Rahoton Ci Gaban HIV: Shin Muna Kusa Da Warkewa?

Wadatacce

• Alurar rigakafi
• Tsarin rigakafi
• Pre-daukan hotuna prophylaxis (PrEP)
• Bayanin kamuwa da cutar bayan fage (PEP)
• Ganewar asali
• Matakai don magani
• Undetectable yayi daidai da baza a iya watsa shi ba
• Milestones a cikin bincike
• Allurar wata-wata
• Niyya kan madatsun ruwan HIV
• Rage kwayar cutar HIV
• 'An warkar da aiki'
• Inda muke yanzu

Bayani

HIV yana raunana garkuwar jiki kuma yana hana ƙarfin jiki don yaƙar cuta. Ba tare da magani ba, HIV na iya haifar da mataki na 3 na HIV, ko AIDS.

Cutar AIDS ta fara ne a cikin Amurka a cikin 1980s. Kimanin mutane sama da miliyan 35 ne suka mutu daga cutar.

Babu halin warkar da cutar kanjamau a halin yanzu, amma yawancin karatun asibiti an sadaukar dasu don binciken magani. Magungunan riga-kafi na yanzu suna ba wa masu ɗauke da kwayar cutar HIV damar hana ci gabarsa da kuma rayuwa daidai da rayuwa.

An sami ci gaba sosai game da rigakafi da maganin cutar kanjamau, godiya ga:

• masana kimiyya
• jami'an kiwon lafiyar jama'a
• hukumomin gwamnati
• kungiyoyi masu zaman kansu
• Masu gwagwarmayar HIV
• kamfanonin harhada magunguna

Alurar rigakafi

Kirkirar allurar rigakafin cutar kanjamau zai kare miliyoyin rayuka. Koyaya, masu bincike basu riga sun gano ingantaccen maganin rigakafin cutar kanjamau ba. A cikin 2009, binciken da aka buga a cikin Journal of Virology ya gano cewa wani maganin rigakafi na gwaji ya hana kusan kashi 31 cikin dari na sabbin masu kamuwa da cutar. Wasarin bincike an dakatar da shi saboda haɗarin haɗari. A farkon shekara ta 2013, Cibiyar Kula da Allergy da Cututtuka na Nationalasa ta dakatar da gwajin asibiti wanda ke gwada allurar rigakafin HVTN 505. Bayanai daga gwajin sun nuna allurar rigakafin bata hana yaduwar kwayar HIV ko rage adadin kwayar cutar HIV a cikin jini. Ana ci gaba da bincike kan allurar rigakafin a duk duniya. Kowace shekara akwai sababbin abubuwan da aka gano. A cikin 2019, sun sanar da cewa sun haɓaka ingantaccen magani yana basu damar:

1. injiniya wasu ƙwayoyin garkuwar don sake kunnawa HIV a cikin ƙwayoyin da ke ɗauke da HIV, ko ɓoye
2. yi amfani da wani tsari na tsarin garkuwar jikin dan adam don kai hari da cire kwayoyin halitta tare da sake kunnawa HIV

Abubuwan da suka samo na iya samar da tushe na rigakafin HIV. Gwajin gwaji na cikin aiki.

Tsarin rigakafi

Kodayake har yanzu babu maganin rigakafin HIV, akwai sauran hanyoyin kariya daga yaduwar cutar. Ana kamuwa da kwayar cutar HIV ta hanyar musayar ruwan jiki. Wannan na iya faruwa ta hanyoyi da dama, gami da:

• Saduwa da jima'i. Yayin saduwa da jima'i, ana iya daukar kwayar cutar ta HIV ta hanyar musayar wasu ruwaye. Sun hada da jini, maniyyi, ko dubura da farji. Samun wasu cututtukan da ake ɗauka ta hanyar jima'i (STIs) na iya ƙara haɗarin kamuwa da kwayar cutar HIV yayin jima'i.
• Raba allurai da sirinji. Allura da sirinji da mutum ya yi amfani da ita na iya ɗauke da kwayar, ko da kuwa ba a ga jini a jiki ba.
• Ciki, haihuwa, da shayarwa. Iyayen da ke dauke da kwayar cutar ta HIV suna iya yada kwayar cutar ga jaririnsu kafin da bayan haihuwa. A lokutan da ake amfani da maganin cutar kanjamau, wannan ba safai ba.

