Enye nusi sɔ be nàse le ɖokuiwò me be nu te ɖe ye dzi eye yeƒe mo wɔ yaa ne èva nya be HIV le ye ŋu. Gake menye wò ɖeka koe o. Egbea la, atikewɔwɔ ŋuti dzɔdzɔmeŋutinunya de ŋgɔ ŋutɔ. HIV nye nɔnɔme si dzi woate ŋu aɖu eye àte ŋu anɔ agbe le lãmesẽ me, eye wòanɔ agbe didi. Aʋawɔnu sesẽtɔ kekeake si le mía si na esiae nye ART zazã. Eyata egbea, mina míaƒo nu tso nusi ART-dɔdamɔnu sia nye, nusi wòwɔna, kple alesi wòwɔa dɔe ŋu bɔbɔe ŋutɔ ale be nàse egɔme.
Nukae nye ART-dɔdamɔnu le nya bɔbɔewo me?
ART nye Antiretroviral Therapy ƒe kpukpui . Kpuie ko la, enye atike siwo wonana tsɔ daa HIV dɔlékuia ƒe ƒuƒoƒo. HIV nye dɔlékui si dzea míaƒe ŋutilã ƒe dɔlélenutsiŋutete dzi. Etɔxɛe la, CD4 lãmenugbagbeviwo (siwo woyɔna hã be kpeɖeŋutɔ T-lãmenugbagbeviwo), siwo wɔa dɔ abe ‘asrafowo’ ene le míaƒe ŋutilã me la, tsrɔ̃a dɔlékui sia. Ne CD4 lãmenugbagbevi siawo bu la, míaƒe ŋutilã ƒe ametakpɔnu la mu. Emegbe mɔnukpɔkpɔ si li be woaxɔ dɔléle sesẽwo kple dɔlékui siwo madzɔ le dzɔdzɔme nu o la lolo wu sã.
Nu vevitɔe nye be ART mate ŋu ada HIV dɔlékuia keŋkeŋ o, gake ate ŋu aɖe HIV dɔlékui (dɔlékui ƒe agbɔsɔsɔ) ƒe agbɔsɔsɔ si le wò ŋutilã me dzi akpɔtɔ ŋutɔ.
Ne dɔlékuiwo ƒe agbɔsɔsɔ dzi ɖe kpɔtɔ la, wò ŋutilã gate ŋu wɔa CD4 lãmenugbagbevi geɖe ake. Esia doa ŋusẽ wò dɔlélenutsiŋutete eye wòkpɔa tawò tso dɔlékui sesẽwo me.
Zi geɖe la, ART lɔ atike eve va ɖo ene ƒokpli ɖe eme. Atike geɖe siwo wɔa dɔ le mɔ vovovowo nu nana wɔa dɔ wu atike ɖeka ko nana. Eɖea afɔku si le dɔlékuia ƒe dɔlélenutsiŋutete ɖe atikeawo ŋu hã dzi kpɔtɔna.
Nukatae woyɔa esia be ‘Antiretroviral’?
HIV le dɔlékuiwo ƒe ƒuƒoƒo aɖe si woyɔna be Retroviruses me . Zi geɖe la, DNA (míaƒe domenyiŋusẽfianu ŋuti nyatakakawo) si le míaƒe lãmenugbagbeviwo me ye wɔa RNA (gbedasi ƒe kɔpiwo). Gake Retrovirus sia wɔa nusi to vovo na ema. Eyae nye be ezãa RNA si le eme tsɔ wɔa DNA le míaƒe lãmenugbagbeviwo me. Esia tae woyɔa atike siawo be ‘Antiretroviral’ elabena wowɔa dɔ tsi tre ɖe ɖoɖo ma ŋu. Àte ŋu ase woyɔ wo be ART, cART (ART si wotsɔ ƒo ƒu) alo HAART (ART si wɔa dɔ ŋutɔ). Esiawo katã nye nya siwo gɔmeɖeɖe ɖeka.
Nukae wòfia be dɔlékui ƒe agbɔsɔsɔ si ‘womate ŋu ade dzesii o’ nanɔ ame si?
