Te mate urutā ngota ā-ao me ā-rohe o te HIV-1 i te tau 1990-2024: arotake pūnaha, rangahau ā-ao, me te tātari i te horapa

Kupu Whakataki

He rangahau hou i whakaputaina i roto iNgā Mate Pirau a te Lancet(2026) e whakarato ana i te tātaritanga whānui rawa atu o te ao mō te mate urutā ngota HIV-1 tae noa ki tēnei wā, e whakauru ana i ngā raraunga arotake pūnaha me te rangahau tirotiro ngota ngota o te ao.

Mā te whakakotahi i ngā huinga raraunga o mua (1990–2021) me ngā raraunga raupapatanga hou kua kohia, neke atu i te1.39 miriona ngā rekoata ira-ira HIV-1 mai i ngā whenua 154 i kohia i waenga i te tau 1990 me te 2024Mā te whakamahi i te maha o ngā tāngata e ora ana me te HIV i whakatauhia e te UNAIDS hei taumaha, i hangaia e ngā kairangahau he mahere ā-ao me te ā-rohe e whakaahua ana i te tohatoha ā-wā me te ā-whenua o ngā momo HIV-1, ngā momo recombinant e horapa ana (CRF), me ngā momo recombinant ahurei (URF).

E whakaatu ana ngā kitenga ahakoa i noho pumau tonu te āhua o te momo HIV-1 o te ao i ngā tekau tau e rua kua pahure ake nei, kei te puta tonu ngā panonitanga ā-rohe nui, inā koa nā te piki haere o te kanorau me te whānui haere o ngā momo recombinant.

Papamuri Ako

He nui te kanorau o ngā ira o te huaketo ngoikore ārai mate tangata momo 1 (HIV-1) nā te tere whakawhiti ira teitei, te kaha ki te whakakotahi anō, me te kaha tuku ira mō te wā roa.

He pānga nui tō tēnei rerekētanga ira ki:

• · te tirotiro irahiko,
• · aromatawai mahi tātaritanga,
• · te aroturuki i te ātete ki te mate huaketo,
• · me ngā rautaki whakawhanake kano kano.

Ko te whāinga o te rangahau he whakaahua i ngā tauira tohatoha ā-ao me ā-rohe o ngā momo HIV-1 me ngā momo recombinant mai i1990 ki te 2024, e whakarato ana i tētahi anga whanaketanga mate urutā ngota hou mō te aukati me te whakahaere i te HIV ā-ao.

Te Hoahoa me ngā Tikanga Ako

I whakahaerehia e ngā kairangahau tētahi arotake pūnaha o ngā pātengi raraunga a PubMed, Embase, Global Health, me CINAHL, e kapi ana i ngā rangahau i whakaputaina i waenga i te 1 o Hānuere 2022 me te 22 o Hānuere 2025.

Hei tāpiritanga, i kohia ngā raraunga mā te whatunga Global HIV Molecular Epidemiology Collaboration.

Ko ngā huinga raraunga e tika ana ko:

• · Ngā mōhiohio mō te momo ngota ngota HIV-1,
• · ngā wāhi tauira kua tautuhia mārama,
• · ngā rā kohikohinga,
• · me ngā tau tauira e rawaka ana.

Ko ngā huinga raraunga whakamutunga i whakaurua:

• · 1,395,222 ngā tuhinga whakairaira HIV-1 
• · 154 whenua 
• · e ono ngā wā mate urutā:1990–1999, 2000–2004, 2005–2009, 2010–2014, 2015–2019, 2020–2024.

I aromatawaihia te horapa o ngā momo ira HIV-1 puta noa i te ao, ā-rohe hoki, mā te whakamahi i ngā tikanga taumaha i whakatikatikaina e UNAIDS.

Te Tohatoha o ngā Momo HIV-1 puta noa i te Ao: Kei te Mana Tonu te Momo C

I roto i2020–2024, ko te momo C tonu te momo matua o te HIV-1 puta noa i te ao, e whakaatu ana i ēnei:

I te nuinga, ko ngā momo recombinant (tae atu ki ngā CRF me ngā URF) i tata ki te22.4% o ngā mate HIV-1 o te ao, e whakaatu ana i te uaua haere o te kanorau ira HIV-1.

Ko te Momo iti C kei te kaha tonu i roto i:

• · Āwherika ki te Tonga,
• · Āhia ki te Tonga,
• · me ētahi whenua o Āwherika ki te Rawhiti.

Nā te mea he nui te wāhanga o te kawenga HIV o te ao kei ēnei rohe, he nui te awe o te momo momo C ki te tauira tohatoha o te ao.

Ngā Rerekētanga Rohe: Ngā Tauira Whanaketanga Motuhake puta noa i ngā Whenua

Ahakoa te āhua pumau o te hanganga HIV-1 o te ao, kei te rerekē haere ngā tauira ā-rohe.

Āwherika ki te Tonga me Āhia ki te Tonga: Te Mana Pumau o te Momo C

Ko te momo tohanga toto C tonu te momo tino kitea i Āwherika ki te Tonga me Āhia ki te Tonga.

I roto i ēnei rohe he nui te taumahatanga, ko te momo huaketo C te nuinga o ngā huaketo e horapa ana, ā, koinei te tino pūtake o te horapa o te momo huaketo C puta noa i te ao.

Heoi anō, e whakaatu ana hoki te rangahau he iti tonu te kapinga tauira ngota i roto i ētahi rohe taumaha, e kī ana me nui ake ngā mahi tirotiro hei hopu ake i te kanorau huaketo ā-rohe.