Daukar wasu matakan kariya na iya kare mutum daga kamuwa da kwayar HIV:

• Yi gwajin cutar kanjamau. Tambayi abokan hulɗa game da matsayinsu kafin yin jima'i.
• Yi gwaji kuma a kula da cutar ta STI. Tambayi abokan hulɗa su yi hakan.
• Lokacin shiga cikin jima'i, farji, da kuma dubura, amfani da hanyar kariya kamar kwaroron roba kowane lokaci (kuma yi amfani dashi daidai).
• Idan allurar ƙwayoyi, ka tabbata ka yi amfani da sabon, allurar haifuwa wanda ba kowa yayi amfani da shi ba.

Pre-daukan hotuna prophylaxis (PrEP)

Rigakafin kamuwa da cutar (PrEP) magani ne na yau da kullun da mutane ke amfani da shi ba tare da HIV ba don rage damar kamuwa da kwayar ta HIV, idan an fallasa ta. Yana da matukar tasiri wajen hana yaduwar kwayar HIV a cikin waɗanda ke da sanannun abubuwan haɗari. Yawan mutanen da ke cikin haɗari sun haɗa da:

• maza masu yin jima'i da maza, idan sun yi jima'i ta dubura ba tare da amfani da kwaroron roba ba ko kuma sun yi jima'i a cikin watanni shida da suka gabata
• maza ko matan da ba sa amfani da hanyar kariya kamar kwaroron roba a kai a kai kuma suna da abokan haɗin gwiwa tare da ƙarin haɗarin cutar HIV ko matsayin cutar HIV ba a sani ba
• duk wanda ya raba allurai ko ya yi amfani da allura a cikin watanni shida da suka gabata
• matan da suke tunanin yin juna biyu tare da abokan da ke dauke da kwayar cutar HIV

Dangane da, PrEP na iya rage barazanar kamuwa da kwayar cutar HIV daga jima'i da kusan kashi 99 cikin dari na mutanen da sanannun abubuwan haɗarin HIV. Don PrEP yayi tasiri, dole ne a sha shi yau da kullun. Duk wanda ke cikin haɗarin kamuwa da kwayar cutar HIV ya kamata ya fara tsarin PrEP, bisa ga shawarar baya-bayan nan daga kungiyar Servicesungiyar Ayyuka ta Rigakafin Amurka.

Bayanin kamuwa da cutar bayan fage (PEP)

Bayanin kamuwa da cutar bayan fage (PEP) haɗuwa ce da magungunan rigakafin gaggawa. Ana amfani da shi bayan da wani ya iya fuskantar cutar HIV. Ma'aikatan kiwon lafiya na iya ba da shawarar PEP a cikin yanayi masu zuwa:

• Mutum na tsammanin wataƙila sun kamu da cutar HIV yayin jima'i (misali, kwaroron roba ya karye ko ba a yi amfani da robaron roba ba).
• Mutum ya raba allurai yayin allurar ƙwayoyi.
• An yiwa mutum fyade.

PEP kawai za'a yi amfani dashi azaman hanyar rigakafin gaggawa. Dole ne a fara shi tsakanin awanni 72 na yiwuwar ɗaukar cutar HIV. Da kyau, ana farawa PEP kusa da lokacin ɗaukar hoto kamar yadda zai yiwu. PEP yawanci ya ƙunshi wata guda na bin maganin cutar kanjamau.

Ganewar asali

Gano cutar kanjamau da kanjamau muhimmin mataki ne na hana yaduwar kwayar ta HIV. A cewar UNAIDS, wani sashe na Majalisar Dinkin Duniya (UN), kusan kashi 25 na mutanen da ke dauke da kwayar cutar ta HIV a duniya ba su san matsayin su na HIV ba. Akwai gwaje-gwaje daban-daban na jini da masu ba da kiwon lafiya za su iya amfani da su don bincika kanjamau. Gwajin kanjamau kai tsaye yana bawa mutane damar gwada bakinsu ko jininsa a wani kebantaccen wuri kuma su sami sakamako cikin mintuna 20 ko ƙasa da hakan.

