Ɛyɛ ade a ɛfata sɛ wobɛte nka sɛ woayɛ basaa na wo ho adwiriw wo bere a wuhu sɛ wowɔ HIV no. Nanso ɛnyɛ wo nkutoo na wowɔ. Ɛnnɛ, aduruyɛ ho nyansahu anya nkɔso kɛse. HIV yɛ tebea a wotumi di so na wubetumi atra ase apɔwmuden, akyɛ. Akode a tumi wom sen biara a yɛwɔ ma eyi ne ART ayaresa. Enti ɛnnɛ, momma yɛnka nea ART ayaresa yi yɛ, nea ɛyɛ, ne sɛnea ɛyɛ adwuma sɛnea ɛbɛyɛ a wobɛte ase no ho asɛm tiawa koraa.
Dɛn ne ART ayaresa wɔ nsɛm a ɛnyɛ den mu?
ART yɛ asɛmfua a wɔatwa no tiaa ama Antiretroviral Therapy . Sɛ yɛbɛka no tiawa a, ɛyɛ nnuru a wɔaka abom a wɔde sa HIV yareɛ. HIV yɛ mmoawa a wɔtow hyɛ yɛn nipadua mu tumi a ɛko tia nyarewa no so. Ne titiriw no, CD4 nkwammoaa (a wɔsan frɛ no T-cells aboafo), a ɛyɛ adwuma te sɛ ‘asraafo’ wɔ yɛn nipadua mu no sɛe mmoawa yi. Sɛ CD4 nkwammoaa yi yera a, yɛn nipadua no ahobammɔ nhyehyɛe no bubu. Afei, hokwan a ɛwɔ hɔ sɛ obi benya nyarewa a emu yɛ den ne ɔyare mmoawa a anka ɛremma obi no dɔɔso kɛse.
Nea ɛho hia ne sɛ ART ntumi nsa HIV koraa, nanso ebetumi atew HIV mmoawa (viral load) dodow a ɛwɔ wo nipadua mu no so kɛse.
Sɛ ɔyare mmoawa no so tew a, wo nipadua no tumi yɛ CD4 nkwammoaa pii bio. Eyi hyɛ wo nipadua mu tumi a ɛko tia nyarewa no mu den na ɛbɔ wo ho ban fi nyarewa a emu yɛ den ho.
Mpɛn pii no, ART hwehwɛ sɛ wɔde nnuru abien kosi anan ka bom. Nnuru pii a ɛyɛ adwuma wɔ akwan horow so a wɔde ma no tu mpɔn sen sɛ wɔde nnuru biako pɛ bɛma. Ɛma asiane a ɛwɔ hɔ sɛ mmoawa no benya ahoɔden a ɛko tia nnuru no nso so tew.
Dɛn nti na wɔfrɛ eyi ‘Antiretroviral’?
HIV ka mmoawa kuw bi a wɔfrɛ wɔn Retroviruses ho . Mpɛn pii no, wɔde DNA (yɛn awosu mu nsɛm) a ɛwɔ yɛn nkwammoaa mu no na ɛyɛ RNA (nkrasɛm mfonini). Nanso saa Retrovirus yi yɛ nea ɛne eyi bɔ abira. Ɛne sɛ, ɛde RNA a ɛwɔ mu no yɛ DNA wɔ yɛn nkwammoaa mu. Ɛno nti na wɔfrɛ saa nnuru yi ‘Antiretroviral’ efisɛ ɛyɛ adwuma tia saa adeyɛ no. Ebia wobɛte sɛ wɔfrɛ wɔn ART, cART (ART a wɔaka abom) anaa HAART (ART a ɛyɛ adwuma kɛse). Eyinom nyinaa yɛ nsɛmfua a ɛkyerɛ ade koro.
Dɛn na ɛkyerɛ sɛ obi benya ɔyare mmoawa a ‘wontumi nhu’?
Eyi ne ART fã a ɛho hia na mfaso wɔ so sen biara. Sɛ wonom w’aduru no yiye a, HIV mmoawa (virus load) dodow a ɛwɔ wo mogya mu no so tew araa ma wontumi mfa nhwehwɛmu a wɔyɛ daa no nhu. Wɔfrɛ eyi sɛ ‘undetectable’ level. Wɔtaa kyerɛkyerɛ eyi mu sɛ mmoawa no dodow a ennu 20 wɔ mogya mililita biara mu (< 20 copies/mL).
‘Undetectable’ nkyerɛ sɛ wɔasa wo yare. Sɛ wugyae w’aduru nom a, mmoawa a wɔde asie wo nipadua mu no betumi ayɛ adwuma bio. Afei nso, sɛ woyɛ HIV nhwehwɛmu a, ɛbɛda so ara ada adi sɛ ‘ɛyɛ papa’ efisɛ saa nhwehwɛmu no hwehwɛ nnuru a ɛko tia mmoawa no, na ɛnyɛ mmoawa no ankasa.
