Phekolo ea Triple e Fetotse Seoa sa HIV ho pota
HAART ke mantsoe a hlalosang "phekolo ea meriana e matlafatsang ea antiretroviral," e leng lentsoe le entsoeng ho elella bofelong ba lilemo tsa bo-1990 ho hlalosa katleho ea meriana e sebelisoang ho phekola HIV.
Pele ho HAART, tšebeliso ea meriana e le 'ngoe kapa e' meli ea li-antiretroviral e ne e atisa ho fokotsa katleho ho bakuli ba nang le HIV, e leng se fellang ka ho hlōleha kalafo ka potlako hammoho le ho se khone ho thibela ka ho feletseng tšoaetso ea kokoana-hloko.
E ne e le ka kenyelletso ea protease inhibitors ka 1996 hore lingaka li khonne ho kopanya lisebelisoa tse tharo kapa tse ling tsa lithethefatsi ka tsela e atlehang ho thibela tšoaetso ea HIV ho pheta-pheta lintlheng tse sa tšoaneng bophelong ba eona. Ha ho fihla HAART, lingaka le bo-rasaense ba ile ba khona ho bona lerothola le tšosang la 50% palo ea mafu a amanang le AIDS US le Europe nakong ea lilemo tse tharo (1995-1999).
Ho phaella ho HAART, mekhoa e mengata ea lithethefatsi e ne e tsejoa hape e le "phekolo e tharo" kapa "liaparo tse tharo tsa lithethefatsi."
Kajeno, lentsoe lena le 'nile la nkeloa sebaka ke li-moniker tse ling, ho akarelletsa le' mala (motsoako oa li-antiretroviral therapy) kapa, esita le ho feta feela, ART (antiretroviral therapy).
HaART Works
Ho fapana le lithethefatsi tse le mong kapa lithethefatsi tse peli tsa moriana, motsoako oa li-antiretroviral tse tharo kapa ho feta li ka sebetsana le sehlopha sa tag, ka katleho li thibela HIV e fapaneng e ka ba teng ka har'a kokoana-hloko e le 'ngoe.
Haeba lithethefatsi tse ling li sa khone ho thibela mofuta o mong oa likokoana-hloko, e mong kapa bobeli ba moemeli e mong o tla ba monyetla o moholo oa ho etsa joalo.
Ka lehlakoreng le leng, ka ho boloka tšoaetso ea kokoana-hloko e fokolisitsoe (e sa bonahaleng ), ho na le likokoana-hloko tse fokolang maling a 'maloa le menyetla e fokolang ea kokoana-hloko ea ho fetola bothata ba ho hanyetsa.
Ke kahoo litsela tsa pele ho HAART li atisang ho hlōleha ka potlako hakaalo: baahi ba fokolang ba mongobo ba lumelloa ho phehella 'me qetellong ba eketseha ka palo ho ba khatello ea bongata ba kokoana-hloko. Ha sena se etsahala, lithethefatsi ha li sa khona ho emisa HIV ho li pheta-pheta, boemo boo re bo hlalosang e le "ho hanyetsa lithethefatsi."
Lithethefatsi Tse Sebelisitsoeng HAART
Hona joale ho na le lihlopha tse hlano tsa meriana ea mafu a khahlanong le kokoana -hloko , e 'ngoe le e' ngoe e thibelang sethaleng se itseng sa bophelo ba HIV:
- ho kena kapa fusion inhibitors (e kenyeletsang bahanyetsi ba CCR5)
- nucleoside le nucleotide reverse transcriptase inhibitors (NRTI / NtRTI)
- e seng nucleoside reverse transcriptase inhibitors (NNRTI)
- integrase inhibitors
- protease inhibitors
Lihlopha tse ling tsa li-antiretroviral li ntse li phenyekolloa, ha lithethefatsi tse ncha li hlaha ho ntlafatsa ho mamella, ho fokotsa liphello tse mpe le ho nolofalletsa li-dosing bakeng sa ba phekoloang.