Matakai don magani

Godiya ga ci gaban kimiyya, ana ɗaukar cutar HIV wata cuta mai saurin magancewa. Maganin rigakafin cutar yana ba mutanen da ke ɗauke da kwayar cutar HIV kula da lafiyarsu. Hakanan yana rage haɗarin su na yada kwayar cutar ga wasu. Kusan kashi 59 na duk mutanen da ke ɗauke da kwayar cutar ta HIV suna karɓar wani nau'in magani, a cewar UNAIDS. Magungunan da ake amfani da su don magance cutar HIV suna yin abubuwa biyu:

• Rage kayan kwayar cuta. Kwayar kwayar cuta shine ma'auni na yawan kwayar cutar HIV RNA a cikin jini. Manufar maganin cutar kanjamau ita ce ta rage kwayar cutar zuwa matakin da ba za a iya gano shi ba.
• Bada izinin jiki ya dawo da adadi na CD4 na al'ada. Kwayoyin CD4 suna da alhakin kare jiki daga ƙwayoyin cuta waɗanda ke haifar da kwayar cutar HIV.

Akwai nau'ikan magungunan kwayar cutar kanjamau da dama:

• Wadanda ba masu hana yaduwar kwayar halitta ba (nucleoside) (NNRTIs) dakatar da sunadarin da HIV ke amfani dashi don kwafin kwayar halittar sa a cikin kwayoyin halitta.
• Masu hana kwafin kwayar cutar ta Nucleoside (NRTIs) ba kwayar cutar HIV matsala saboda haka ba zata iya yin kwafin kwayar halittarta a cikin kwayoyin halitta ba.
• Masu hana kariya dakatar da enzyme wanda HIV ke buƙatar yin kwafin aiki na kansa.
• Shigarwa ko masu hana fuska hana HIV shiga cikin ƙwayoyin CD4.
• Cire masu hanawa hana haɗin aiki. Ba tare da wannan enzyme ba, HIV ba zai iya shigar da kansa cikin kwayar CD4 ta DNA ba.

Magungunan HIV sau da yawa ana ɗauka a cikin takamaiman haɗuwa don hana ci gaban juriya da ƙwayoyi. Dole ne a sha magungunan HIV koyaushe don yin tasiri. Mutumin da ke dauke da kwayar cutar HIV ya kamata ya yi magana da mai ba shi kiwon lafiya kafin ya yi tunanin sauya magunguna don rage illa ko saboda gazawar magani.

Undetectable yayi daidai da baza a iya watsa shi ba

Bincike ya nuna cewa cimmawa da kuma kiyaye nauyin kwayar cutar da ba a iya ganowa ta hanyar maganin cutar kanjamau yadda ya kamata yana kawar da barazanar yada kwayar cutar HIV ga abokin zama. Babban binciken bai gano wani yanayi na yaduwar kwayar cutar ta HIV ba daga wanda ya kamu da cutar (kwayar cutar da ba a iya ganowa ba) mai dauke da kwayar cutar ta HIV zuwa ga mai cutar ta HIV. Wadannan karatuttukan sun biyo dubban ma'aurata masu hadewa cikin shekaru da yawa. Akwai dubunnan lokuta na jima'i ba tare da kwaroron roba ba. Tare da fahimtar cewa U = U ("undetectable = untransmittable") ya zo mafi girma girmamawa a kan "magani a matsayin rigakafin (TasP)." UNAIDS na da burin "90-90-90" don kawo ƙarshen cutar ta AIDS. Zuwa 2020, wannan shirin yana nufin:

• Kashi 90 na duk mutanen da ke dauke da kwayar cutar HIV su san matsayin su
• Kashi 90 na duk mutanen da suka kamu da kwayar cutar HIV suna shan maganin rage kaifin cutar
• Kashi 90 cikin 100 na duk mutanen da ke karɓar maganin rigakafin cutar za a kashe su sosai

Milestones a cikin bincike

Masu bincike suna aiki tuƙuru don neman sababbin magunguna da kuma maganin cutar HIV. Suna nufin neman hanyoyin kwantar da hankali wanda ke karawa da inganta yanayin rayuwa ga mutanen da ke wannan yanayin. Bugu da kari, suna fatan samar da allurar rigakafi da gano maganin cutar kanjamau. Anan akwai taƙaitaccen ra'ayi akan hanyoyi masu mahimmanci masu yawa na bincike.

Allurar wata-wata

An shirya yin allurar kwayar cutar HIV kowane wata a farkon shekara ta 2020. Ya haɗu da magunguna biyu: mai haɗa maganin hana cabotegravir da NNRTI rilpivirine (Edurant). Nazarin asibiti ya gano cewa allurar kowane wata tana da tasiri wajen kawar da kwayar HIV kamar yadda ake amfani da ita yau da kullun na magunguna uku.

