti
• vakuru vehutano
• masangano ehurumende
• nzanga-based masangano
• Varwiri veHIV
• makambani emishonga

Mushonga

Kugadzirwa kwemushonga weHIV kunoponesa mamirioni ehupenyu. Zvisinei, vaongorori havasati vawana mushonga unoshanda weHIV. Muna 2009, ongororo yakaburitswa muRondedzero yeVirology yakawana kuti jekiseni rekuyedza rakadzivirira zvikamu makumi matatu nezvitatu kubva muzana zvezvirwere zvitsva. Kumwe kutsvagurudza kwakamiswa nekuda kwenjodzi dzine njodzi. Mukutanga kwegore ra2013, National Institute of Allergy and Infectious Diseases yakamisa kiriniki yekuyedza yaiyedza majekiseni emushonga weHVTN 505. Dhata kubva mukuyedzwa yakaratidza kuti mushonga hauna kudzivirira kutapurirana kweHIV kana kudzikisa huwandu hweHIV muropa. Kutsvagisa majekiseni kuri kuenderera mberi pasirese. Gore rega rega kune zvitsva zvinowanikwa. Mu2019, vakazivisa kuti ivo vakagadzira yekurapa yekurapa ichivatendera ku:

1. mainjiniya mamwe immune system maseru ekuti amutsiridze HIV mumasero ane hutachiona hweHIV isingashandi, kana yakavanzika
2. shandisa imwe seti yeinjiniya immune system maseru kurwisa nekubvisa maseru ane Mukondombera zvakare

Zvavakawana zvinogona kupa hwaro hwejekiseni reHIV. Kliniki miedzo iri mumabasa.

Kudzivirira kwekutanga

Kunyange hazvo pasina mushonga wekudzivirira Mukondombera, pane dzimwe nzira dzekudzivirira kubva mukutapurirana. HIV inoparadzirwa kuburikidza nekuchinjana kwemvura dzemumuviri. Izvi zvinogona kuitika nenzira dzakasiyana siyana, kusanganisira:

• Zvepabonde. Panguva yekusangana pabonde, HIV inogona kutapuriranwa kuburikidza nekuchinjana zvimwe zvinwiwa. Izvo zvinosanganisira ropa, urume, kana anal uye vaginal secretions. Kuva nezvimwe zvirwere zvepabonde (STIs) kunogona kuwedzera mukana wekutapurirwa kweHIV panguva yepabonde.
• Yakagovaniswa tsono uye majekiseni. Tsono uye majekiseni ayo akamboshandiswa nemunhu aneHIV anogona kunge aine hutachiona, kunyangwe pasina ropa rinoonekwa paari.
• Kubata, kubereka, uye kuyamwisa. Vanamai vane hutachiona hweHIV vanokwanisa kutapurira hutachiwana uhwu kuvacheche vavo vasati vasununguka uye mushure mekuberekwa. Mune zviitiko apo mushonga weHIV unoshandiswa, izvi hazviwanzoitika.

Kutora matanho ekuzvidzivirira kunogona kudzivirira munhu kubva mukutapukirwa neHIV:

• Ongororwai Mukondombera. Bvunza vanhu bonde nezve chimiro chavo usati waita bonde.
• Kuongororwa nekurapwa zvirwere zvepabonde. Kumbira vanoita zvepabonde kuti vaite zvakafanana.
• Paunenge uchiita bonde remukanwa, remunhukadzi uye rezvemashure, shandisa nzira yekudzivirira semakondomu nguva dzese (uye ishandise nemazvo).
• Kana uchipinza mishonga, ita shuwa kushandisa tsono nyowani, isina kubereka isina kushandiswa nemumwe munhu.

