Kuongororwa kwezvirwere zveHIV-1 pasi rose nedunhu panguva ya1990-2024: ongororo yakarongeka, ongororo yepasi rose, uye ongororo yekupararira kwayo

Nhanganyaya

Chidzidzo chakabudiswa munguva pfupi yapfuura muZvirwere Zvinotapukira zveLancet(2026) inopa ongororo yakazara yepasi rose yeHIV-1 molecular epidemiology kusvika pari zvino, ichibatanidza data rekuongorora rakarongeka uye ongororo yepasi rose yekuongorora mamorekuru.

Nekubatanidza data raivepo kare (1990–2021) nedata idzva rakaunganidzwa, chidzidzo ichi chakabatanidza zvinopfuuraZvinyorwa zveHIV-1 miriyoni kubva kunyika 154 zvakaunganidzwa pakati pa1990 na2024Vachishandisa huwandu hwevanhu vanorarama neHIV hwakafungidzirwa neUNAIDS sezvinhu zvinoyera, vaongorori vakagadzira mamepu epasi rose needunhu anotsanangura kupararira kweHIV-1 subtypes panguva nenzvimbo, mafomu erecombinant anotenderera (CRFs), uye mafomu erecombinant akasiyana (URFs).

Zvakawanikwa zvinoratidza kuti kunyangwe mamiriro epasi rose eHIV-1 subtype akaramba akagadzikana mumakumi maviri emakore apfuura, shanduko huru dziri kuitika munzvimbo dzakasiyana, kunyanya nekuda kwekuwedzera kwekusiyana-siyana uye kuwedzera kwemarudzi e recombinant.

Chidzidzo cheMamiriro Ezvinhu

Human immunodeficiency virus type 1 (HIV-1) inoratidza kusiyana-siyana kwemajini nekuda kwehuwandu hwayo hwekuchinja, kugona kwayo kubatanidza, uye mafambiro ekutapurirana kwenguva refu.

Kusiyana kwemajini uku kune zvakunoreva kune:

• · Kuongororwa kwemamorekuru,
• · Kuongororwa kwekushanda kwekuongorora,
• · Kuongororwa kwekusagona kurwisa ma ARV,
• · uye nzira dzekugadzira majekiseni.

Chidzidzo ichi chaive nechinangwa chekutsanangura marongerwo emarudzi eHIV-1 nemarudzi erecombinant pasi rose nedunhu kubva ku1990 kusvika 2024, ichipa hurongwa hwakagadziridzwa hwekudzivirira nekudzora HIV pasi rose.

Kugadzira Zvidzidzo uye Maitiro

Vaongorori vakaita ongororo yakarongeka yePubMed, Embase, Global Health, CINAHL databases, vachifukidza zvidzidzo zvakaburitswa pakati paNdira 1, 2022, naNdira 22, 2025.

Pamusoro pezvo, data rakaunganidzwa kuburikidza neGlobal HIV Molecular Epidemiology Collaboration network.

Madhata akakodzera anosanganisira:

• · Ruzivo rwemhando yeHIV-1 molecular subtype,
• · nzvimbo dzakatsanangurwa zvakajeka dzekutora sampuli,
• · mazuva ekuunganidzwa kwezvinhu,
• · uye nhamba dzemuenzaniso dzakakwana.

Seti yekupedzisira yedata yaisanganisira:

• · Zvinyorwa zveHIV-1 zvemajini 1,395,222 
• · Nyika 154 
• · Nguva nhanhatu dzezvirwere:1990–1999, 2000–2004, 2005–2009, 2010–2014, 2015–2019, 2020–2024.

Kuwanda kwemarudzi eHIV-1 pasi rose uye munharaunda kwakafungidzirwa uchishandisa nzira dzeUNAIDS dzekuyera uremu.

Kupararira kweHIV-1 Subtypes pasi rose: Subtype C inoramba ichinyanya kukosha

Munguva2020–2024rudzi rweC rwakaramba rwuri rudzi rweHIV-1 rwakanyanya pasi rose, zvichikonzera:

Zvose, mafomu e recombinant (kusanganisira CRFs neURFs) airatidza kuti aisvika22.4% yevanhu vane HIV-1 pasi rose, zvichiratidza kuoma kuri kuwedzera kwekusiyana kwemajini eHIV-1.

Subtype C inoramba ichitonga zvakanyanya mu:

• · Kuchamhembe kweAfrica,
• · Kumaodzanyemba kweAsia,
• · uye nyika dzinoverengeka dzeEast Africa.