Esiae nye ART ƒe akpa vevitɔ kekeake eye wòɖea vi wu. Ne èno wò atikewo nyuie la, HIV dɔlékui (dɔlékui ƒe agbɔsɔsɔ) si le wò ʋu me dzi ɖena kpɔtɔna ale gbegbe be womete ŋu dea dzesii to dodokpɔ siwo wowɔna edziedzi me o. Woyɔa esia be dzidzenu si ‘womate ŋu ade dzesii o’ . Zi geɖe la, woɖea esia gɔme be dɔlékuia ƒe agbɔsɔsɔ si mede 20 o le ʋu mililita ɖeka me (< kɔpi 20/mL).
‘Womate ŋu ade dzesii o’ mefia be woda gbe le ŋuwò o. Ne èdzudzɔ wò atikewo nono la, dɔlékui si ɣla ɖe wò ŋutilã me ate ŋu agawɔ dɔ ake. Azɔ hã, ne èdo HIV dɔlékuia kpɔ la, adze kokoko be ‘enyo’ elabena dodokpɔ mawo dia dɔlékuiwutike siwo tsia tre ɖe dɔlékuia ŋu, ke menye dɔlékuia ŋutɔ o.
Gake ɖo ŋku esia dzi: Womate ŋu ade dzesii o = Womate ŋu aɖoe o (U=U) . Esia fia be ne wò dɔlékui ƒe agbɔsɔsɔ gakpɔtɔ le agbɔsɔsɔ si womate ŋu ade dzesii o me la, màte ŋu atsɔ HIV dɔlékuia ana ame bubu to gbɔdɔdɔ me o. Esia nye kpeɖodzi le dzɔdzɔmeŋutinunya me egbea. Azɔ hã, ame si le ɖoƒe sia ate ŋu anɔ agbe si sɔ, si didi, abe amesi si HIV mele o ene.
Aleke ART wɔa dɔe? HIV dɔlékuia ƒe ŋutinya
Be míase alesi atike sia wɔa dɔe gɔme la, ele be míase alesi HIV dɔlékuia gena ɖe míaƒe lãmenugbagbeviwo me hewɔa eƒe kɔpiwo gɔme gbã.
Bu HIV dɔlékuia be enye fiafitɔ. Wò CD4 lãmenugbagbevi nye aƒe. Fiafitɔ sia gena ɖe aƒea me, zãa dɔwɔnu mawo ke le aƒea me, wɔa eƒe kɔpi geɖe wu, eye wòti kpo yia aƒe bubuwo me. Le esia wɔwɔ me la, aƒe gbãtɔ ma (CD4 lãmenugbagbevi) tsrɔ̃na.
Afɔɖeɖe vovovowo li woawɔ le ɖoɖo sia me. ART-tikewo wɔa dɔ ne wodzudzɔ afɔɖeɖe siawo dometɔ ɖeka alo esi wu nenema.
| Afɔɖeɖewo | Dɔwɔwɔ si yia edzi (le nya bɔbɔewo me) . |
|---|---|
| 1. Kpekpeɖeŋunana | Dɔlékuia zãa eƒe protein ɖeka (GP120) tsɔ léna ɖe ‘keyhole’ (receptor) si le míaƒe CD4 lãmenugbagbeviwo ƒe anyime ŋu. |
| 2. Fusion ƒe ƒuƒoƒo | Dɔlékuia ƒe gotagome gota la tsakana kple CD4 lãmenugbagbevi ƒe go. |
| 3. Nyawo tsɔtsɔ yi eme | Dɔlékuia ƒe ‘dɔwɔnuɖaka’ (Capsid) - si nye eƒe domenyiŋusẽfianu ŋuti nyatakaka (RNA) kple enzyme siwo hiã be woatsɔ awɔ kɔpiwo - gena ɖe lãmenugbagbevi la me. |
| 4. Nuŋɔŋlɔ si Wogbugbɔ Ðo | Wozãa enzyme (reverse transcriptase) si dɔlékuia tsɔ vɛ tsɔ wɔa DNA tso dɔlékuia ƒe RNA me. Ele abe amedzrogbe aɖe gɔmeɖeɖe ɖe mía ŋutɔwo tɔ me ene. |