Pre-exposure prophylaxis (PrEP)

Pre-exposure prophylaxis (PrEP) mushonga wezuva nezuva unoshandiswa nevanhu vasina HIV kudzikisa mikana yavo yekutapukirwa neHIV, kana ikaratidzwa. Inonyanya kushanda mukudzivirira kutapukirwa kweHIV kune avo vane njodzi dzinozivikanwa. Vanhu vari panjodzi vanosanganisira:

• varume vanoita bonde nevarume, kana vakaita bonde nekumashure kunobuda nako tsvina vasina kushandisa kondomu kana vakamboita njovhera mumwedzi mitanhatu yadarika
• varume kana vakadzi vasingashandisi nzira yekudzivirira semakondomu nguva dzose uye vane vavanowirirana nenjodzi yakawedzera yeHIV kana chimiro chisingazivikanwe cheHIV
• chero munhu akagovana tsono kana akashandisa jekiseni zvinodhaka mumwedzi mitanhatu yadarika
• vakadzi vari kufunga kubata pamuviri nevarume vane hutachiona hweHIV

Sekureva kweiyo, PrEP inogona kudzora mukana wekutapukirwa neHIV kubva pabonde nevanhu vanosvika zvikamu makumi mapfumbamwe nemapfumbamwe kubva muzana muvanhu vane njodzi dzekuzvitapurira HIV. Kuti PrEP ibudirire, inofanirwa kutorwa zuva nezuva uye zvinogara zvakadaro. Wese munhu ari panjodzi yeHIV anofanira kutanga chirongwa chePrEP, sekurudziro ichangobva kuitwa kubva kuUS Preventive Services Task Force.

Post-exposure prophylaxis (PEP)

Post-exposure prophylaxis (PEP) mubatanidzwa we emergency emergency antiretroviral drug. Inoshandiswa mushure mekunge mumwe munhu angave akafumurwa neHIV. Vanopa hutano vanogona kukurudzira PEP mune inotevera mamiriro:

• Munhu anofunga kuti vangangodaro vakasangana neHIV panguva yebonde (semuenzaniso, kondomu rakatyoka kana kuti hapana kondomu rakashandiswa).
• Munhu akagovana tsono pakujova mishonga.
• Munhu akabatwa chibharo.

PEP inofanira kushandiswa chete senzira yekudzivirira yechimbichimbi. Inofanirwa kutanga mukati maawa makumi maviri nemaviri kubva mukukwanisa kusangana neHIV. Sezvineiwo, PEP inotangwa iri padyo nenguva yekuburitswa sezvinobvira. PEP kazhinji inosanganisira mwedzi wekutevedzera antiretroviral therapy.

Kunyatsoongorora

Kuongorora HIV neAIDS idanho rakakosha mukudzivirira kutapurirwa kweHIV. Sekureva kweUNAIDS, chikamu cheUnited Nations (UN), dzinosvika makumi maviri neshanu muzana yevanhu vane hutachiwana hweHIV pasirese havazive chimiro chavo cheHIV. Kune akatiwandei akasiyana bvunzo dzeropa dzinogona kushandiswa nevanoona nezvehutano kuongorora hutachiona hweHIV. Kuzviongorora hutachiwana hweHIV kunotendera vanhu kuyedza mate kana ropa ravo pakavanda uye vanogamuchira mhedzisiro mukati memaminitsi makumi maviri kana mashoma.

Matanho ekurapwa

Kutenda kufambira mberi musainzi, HIV inoonekwa sechirwere chisingaperi chisingarapike. Mishonga yemaARV inobvumira vanhu vanorarama neHIV kuchengetedza hutano hwavo. Izvo zvinoderedzawo njodzi yavo yekuendesa hutachiona kune vamwe. Vanosvika makumi mashanu neshanu muzana muzana yevanhu vese vane hutachiona hweHIV vanowana mamwe marapirwo, sekureva kweUNAIDS. Mishonga inoshandiswa kurapa HIV inoita zvinhu zviviri:

• Deredza hutachiona huwandu. Huwandu hwehutachiona chiyero cheuwandu hweHIV RNA muropa. Chinangwa cheHIV antiretroviral therapy kudzora hutachiona kusvika padanho risingaonekwe.
• Bvumira muviri kuti udzorere huwandu hwemaCD4 cell hwayo. MaCD4 ane chekuita nekuchengetedza muviri kuzvirwere zvinogona kukonzera hutachiona hweHIV.