Niyya kan madatsun ruwan HIV

Wani ɓangare na abin da ke sa gano maganin cutar kanjamau abu ne mai wuya shine cewa garkuwar jiki tana da matsala game da niyyar matattarar ɗakunan ƙwayoyin cuta tare da HIV. Tsarin rigakafi yawanci ba zai iya gane ƙwayoyin da ke ɗauke da kwayar cutar HIV ba ko kuma kawar da ƙwayoyin da ke ƙwayoyin ƙwayoyin cuta masu ƙwazo. Maganin rigakafin rigakafin ƙwayar cuta ba ya kawar da tafkunan HIV. suna binciken magunguna iri biyu na kwayar HIV, duka biyun da zasu iya lalata magunan HIV:

• Maganin aiki. Irin wannan maganin zai iya sarrafa kwayar cutar HIV idan babu maganin rigakafin cutar.
• Magungunan haifuwa Irin wannan maganin zai kawar da kwayar cutar da ke iya kwafin ta gaba daya.

Rage kwayar cutar HIV

Masu bincike a jami’ar Illinois da ke Urbana-Champaign suna amfani da kwaikwayon kwamfuta don nazarin kwayar cutar HIV. Capsid shine akwati don kayan kwayar cutar. Yana kare kwayar cutar daga garkuwar jiki. Fahimtar kayan kwalliyar da yadda take hulɗa da muhallin ta na iya taimaka wa masu bincike gano hanyar buɗe ta. Karya kapsid na iya sakin kwayoyin halittar kwayar cutar HIV a cikin jiki inda za a iya lalata shi ta hanyar garkuwar jiki. Yana da alamar iyaka a cikin maganin cutar kanjamau da magani.

'An warkar da aiki'

Timothy Ray Brown, Ba’amurke da ya taba zama a Berlin, ya sami cutar kanjamau a 1995 kuma ya kamu da cutar sankarar bargo a 2006. Yana daya daga cikin mutane biyu da wasu lokuta ake kira “mai haƙuri na Berlin.” A shekara ta 2007, Brown ya karɓi dashen ƙwayar ƙwayar cuta don magance cutar sankarar bargo - kuma ya dakatar da maganin cutar kanjamau. HIV a cikin shi tun lokacin da aka aiwatar da wannan aikin. Nazarin sassan jikinsa da yawa a Jami'ar California, San Francisco ya nuna cewa ba shi da kwayar cutar HIV. An dauke shi "ya warke yadda ya kamata," a cewar wani binciken da aka buga a PLOS Pathogens. Shine mutum na farko da ya warke daga cutar HIV. A watan Maris na 2019, bincike ya bayyana ga wasu mazaje biyu da suka sami cutar kanjamau da kansar. Kamar Brown, duka mutanen biyu sun sami dashen ƙwayoyin halitta don magance kansar su. Dukkanin mutanen sun kuma dakatar da maganin rage kaifin cutar bayan sun karbi dashensu. A lokacin da aka gabatar da binciken, "mai haƙuri London" ya sami damar kasancewa a cikin gafarar cutar HIV har tsawon watanni 18 da kirgawa. "Mai haƙuri Dusseldorf" ya iya kasancewa a cikin gafarar cutar HIV har tsawon watanni uku da rabi yana lissafawa.

Inda muke yanzu

Da kyar masu bincike suka fahimci kwayar cutar ta HIV shekaru 30 da suka gabata, balle yadda za a warkar da ita ko kuma warkar da ita. A cikin shekarun da suka gabata, ci gaba a fasaha da ƙwarewar likita sun kawo ci gaba da magungunan HIV. Magungunan antiretroviral masu nasara na iya dakatar da ci gaban kwayar cutar HIV da rage rage kwayar cutar kwayar mutum zuwa matakan da ba a iya ganowa. Samun nauyin kwayar cutar da ba a iya ganowa ba kawai inganta lafiyar mutumin da ke dauke da kwayar cutar HIV ba ne, amma kuma yana kawar da haɗarin da ke tattare da su na yada kwayar cutar ta HIV zuwa ga abokin tarayya. Har ila yau, maganin shan magani na musamman zai iya hana masu juna biyu masu dauke da kwayar cutar ta HIV daukar kwayar cutar zuwa ga 'ya'yansu. Kowace shekara, ɗaruruwan gwaje-gwaje na asibiti na nufin neman ko da mafi kyawun maganin cutar kanjamau da fatan samun wata rana. Tare da wadancan sabbin magungunan sun zama ingantattun hanyoyin hana yaduwar kwayar HIV. Karanta wannan labarin a cikin Mutanen Espanya.