Nekuti matunhu aya ane chikamu chikuru chehuwandu hweHIV pasi rose, kutonga kwe subtype C kunokanganisa zvakanyanya kupararira kwehutachiona pasi rose.

Kusiyana Kwenzvimbo: Maitiro Akasiyana Ekushanduka-shanduka Mumakondinendi

Kunyangwe chimiro cheHIV-1 pasi rose chichiratidzika kunge chakasimba, maitiro enzvimbo ari kuchinja zvakanyanya.

Kumaodzanyemba kweAfrica neSouth Asia: Kutonga kweSubtype C kunogara kwenguva refu

Kumaodzanyemba kweAfrica neSouth Asia zvichiri kuzivikanwa zvakanyanya nekupararira kwemhando yeC.

Munzvimbo idzi dzine vanhu vakawanda, rudzi rweC runomiririra huwandu hwakawanda hwemavhairasi ari kupararira, zvichiita kuti ive ndiyo inonyanya kukonzera kupararira kwerudzi rweC pasi rose.

Zvisinei, chidzidzo ichi chinosimbisawo kuti kufukidzwa kwemasampuru emamorekuru munzvimbo dzine mutoro wakanyanya kuchiri kushoma, zvichiratidza kuti panodiwa mamwe mabasa ekutarisa kuti vabate zviri nani kusiyana kwemavhairasi munharaunda.

North America neLatin America: Kuenderera mberi kweSubtype B Dominance

Subtype B inoramba iri dzinza guru rinotenderera mu:

• · Kuchamhembe kweAmerica,
• · Latin America.

Nzvimbo idzi dzinoratidza maitiro ezvirwere zvemamorekuru akasimba zvichienzaniswa nenzvimbo dziri kuchinja nekukurumidza kwezvikamu.

Kumadokero nepakati peEurope: Kuwedzera Kusiyana-siyana Kwemajini

Kumadokero nepakati peEurope zviri kusangana nekuchinja zvishoma nezvishoma kubva padenda rerudzi rweB kuenda kunzvimbo ine hutachiona hwakasiyana-siyana.

Mafambiro makuru anosanganisira:

• · Kuderera kwechikamu chemhando B,
• · kuwedzera kwemupiro wemafomu e recombinant,
• · Kuwanda kwemadzinza asiri eB.

Shanduko idzi dzinoratidza kuti kusiyana kwemamorekuru eHIV-1 kuri kuramba kuchikosha kunyangwe munzvimbo dzine nhoroondo dzerudzi rweB-dzakanyanya.

East Asia: Kuwedzera Nokukurumidza Kwemhando DzeRecombinant

East Asia yakaratidza imwe yeshanduko huru dzezvirwere.

Chidzidzo chacho chakawana kuti:

• · CRF07_BC yakawedzera zvakanyanya nekufamba kwenguva,
• · mhando B yakaderera zvakanyanya.

CRF07_BC yakawedzera kubva painenge13.1% pakati pa2000–2004 kusvika 48.1% pakati pa2020–2024, zvichiratidza shanduko huru muhutachiona hweHIV-1 hwemunharaunda.

Kuchinja uku kunoratidza kukosha kwekutarisa mamorekuru nguva dzose munzvimbo dzine mafomu e recombinant ari kuva nesimba.

Mafomu Ekubatanidza: Chikamu Chiri Kukura Chekusiyana-siyana kweHIV-1 Pasirose

Huwandu hwemarudzi e recombinant hwakawedzera pasi rose mumakumi emakore apfuura:

• · 2000–2004: inenge 20.8%
• · 2010–2014: inenge 24.2%
• · 2020–2024: inenge 22.4%

Kunyangwe huwandu hwepasi rose hwakaderera zvishoma munguva pfupi yapfuura, mafomu e recombinant ari kuramba achikura munzvimbo dzakasiyana siyana, kunyanya:

• · Kumabvazuva kweAsia,
• · Kumadokero nepakati peEurope.

Chidzidzo ichi chinoratidza kuti mafomu e recombinant anogona kunge achiri kutarisirwa pasi mune dzimwe nzvimbo nekuti mapurogiramu mazhinji ekutarisa anonyanya kuvimba nenzvimbo dzisina kukwana dze genomic, idzo dzingasanyatsoona maitiro akaomarara e recombination.