Bokamoso ba HAART
Ntle le ho fana ka khatello ea nako e telele ea HIV ho batho ba nang le tšoaetso, HAART e se e sebelisoa e le mokhoa oa ho fokotsa litekanyetso tsa tšoaetso ho batho ba bangata ba kotsing e kholo. Leano, le tsejoang e le ts'oaetso e le thibelo (TasP) , e bontšitsoe ho fokotsa "tšoaetso ea kokoana-hloko ea sechaba" har'a baahi, ho etsa hore ho be thata haholo ho fetisetsa tšoaetso ho motho ea nang le tšoaetso ho motho ea sa tšoaetsoeng.
Ho feta moo, HAART e bontšitsoe ho fokotsa kotsi ea hore mafu a mabeli a HIV le a se nang HIV a kenyeletsane le mafu a pelo. Ka lebaka leo, hona joale ho khothalletsoa hore HAART e qalisoe ho batho bohle ba nang le HIV , ho sa tsotellehe boemo ba 'mele oa ho itšireletsa mafung, chelete, sebaka sa morabe, morabe, kapa tšoaetso ea kokoana-hloko ea HIV.
Khopolo ea HAART e ka 'na ea fetoha le ho ntlafatsoa ha lithethefatsi tsa meriana ea mafu a mangata a sa feleng (mohlomong ho lumella liente tse ts'oaroang ka khoeli le kotara) le lithethefatsi tse latelang tsa moloko o ikemiselitseng ho theola litebelisoa tsa meriana tse tharo tsa lithethefatsi bakeng sa lithethefatsi tse seng kae feela.
Mekhoa e 'meli e meholo ea Phase III, e bitsoang SWORD-1 le SWORD-2, e bontšitse hore tšebeliso ea Tivicay (dolutegravir) le Edurant (rilpivirine) e entse hore ho be le tšoaetso e matla ea kokoana-hloko ea libeke tse 48 e nang le litla-morao tse fokolang. Teko e 'ngoe e menyenyane, e bitsoang thuto ea LAMIDOL, e bontšitse hore Tivicay e sebelisitsoeng le lamivudine (e leng moloko o moholo oa lithethefatsi) e na le monyetla oa ho fihlela liphello tse tšoanang ho bakuli ba neng ba kile ba tšoaroa pele.
Lisebelisoa:
> Sinone, G. le Frengley, J. "Tšusumetso ea HAART ka Mabaka a Lefu la Batho ba nang le AIDS nakong e telele." Journal of Health Urban. June 2000; 77 (2): 166-75.
> Cohen, M .; Chen, Y .; McCauley, M .; et al. "Thibelo ea HIV-1 tšoaetso ea pele ea kokoana-hloko ea li-antiretroviral." New England Journal of Medicine. La 11 August, 2011; 365 (6): 493-505.
> INSIGHT QALANG Sehlopha sa Thuto. "Tlhahlobo ea Phekolo ea Antiretroviral nakong ea Bokhachane ba Pele ba HIV." New England Journal of Medicine. La 20 July, 2015; DOI: 10.1056 / NEJMoa1506816.
> Llibre, J .; Hung, C .; Brinson, C .; et al. "Phase III SWORD 1 & 2: swithela ho DTG + RPV e boloka virologic ho hatella ka 48 wks." Tlhahlobo ea 2017 ka li-Retroviruses le mafu a mang a ts'oaetsoang (CROI); La 13-16 February, 2017; Seattle; e hlakileng 44LB
> Joly, V .; Burdet, C ;; Landman, R .; et al. "Liphetho tse tšepisang tsa" tlhokomelo ea > dolutegravir > + lamivudine ho ANRS 167 > LAMIDOL > teko. " Tlhahlobo ea 2017 ka li-Retroviruses le mafu a mang a ts'oaetsoang (CROI); La 13-16 February, 2017; Seattle; e hlakileng 458.