| 5. Nuwɔwɔ ɖekae | Dɔlékui ƒe DNA yeye si wowɔ la gena ɖe míaƒe lãmenugbagbevi ƒe nucleus me eye wòwɔa ɖeka kple mía ŋutɔwo ƒe DNA. Esia kpena ɖe enzyme bubu si woyɔna be ‘Integrase’ ŋu. Fifia míaƒe lãmenugbagbevi la susui be esia hã nye ye ŋutɔ yeƒe akpa aɖe. |
| 6. Nuŋɔŋlɔ & Gbegɔmeɖeɖe | Míaƒe lãmenugbagbeviwo, abe woawo ŋutɔ ƒe DNA ene, wɔa dɔlékui ƒe DNA sia ƒe kɔpiwo, eye emegbe wodzea dɔlékui ƒe proteinwo wɔwɔ gɔme le gbedasi mawo dzi. |
| 7. Takpekpe | Enzyme bubu si woyɔna be ‘Protease’ va, lãa protein kakɛ siawo siwo wowɔ, eye wòƒoa wo nu ƒu wòzua dɔlékui ƒe kɔpi yeyewo. |
| 8. Budding & Lãmenugbagbeviwo ƒe Ku | Dɔlékui yeye siwo wowɔ la atsrɔ̃ CD4 lãmenugbagbevi la, asi, eye woadze CD4 lãmenugbagbevi bubu siwo le lãmesẽ me dzi. |
ART-tikewo wɔa dɔ to nudede afɔɖeɖe siwo míeyɔ ɖe etame dometɔ ɖeka me. Atike aɖewo xea mɔ na dɔlékuia be wòagage ɖe lãmenugbagbevi la me o. Ame bubuwo xea mɔ nɛ be wòagawɔ DNA o. Ame bubuwo hã xea mɔ nɛ be wòagaƒo dɔlékui yeyewo nu ƒu o.
Atike kawoe wozãna le ART dada me?
Woate ŋu ama ART-tikewo ɖe hatsotso vevi geɖe me. Ƒuƒoƒo ɖesiaɖe wɔa dɔ to HIV dɔlékuia ƒe agbenɔnɔ ƒe akpa vovovo ŋudɔwɔwɔ me.
- Nusiwo xea mɔ na dɔlékuia be wòage ɖe CD4 lãmenugbagbevi la me o.
- Capsid Inhibitors: Xɔ mɔ na dɔlékuia ƒe ‘dɔwɔnuɖaka’ (Capsid) be wòagaʋu alo agbugbɔ aƒo ƒu o.
- Nucleoside Reverse Transcriptase Inhibitors (NRTIs): Ne dɔlékuia wɔ DNA la, enaa anyikpe ‘aʋatso’ siwo le abe ‘brik’ siwo wòhiã ene. Ne wozã esiawo la, womate ŋu awu DNA ƒe kɔsɔkɔsɔa nu o.
- Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTIs): Esiawo yia enzyme si wɔa DNA (Reverse Transcriptase) gbɔ tẽ eye womewɔa dɔ o.
- Integrase Inhibitors (INSTIs): Woxea mɔ na enzyme (integrase) si ƒoa dɔlékui ƒe DNA nu ƒu ɖe míaƒe lãmenugbagbevi ƒe DNA ŋu.
- Protease Inhibitors (PIs): Dzudzɔ protein-tsonu enzyme (protease) be wòagaƒo dɔlékui yeyewo nu ƒu o.
- Pharmacokinetic Enhancers (Boosters): Esiawo mekpɔa ŋusẽ ɖe dɔlékuia dzi tẽ o, ke boŋ wokpena ɖe ART atike bubuwo ŋu be woanɔ ŋutilãa me ɣeyiɣi didi eye woanɔ agbɔsɔsɔ gã me.
Zi geɖe la, atike siwo wona wò la nyea hatsotso siawo dometɔ geɖe ƒe ƒuƒoƒo. Le kpɔɖeŋu me, ate ŋu anye atikekui ɖeka si me NRTI eve kple integrase inhibitor le.
Aleke mawɔ atia ART-tike si sɔ nam?
Ðɔkta si le dɔ dam na wò la atso nya me le atike vovovo siwo sɔ na wò wu ŋu ne ebu nu geɖe ŋu vɔ.