Nanso kae eyi: Wontumi nhu = Wontumi mfa nkɔ (U=U) . Wei kyerε sε, sε wo virus load no da so ara wכ baabi a wontumi nhunu a, worentumi mfa nna mu mfa HIV nkɔma obi foforo. Eyi yɛ nea nyansahu ada no adi nnɛ. Afei nso, obi a ɔwɔ saa gyinabea yi betumi atra ase a ɛfata, akyɛ, te sɛ obi a onni HIV.
Ɔkwan bɛn so na ART yɛ adwuma? HIV mmoawa no ho asɛm
Sɛ yɛbɛte sɛnea aduru yi yɛ adwuma ase a, ɛsɛ sɛ yedi kan te sɛnea HIV mmoawa no hyɛn yɛn nkwammoaa mu na ɛyɛ ne ho mfonini ase.
Susuw HIV mmoawa no ho sɛ owifo. Wo CD4 nkwammoaa no yɛ ofie. Owifo yi hyɛn fie hɔ, de nnwinnade koro no ara di dwuma wɔ fie hɔ, yɛ ne ho mfonini pii bio, na ohuruw kɔ afie afoforo mu. Wɔ saa adeyɛ no mu no, wɔsɛe saa mfitiase fie no (CD4 nkwammoaa) no.
Anamɔn pii wɔ hɔ a wɔfa so yɛ saa adeyɛ yi. ART nnuru yɛ adwuma denam anammɔn yi biako anaa nea ɛboro saa a wogyae so.
| Anamɔn a wɔfa so yɛ | Adeyɛ a ɛkɔ so (wɔ nsɛm a ɛnyɛ den mu) . |
|---|---|
| 1. Nneɛma a wɔde bata ho | Virus no de ne protein no biako (GP120) di dwuma de bata ‘keyhole’ (receptor) bi a ɛwɔ yɛn CD4 nkwammoaa no ani ho. |
| 2. Nneɛma a wɔde bom | Virus no akyi abon no ne CD4 nkwammoaa no abon no bom. |
| 3. Nsɛm a wɔde hyɛ mu | Virus no 'adwinnade adaka' (Capsid) - kyerɛ sɛ, n'awosu mu nsɛm (RNA) ne enzymes a ehia na wɔde ayɛ mfonini ahorow - hyɛn nkwammoaa no mu. |
| 4. Nkyerɛwee a Wɔdannan no | Wɔde enzyme (reverse transcriptase) a mmoawa no de ba di dwuma de yɛ DNA fi mmoawa no RNA mu. Ɛte sɛ nea yɛrekyerɛ ahɔho kasa ase akɔ yɛn ankasa kasa mu. |
| 5. Nkabom | Mmoawa DNA a wɔayɛ no foforo no hyɛn yɛn nkwammoaa no nucleus mu na ɛne yɛn ankasa DNA bom. Eyi nam enzyme foforo a wɔfrɛ no ‘Integrase’ na ɛboa. Seesei yɛn nkwammoaa no susuw sɛ eyi nso yɛ n’ankasa fã. |
| 6. Nkyerɛwee & Nkyerɛase | Yɛn nkwammoaa, te sɛ wɔn ankasa DNA no, yɛ ɔyare mmoawa DNA yi bi, na afei wofi ase yɛ ɔyare mmoawa protein ahorow a egyina saa nkrasɛm no so. |
| 7. Nhyiam a wɔyɛ | Enzyme foforo bi a wɔfrɛ no ‘Protease’ ba, etwitwa protein asinasin a ayɛ yi, na ɛboaboa ano ma ɛyɛ mmoawa foforo. |
| 8. Budding & Nkwammoaa Owu | Mmoawa a wɔayɛ foforo no bɛsɛe CD4 nkwammoaa no, aguan, na wɔatow ahyɛ CD4 nkwammoaa afoforo a wɔwɔ apɔwmuden so. |
ART nnuru yɛ adwuma denam anammɔn a yɛaka ho asɛm wɔ atifi hɔ no biako a ɛde ne ho hyɛ mu no so. Nnuru bi siw mmoawa no kwan sɛ ɛnkɔ nkwammoaa no mu. Afoforo nso siw no kwan sɛ ɛnnyɛ DNA. Ebinom nso siw ano sɛ ɛnboaboa mmoawa foforo ano.
Nnuru bɛn na wɔde di dwuma wɔ ART ayaresa mu?