Kune mhando dzakasiyana dzemishonga yeHIV:

• Kwete-nucleoside reverse transcriptase inhibitors (NNRTIs) kudzima puroteni inoshandiswa neHIV kugadzira makopi ezvechiwanikwa mumasero.
• Nucleoside reverse transcriptase inhibitors (NRTIs) ipa hutachiwana hweHIV hwakashata saka haugone kugadzira makopi emagetsi ayo mumasero.
• Protease inhibitors kudzima enzyme iyo HIV inoda kuita makopi anoshanda eayo.
• Kupinda kana fusion inhibitors kudzivirira hutachiona hweHIV kupinda mumasero eCD4.
• Integrase inhibitors kudzivirira chiitiko che integrase. Pasina enzyme iyi, HIV haigone kuzvipinza muCD4 yesero reCD4.

Mishonga yeHIV inowanzo kutorwa musanganiswa chaiyo yekudzivirira kukura kwekusada kwemishonga. Mishonga yeHIV inofanira kutorwa nguva dzose kuti ibudirire. Munhu ane hutachiwana hweHIV anofanirwa kutaura nemubatsiri wake wehutano asati afunga nezvekuchinja mishonga yekudzora mhedzisiro kana nekuda kwekutadza kurapwa.

Isingawanikwe yakaenzana isingachinjiki

Kutsvagurudza kwakaratidza kuti kuzadzisa nekuchengetedza huwandu hwehutachiona husingaonekwe kuburikidza nehutachiona hweantiretroviral zvinobvisa mukana wekutapurira HIV kune waunofambidzana naye. Zvidzidzo zvikuru hazvina kuwana zviitiko zvekupfuudzwa kweHIV kubva kune inoramba ichidzvinyirirwa hutachiona (isingaonekwe huwandu hwehutachiona) hwehutachiwana hweHIV kune mumwe asina HIV. Idzi fundo dzakatevera zviuru zvevakavhenganiswa-chinzvimbo vakaroora kweanopfuura makore akati. Paive nezviuru zvezviitiko zvebonde zvisina makondomu. Nekuziva kuti U = U ("isingaonekwe = isingachinjiki") inosvika pakukoshesa "kurapwa sekudzivirira (TasP)." UNAIDS ine chinangwa che "90-90-90" kupedza denda reAIDS. Na 2020, chirongwa ichi chakanangana ne:

• Zvikamu makumi mapfumbamwe kubva muzana zvevanhu vese vanorarama neHIV vanoziva mamiriro avo
• Zvikamu makumi mapfumbamwe kubva muzana zvevanhu vese vanoonekwa kuti vane hutachiwana hweHIV vari pamishonga yemaARV
• 90 muzana yevanhu vese vanogamuchira maantiretroviral therapy kuti vadzvinyirwe hutachiona

Zviitiko zvikuru mukutsvaga

Vanoongorora vanoshanda zvakaoma vachitsvaga mishonga mitsva nemishonga yeHIV. Ivo vari kutsvaga kutsvaga kurapwa kunowedzera nekuvandudza hupenyu hwevanhu vane mamiriro aya. Pamusoro pezvo, vanotarisira kugadzira mushonga wekudzivirira nekuwana mushonga weHIV. Heano tarisiro ipfupi yenzvimbo dzinoverengeka dzakakosha dzekutsvaga.

Majekiseni emwedzi nemwedzi

Jekiseni remwedzi wega reHIV rakarongerwa kuwanikwa mukutanga kwa2020. Inobatanidza mishonga miviri: iyo integrase inhibitor cabotegravir neNNRTI rilpivirine (Edurant). Zvidzidzo zvekiriniki zvakawana kuti jekiseni remwedzi nemwedzi raive rakabudirira mukudzvinyirira HIV seyakajairwa mazuva ese emishonga yemuromo.