- Wò dɔlékui ƒe agbɔsɔsɔ kple CD4 ƒe xexlẽme: Ele vevie be nànya nusiwo nye asixɔxɔ siawo ne èle atikewɔwɔ gɔme dzem.
- Dɔlékuia ƒe atikewo ƒe dɔlélenutsiŋutete: Ɣeaɖewoɣi la, dɔlékuia va te ŋu nɔa te ɖe atike aɖewo nu. Woate ŋu awɔ dodokpɔ aɖe atsɔ anya.
- Ne dɔléle bubu aɖewo le ŋuwò, abe ayikudɔ, aklãdɔ, dzidɔ, suklidɔ, alo ʋumemi si sɔ gbɔ ene la, ele be nàgblɔ wo na wò ɖɔkta.
- Atike bubu siwo zãm nèle: Ne èle atike zãm na dɔléle bubu aɖe la, kadodo ate ŋu anɔ atike mawo kple ART-tikewo dome.
- Fufɔfɔ: Ne èfɔ fu alo nèle ɖoɖo wɔm be yeafɔ fu la, atike siwo le dedie siwo sɔ na wò la li.
- Atikea nono bɔbɔe: Bu eŋu kpɔ nenye be enye atikekui si wozãna zi ɖeka gbesiagbe alo atikekui eve gbesiagbe, nenye be ele be woanoe kple nuɖuɖu alo manɔmee, kple alesi wòsɔ ɖe wò agbenɔnɔ nu hã.
Viɖe kple afɔku kawoe le ART zazã me?
Viɖe siwo le eŋu
- Dɔlélenutsiŋutete ƒe ŋusẽdodo: CD4 lãmenugbagbeviwo ƒe xexlẽme dzina ɖe edzi, si wɔnɛ be wò ŋutilã ƒe ŋutete be wòatsi tre ɖe dɔléle ŋu dzina ɖe edzi.
- Takpɔkpɔ tso dɔlékui sesẽwo me: HIV ate ŋu akpɔ ame ta tso mɔnukpɔkpɔ ƒe dɔlékuiwo abe aklãdɔ kple yɔmekpe ene me.
- Kansa xɔxɔ ƒe afɔkua dzi ɖena kpɔtɔna: Afɔku si le kansa siwo do ƒome kple HIV (e.g. Kaposi sarcoma, non-Hodgkin lymphoma) xɔxɔ me dzi ɖena kpɔtɔna.
- Mɔxexe ɖe AIDS nu: Ne womewɔ atike nɛ o la, HIV dɔlékuia ate ŋu ayi ŋgɔ va ɖo eƒe akpa mamlɛtɔ si woyɔna be AIDS (Acquired Immunodeficiency Syndrome). ART tɔ te esia.
- Mɔxexe ɖe dɔlékuiwo xɔxɔ nu na ame bubuwo:Abe alesi míegblɔe va yi ene (U=U) , ne womate ŋu ade dzesi wò dɔlékui ƒe agbɔsɔsɔ o la, màte ŋu akakae na ame bubuwo to gbɔdɔdɔ me o.
- Lãmesẽ, agbenɔƒe didi: Ame si noa atike nyuie ate ŋu anɔ agbe si sɔ, abe amesi si HIV mele o ene.
Afɔkuwo kple eƒe nugbegblẽ le ame ŋu
Ame aɖewo ate ŋu akpɔ eƒe nugbegblẽ le ame ŋu ne wodze ART zazã gɔme zi gbãtɔ. Gake zi geɖe la, nusiawo nɔa anyi ɣeyiɣi kpui aɖe eye wodzona le kwasiɖa ʋɛ aɖewo megbe ne ŋutilãa le tɔtrɔm ɖe atikeawo ŋu.
- Aɖuɖɔtoe, ʋuʋudedi
- Dɔgbo ƒe vevesese, aɖuɖɔtoe
- Taɖuame
- Taɖuame
- Ðeɖiteameŋu, ɖeɖiteameŋu
- Alɔ̃ madɔmadɔ
- Ŋutilã ƒe ʋuʋudedi
Ne èkpɔ dzesi siawo dometɔ aɖe la, mègadzudzɔ wò atikewo nono eye nàgblɔe na wò ɖɔkta o. Ate ŋu akpe ɖe ŋuwò nàkpɔ egbɔkpɔnu alo ne ehiã la, atrɔ wò ɖe atike bubu si sɔ na wò wu ŋu. Atike aɖewo ate ŋu agblẽ nu le ŋuwò ɣeyiɣi didi, abe wò ʋumemi ƒe agbɔsɔsɔ dzi ɖeɖe kpɔtɔ ene. Esia tae wò ɖɔkta alé ŋku ɖe ŋuwò edziedzi ɖo.