Kusimbisa nzira dzekutarisa majini kuchave kwakakosha, kunyanya munzvimbo dzine mutoro mukuru wekupararira kweHIV uye huwandu hwehutachiona huri kuwedzera.

Hutano Hweveruzhinji uye Zvinokonzera Kliniki

1. Maitiro Ekuongorora Anoda Kuongororwa Kunoramba Kuchienderera Mberi Kwemhando Dzepasi

Kuwedzera kwekusiyana kwemajini eHIV-1 kunoratidza kukosha kwekuenderera mberi nekuongorora matekinoroji ekuongorora zvirwere zvakasiyana-siyana.

Kunyangwe mapuratifomu aripo ekuongorora HIV uye ekuongorora huwandu hwehutachiona akaratidza kushanda kwakakura, kuongororwa kunoramba kuchiitwa pamusoro pemhando dziri kubuda uye mafomu e recombinant kuchiri kukosha.

Kuongororwa kweramangwana kunofanira kusanganisira:

• · Kuongororwa kwezvirwere zvemamorekuru,
• · Kuongorora mashandiro ekuongorora chirwere,
• · uye kuongorora kushanduka kwehutachiona.

2. Kuongororwa Kwekusashanda Kwemishonga Kunoda Kufukidzwa Kwakakura Kwemajini

Kuwedzera kwemarudzi akasiyana-siyana eHIV-1 kunogona kukanganisa kubuda, kuonekwa, uye kududzirwa kwekuchinja kwezvirwere zvine chekuita nekurapwa kweHIV.

Dzimwe ongororo dzakaratidza kuti mhando dzakasiyana dzeHIV-1, kusanganisira mhando dzine chekuita neA6/A1, dzinogona kunge dzakabatana nenjodzi yakawedzera yekukundikana kwehutachiona pasi pemamwe marapirwo ekurapa e cabotegravir/rilpivirine anoshanda kwenguva refu.

Zvisinei, mhedzisiro yekuramba inokonzerwa nezvinhu zvakawanda, zvinosanganisira:

• · shanduko dzekudzivirira kwepakutanga,
• · nhoroondo yekurapwa,
• · kutevedzera,
• · uye nhoroondo yemajini ehutachiona.

Nokudaro, kuongorora kusingadziviriri kwemarudzi akasiyana-siyana kuchiri kukosha zvakanyanya.

3. Kugadzirwa kweMajekiseni Kunofanira Kufunga Nezvekusiyana-siyana Kwehutachiona Munzvimbo

Kusiyana-siyana kwemajini eHIV-1 kuchiri chimwe chezvinetso zvikuru pakugadzirwa kwemishonga yekudzivirira zvirwere.

Kupararira kuri kuita kupararira kwemarudzi akasiyana-siyana uye mafomu e recombinant kunoratidza kudiwa kwenzira dzekudzivirira dzinofunga nezve:

• · mhando dzinotenderera munzvimbo dzakasiyana,
• · Mafambiro ekushanduka-shanduka kwehutachiona,
• · uye kuvharwa kwakakura kwemasoja emuviri.

Nzira imwe chete pasi rose ingasagadzirisa zvizere kusiyana kweHIV-1 kuri kupararira pasi rose.

Mhedziso

Ongororo iyi inokosha yepasi rose yeHIV-1 molecular epidemiology inoratidza kuti mamiriro ehutachiona pasi rose anoratidzwa nekuenderera mberi uye kuchinja.

Kunyange hazvo rudzi rweC ruchiri kukonzera inenge hafu yehutachiona hweHIV-1 pasi rose, maitiro emamorekuru emunharaunda ari kuchinja nekukurumidza, uye mafomu e recombinant ari kuwedzera kuumba denda munzvimbo dzakadai seEast Asia neEurope.

Zvakawanikwa izvi zvinosimbisa kukosha kwekuchengetedzwa kwenguva refu kwemamorekuru, kuongororwa kwezvirwere zvakasiyana-siyana, uye nzira dzakabatanidzwa dzekuongorora majini kuti dzitsigire kudzivirira HIV zvinobudirira, kutarisa kurapwa, uye kugadzira majekiseni ekudzivirira mune ramangwana.

Referensi

1. Kupararira kweHIV-1 pasi rose nedunhu panguva ye1990–2024: ongororo yakarongeka, ongororo yepasi rose, uye ongororo yekupararira kwayo. Zvirwere Zvinotapukira zveLancet, 2026.