Wobetumi akyekyɛ ART nnuru mu akuw atitiriw pii. Kuw biara yɛ adwuma denam HIV mmoawa no asetra mu fã soronko bi a wɔde wɔn ani si so so.
- Nneɛma a esiw mmoawa no kwan: Eyinom mma mmoawa no ntumi nkɔ CD4 nkwammoaa no mu.
- Capsid Inhibitors: Siw mmoawa no ‘adwinnade adaka’ (Capsid) kwan sɛ emmue anaasɛ ɛnsan boaboa ano.
- Nucleoside Reverse Transcriptase Inhibitors (NRTIs): Sɛ mmoawa no yɛ DNA a, ɛma wonya birikisi ‘atoro’ a ɛte sɛ ‘birikisi’ a ohia. Sɛ wɔde eyinom di dwuma a, wontumi nwie DNA nkɔnsɔnkɔnsɔn no.
- Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTIs): Eyinom kɔ enzyme a ɛyɛ DNA (Reverse Transcriptase) no nkyɛn tẽẽ na ɛma ɛnyɛ adwuma.
- Integrase Inhibitors (INSTIs): Siw enzyme (integrase) a ɛka mmoawa DNA bom kɔ yɛn nkwammoaa DNA ho no ano.
- Protease Inhibitors (PIs): Siw enzyme a ɛtwa protein (protease) no kwan sɛ ɛnboaboa mmoawa foforo ano.
- Pharmacokinetic Enhancers (Boosters): Eyinom nnya mmoawa no so nkɛntɛnso tẽẽ, na mmom ɛboa ma ART nnuru afoforo tra nipadua no mu kyɛ na ɛdɔɔso.
Mpɛn pii no, nnuru a wɔde ma wo no yɛ saa akuw yi pii a wɔaka abom. Sɛ nhwɛso no, ebetumi ayɛ aduru biako a wɔde NRTI abien ne integrase inhibitor ayɛ.
Mɛyɛ dɛn apaw ART aduru a ɛfata ama me?
Oduruyɛfo a ɔresa wo yare no bɛkyerɛ nnuru a wɔde bɛka abom a ɛfata sen biara ama wo bere a wasusuw nneɛma pii ho awie no.
- Wo mmoawa dodow ne CD4 dodow: Ɛho hia sɛ wuhu nea saa gyinapɛn ahorow yi yɛ bere a worefi ayaresa ase no.
- Nnuru a mmoawa no tumi ko tia: Ɛtɔ mmere bi a, mmoawa no tumi ko tia nnuru bi. Wobetumi ayɛ sɔhwɛ bi de ahu.
- Sɛ wowɔ ayaresa tebea foforo biara, te sɛ asaabo mu yare, mmerɛbo mu yare, komayare, asikreyare, anaa srade a ɛdɔɔso a, ɛsɛ sɛ woka ho asɛm kyerɛ wo duruyɛfo.
- Nnuru afoforo a worenom: Sɛ worenom nnuru a wɔde sa tebea foforo biara a, ebia nkitahodi bɛda saa nnuru no ne ART nnuru no ntam.
- Nyinsɛn: Sɛ woanyinsɛn anaa woreyɛ nhyehyɛe sɛ wubenyinsɛn a, nnuru bi wɔ hɔ a ahobammɔ wom a ɛfata wo.
- Ɛnyɛ den sɛ wobɛnom aduru no: Susuw sɛ ebia ɛyɛ aduru a wɔde di dwuma pɛnkoro da biara anaa nea wɔde di dwuma mprenu da biara, sɛ ebia ɛsɛ sɛ wonom ka aduan ho anaasɛ wɔmfa nni dwuma, ne sɛnea ɛne w’asetra kwan hyia no ho.
Mfaso ne asiane bɛn na ɛwɔ ART ayaresa so?
Mfaso a ɛwɔ so
- Nkwammoaa a ɛko tia nyarewa a wɔbɛhyɛ mu den: CD4 nkwammoaa dodow kɔ soro, na ɛma wo nipadua no tumi ko tia nyarewa no yɛ kɛse.
- Ahobammɔ a wɔbɔ fi nyarewa a emu yɛ den ho: HIV tumi bɔ obi ho ban fi nyarewa a ɛma hokwan te sɛ ahurututu mu yare ne nsamanwaw ho.
- Kokoram ho asiane a ɛso tew: Asiane a ɛwɔ hɔ sɛ obi benya kokoram a ɛfa HIV ho (e.g. Kaposi sarcoma, non-Hodgkin lymphoma) so tew.
- AIDS a wobesiw ano: Sɛ wɔansa a, HIV yare no betumi akɔ so akodu nea etwa to a wɔfrɛ no AIDS (Acquired Immunodeficiency Syndrome). ART gyae eyi.