Aleke nèléa ŋku ɖe atikewɔwɔ ƒe dzidzedzekpɔkpɔ ŋu?
Ne èdze ART gɔme vɔ la, wò ɖɔkta alé ŋku ɖe ŋuwò le ɖoɖowɔɖi aɖe koŋ dzi. Awɔ dodokpɔ vevi eve.
| Dodokpɔ | Nusi wokpɔ mɔ na be wòado tso eme | Zi ƒe xexlẽme |
|---|---|---|
| Dɔlékuiwo ƒe Agbɔsɔsɔ | Asixɔxɔ sia ɖiɖi va ɖo afisi ‘womate ŋu ade dzesii o’. | Zi geɖe le ɣleti ʋee gbãtɔwo me le gɔmedzedze megbe, emegbe ɣleti 3-6 ɖesiaɖe. |
| CD4 lãmenugbagbeviwo ƒe xexlẽme (CD4 Xexlẽme) . | Asixɔxɔ sia dzina ɖe edzi . (Lãmesẽ ƒe agbɔsɔsɔ le 500-1500 dome) | Le gɔmedzedzea me la, ɣleti 3-6 ɖesiaɖe, emegbe ne ehiã. |
Mègana wò atike nono ŋkeke ɖeka pɛ hã nato ŋuwò o!
Kuxi gãtɔ kekeake si le ART-dɔdamɔnu ƒe dzidzedzekpɔkpɔ ŋue nyeNo wò atike gbesiagbe, le ɣeyiɣi nyuitɔ dzi, eye ŋkeke ɖeka pɛ hã mato ŋuwò o. Ne agbɔsɔsɔme aɖe to ŋuwò la, mɔnukpɔkpɔ sua dɔlékuia si be wòagadzi ɖe edzi le wò ŋutilã me ake. Ne edzɔ alea la, dɔlékuia ate ŋu anɔ te ɖe atike si nom nèle nu (atikewo ƒe dɔlélenutsiŋutete). Emegbe atike la adzudzɔ dɔwɔwɔ eye ahiã be nàyi atike bubuwo gbɔ. Eyata ele vevie be nàno wò atike ɖe game dzi, eɖanye to ŋkuɖodzinya aɖe ɖoɖo ɖe wò telefon dzi alo biabia tso ƒomea me tɔ aɖe si be wòaɖo ŋku edzi na wò o.
Gbedasi si Wotsɔ Yi Aƒeme
- ART nye atike si xɔa ame ɖe agbe si léa HIV dɔlékuia nu. Togbɔ be mate ŋu ada HIV o hã la, ate ŋu akpe ɖe ŋuwò nànɔ agbe le lãmesẽ me, eye wòadidi.
- Ele vevie be nàno wò atikewo gbesiagbe kple ɖe game dzi. Ne èto atike si nèzãna ŋu la, dɔlékuia ate ŋu anɔ te ɖe atikeawo nu.
- Ne dɔlékui ƒe agbɔsɔsɔ si le wò ʋu me ‘womate ŋu ade dzesii o’ la, màte ŋu atsɔ HIV na ame bubu to gbɔdɔdɔ me o (U=U).
- Nugbegblẽ le ame ŋu ate ŋu ado mo ɖa le atikewɔwɔ ƒe gɔmedzedze, gake zi geɖe la, wonɔa anyi ɣeyiɣi kpui aɖe ko. Ƒo nu kple wò ɖɔkta tso vevesese ɖesiaɖe ŋu.
- HIV dɔlékuia nye dɔléle bubu si nɔa anyi didi. Ne wowɔ atike na wò nyuie eye nèkpɔ egbɔ nyuie la, àte ŋu anɔ agbe si me dzidzeme le. Menye wò ɖeka koe o.
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