Kutarisa matura eHIV

Chikamu chezvinoita kuti kutsvaka mushonga weHIV kuome ndechekuti immune system ine dambudziko rekutarisa matura emasero ane HIV. Iyo immune system kazhinji haigone kuziva masero ane HIV kana kubvisa maseru ari kushingaira kuburitsa hutachiona. Mushonga weantiretroviral haubvise matura eHIV. vari kutsvaga mhando mbiri dzakasiyana dzekurapwa kweHIV, zvese izvi zvinogona kukanganisa matura eHIV:

• Basa rinoshanda. Rudzi urwu rwekurapa rwaizodzora kudzokororwa kweHIV kana pasina antiretroviral therapy.
• Sterilizing mushonga. Rudzi urwu rwekurapa rwunobvisa zvachose hutachiona hunokwanisa kudzokorodza.

Kuputsa hutachiona hweHIV

Vatsvagiri paUniversity yeIllinois kuUrbana-Champaign vanga vachishandisa mienzaniso yemakomputa kudzidza nezveHIV capsid. Iyo kapidhi ndiyo mudziyo wehutachiona hwechibereko. Inodzivirira hutachiona kubva pakuparadzwa nema immune system. Kunzwisisa kugadzirwa kweiyo capsid uye nemabatiro ainoita nemamiriro ayo kunogona kubatsira vatsvagiri kuwana nzira yekuivhura yakavhurika. Kutyora kapidhi kunogona kuburitsa hutachiona hweHIV mumuviri umo unogona kuparadzwa nema immune system. Iyo inovimbisa muganho mukurapa kweHIV uye kurapwa.

‘Kushanda pabasa’

Timothy Ray Brown, muAmerica aimbogara muBerlin, akabatwa chirwere cheHIV muna 1995 uye chirwere cheleukemia muna 2006. Ndiye mumwe wevanhu vaviri dzimwe nguva anonzi "murwere weBerlin." Muna 2007, Brown akagamuchira stem cell yekuisa kurapa leukemia - uye akamira antiretroviral therapy. HIV maari kubva pakaitwa nzira iyoyo. Ongororo dzezvikamu zvakawanda zvemuviri wake paUniversity yeCalifornia, San Francisco zvakamuratidza kuti haana hutachiwana hweHIV. Iye anoonekwa se "akanyatsopora," sekureva kwechidzidzo chakaburitswa muPLOS Pathogens. Ndiye munhu wekutanga kupora kubva kuHIV. Muna Kurume 2019, tsvagiridzo yakaitwa pachena kune vamwe varume vaviri avo vakagashira kuongororwa vane hutachiwana hweHIV negomarara. SaBrown, vese varume vakagashira maseru ekushandura kenza yavo. Varume vaviri ava vakamisa zvakare mishonga yemaantiretroviral mushure mekugamuchira magemenzi avo. Panguva yakatsvagirwa tsvagiridzo, "murwere weLondon" anga akwanisa kugara mukuregererwa kweHIV kwemwedzi gumi nemisere uye kuverenga. "Murwere weDusseldorf" anga akwanisa kugara mukuregererwa kweHIV kwemwedzi mitatu nehafu uye kuverenga.

Kwatiri ikozvino

Vanoongorora vakanzwisisa HIV makore makumi matatu apfuura, ndoda kuti marapwe sei. Kwemakumi emakore, kufambira mberi kwetekinoroji uye kugona kwehunyanzvi kwakaunza zvakanyanya kurapwa kweHIV. Kubudirira kweantiretroviral kurapwa ikozvino kunogona kumisa kufambira mberi kweHIV uye kudzikisira hutachiona hwemunhu kumatanho asingaonekwe. Kuva nehutachiona husingaonekwe hakungogadzirise hutano hwemunhu ane hutachiwana hweHIV chete, asi zvakare kunopedza njodzi yekuti vatapurire HIV kune wavanobata naye. Kurapa kwakanangana nemishonga kunogona kudzivirira vanhu vane nhumbu vane hutachiwana kubva mukutapurira hutachiona kuvana vavo. Gore rega rega, mazana emakiriniki ekuedzwa anovavarira kutsvaga zvirinani kurapwa kweHIV netarisiro yezuva rimwe chete yekuwana mushonga. Nemishonga mitsva iyi kunouya nzira dziri nani dzekudzivirira kutapukirwa kweHIV. Verenga chinyorwa ichi muchiSpanish.