- Nyarewa a wobesiw ano ama afoforo:Sɛnea yɛadi kan aka no (U=U) , sɛ wontumi nhu wo mmoawa a ɛwɔ wo mu no a, worentumi mfa nna so ntrɛw nkɔ afoforo mu.
- Apɔwmuden, nkwa tenten: Obi a ɔnom nnuru yiye no betumi atra ase sɛnea ɛsɛ, te sɛ obi a onni HIV.
Asiane ne nea efi mu ba
Ebia nnipa binom benya nsunsuanso bɔne bere a wodi kan fi ase ART no. Nanso, eyinom taa yɛ bere tiaa mu de na ɛkɔ adapɛn kakraa bi akyi bere a nipadua no reyɛ nsakrae wɔ aduru no ho no.
- Akisikuru, ɔfe
- Yafunu mu yare, akisikuru
- Tipaeɛ
- Adwene a ɛyɛ basaa
- Ɔbrɛ, ɔbrɛ
- Asoroben
- Wora a ɛyɛ mmerɛw
Sɛ wuhu saa sɛnkyerɛnne ahorow yi bi a, nnyae wo nnuru nom na ka kyerɛ wo duruyɛfo. Obetumi aboa wo ma woanya ano aduru anaasɛ sɛ ɛho hia a, ɔbɛdan wo akɔ aduru foforo a ɛfata wo so. Nnuru bi betumi anya nsunsuanso bɔne a ɛtra hɔ kyɛ, te sɛ wo srade dodow a ɛkɔ soro. Ɛno nti na wo duruyɛfo bɛhwɛ wo daa no.
Wobɛyɛ dɛn ahwɛ sɛnea ayaresa no di yiye?
Sɛ wufi ase yɛ ART wie a, wo duruyɛfo no bɛhwɛ wo wɔ nhyehyɛe pɔtee bi mu. Ɔbɛyɛ sɔhwɛ atitiriw abien.
| Sɔhwɛ | Nea wɔhwɛ kwan sɛ ebefi mu aba | Mpɛn dodow a wɔde yɛ adwuma |
|---|---|---|
| Viral Load a Wɔde Di Dwuma | Saa botae yi so atew akodu ‘undetectable’ level. | Mpɛn pii no wɔ asram kakraa a edi kan no mu bere a wɔafi ase akyi, afei asram 3-6 biara. |
| CD4 nkwammoaa dodow (CD4 Dodow) . | Saa bo yi kɔ soro . (Akwahosan dodow yɛ 500-1500 ntam) | Mfiase no asram 3-6 biara, afei sɛnea ɛho hia. |
Mma da koro mpo a wobɛnom w’aduru no nmpa wo ti so!
Asɛnnennen kɛse a ɛwɔ hɔ ma ART ayaresa no nkonimdi neNom w’aduru da biara, wɔ bere a ɛfata mu, a da koro mpo nmpa wo ti so. Sɛ wopa dodow bi a, mmoawa no wɔ hokwan sɛ ɛbɛdɔɔso bio wɔ wo nipadua mu. Sɛ ɛba saa a, mmoawa no betumi ayɛ nea ɛko tia aduru a worenom (nnuru a ɛko tia). Afei aduru no begyae adwumayɛ na ɛsɛ sɛ wokɔ ayaresa afoforo. Enti, ɛho hia sɛ wonom w’aduru no bere ano, sɛ́ ebia wode nkaebɔ bi besi wo fon so anaasɛ wobɛka akyerɛ w’abusua muni bi sɛ ɔnkae wo.
Nkrasɛm a Wɔde Kɔ Fie
- ART yɛ aduru a egye nkwa a esiw HIV yare mmoawa ano. Bere a entumi nsa HIV no, ebetumi aboa wo ma woanya apɔwmuden, nkwa tenten.
- Ɛho hia sɛ wobɛnom w’aduru no da biara ne bere ano. Sɛ wopa wo dodow a wode ma no a, mmoawa no betumi ayɛ nea ɛko tia aduru no.
- Sɛ mmoawa dodoɔ a ɛwɔ wo mogya mu no ‘ntumi nhunu’ a, worentumi mfa nna mu HIV nkɔma obi foforɔ (U=U).
- Nsunsuanso bɔne betumi aba ntɛm wɔ ayaresa mu, nanso mpɛn pii no ɛyɛ bere tiaa mu de. Wo ne wo duruyɛfo nkasa mfa ɔhaw biara a ɛbɛba no ho.
- HIV yɛ yare foforo a enni sabea ara kwa. Sɛ wonya ayaresa na wodi ho dwuma yiye a, wubetumi atra ase a ɛyɛ anigye. Ɛnyɛ wo nko ara.
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