Amerika Te Raki me Amerika Latina: Te Mana Tonu o te Momo-iti B

Ko te Momo iti B tonu te whakapapa matua e horapa ana i roto i:

• · Amerika ki te Raki,
• · Amerika Latina.

He pumau tonu ngā tauira mate urutā ngota ngota o ēnei rohe ki ērā o ngā rohe e tere haere ana ngā whakawhiti momo āhua.

Ūropi ki te Hauāuru me te Waenganui: Te Whakanui Ake i te Kanorau Ira

Kei te pāngia a Ūropi ki te Hauāuru me te Waenganui o Ūropi e te nekehanga āta haere mai i te mate urutā momo B ki tētahi whenua huaketo kanorau ake.

Ko ngā au matua ko:

• · te hekenga o te ōwehenga o te momo B,
• · te whakanui ake i te takoha o ngā momo hangarua,
• · te tipu haere o ngā momo whakapapa kore-B.

E whakaatu ana ēnei huringa kei te piki haere te hiranga o te kanorau ngota ngota HIV-1 ahakoa i roto i ngā rohe e matua ana te momo B i ngā wā o mua.

Āhia ki te Rawhiti: Te Whanui Tere o ngā Momo Recombinant

I whakaatuhia e Āhia ki te Rawhiti tētahi o ngā panonitanga nui o te mate urutā.

I kitea i roto i te rangahau:

• · Kua tino piki ake te CRF07_BC i roto i te wā,
• · kua tino heke te momo B.

Kua piki ake te CRF07_BC mai i te tata ki te13.1% i waenganui i te tau 2000–2004 ki te 48.1% i waenganui i te tau 2020–2024, e whakaatu ana i tētahi huringa nui i roto i te mate urutā HIV-1 ā-rohe.

E whakaatu ana tēnei panonitanga i te hiranga o te tirotiro tonu i ngā ngota ngota i ngā rohe kei te kaha haere te whakamahi i ngā momo recombinant.

Ngā Āhua Whakahou: He Wāhanga Tipu o te Kanorau HIV-1 o te Ao

I piki ake te ōwehenga o ngā momo hangarua puta noa i te ao i ngā tekau tau kua pahure ake nei:

• · 2000–2004: tata ki te 20.8%
• · 2010–2014: tata ki te 24.2%
• · 2020–2024: tata ki te 22.4%

Ahakoa i paku heke te ōwehenga o te ao i ngā wā tata nei, kei te horapa tonu ngā momo hangarua i roto i ētahi rohe, inā koa:

• · Āhia ki te Rawhiti,
• · Ūropi ki te Hauāuru me te Waenganui.

E kī ana te rangahau, tera pea kāore tonu i te tino arohia ngā momo hangarua i ētahi wāhi nā te mea he maha ngā kaupapa tirotiro e whakawhirinaki ana ki ngā rohe ira motuhake, e kore pea e tino tautuhi i ngā tauira hangarua matatini.

Nō reira, he mea nui te whakapakari i ngā huarahi tirotiro ira, inā koa i ngā rohe he nui te horapa o te HIV me te piki haere o te kanorau huaketo.

Hauora Tūmatanui me ngā Pānga Hauora

1. Me Arotake Tonu ngā Pūnaha Tātaritanga i ngā Momo-Iti

Ko te pikinga ake o te kanorau ira HIV-1 e whakaatu ana i te hiranga o te aromatawai tonu i ngā hangarau tātaritanga puta noa i ngā momo papamuri huaketo.

Ahakoa kua whakaatuhia e ngā tūāpapa whakamātautau tātaritanga HIV me te kawenga huaketo o nāianei te whānui o te whakamahinga, he mea nui tonu te manatoko tonu ki ngā momo hou me ngā momo recombinant.

Me whakauru ngā mahi tirotiro ā muri ake nei:

• · te mate urutā ngota,
• · te aroturukitanga mahi tātaritanga,
• · me te tātaritanga whanaketanga huaketo.

2. Me whānui ake te kapinga ira mō te tirotiro ātete ki te rongoā

Tērā pea ka pā te whānui haere o ngā momo whakapapa HIV-1 ki te putanga mai, te kitenga, me te whakamārama i ngā whakarerekētanga ira e pā ana ki te ātete.

Kua whakaarohia e ētahi rangahau he hononga pea ngā momo whakapapa HIV-1 motuhake, tae atu ki ngā momo e pā ana ki te A6/A1, ki te pikinga ake o te mōrearea o te korenga o te mahi virological i raro i ētahi tautuhinga maimoatanga cabotegravir/rilpivirine e mahi roa ana.

Heoi, he maha ngā āhuatanga e pāngia ai ngā putanga o te ātete, tae atu ki:

• · ngā whakarerekētanga ātete taketake,
• · hītori maimoatanga,
• · te piripono,
• · me te papamuri ira huaketo.

Nō reira, kei te piki haere tonu te hiranga o te aroturukitanga ātete e mōhio ana ki ngā momo momo.

3. Me Whai Whakaaro te Whanaketanga Kano Kano ki te Kanorau o te Huakita ā-Rohe

Ko te whānuitanga o te kanorau ira o te HIV-1 tētahi o ngā wero nui mō te whakawhanaketanga o te kano kano.

Ko te horapa haere o ngā momo me ngā momo recombinant e whakaatu ana i te hiahia mō ngā rautaki kano kano e whai whakaaro ana ki:

• · ngā momo totoro ā-rohe,
• · ngā au whanaketanga huaketo,
• · me te whānuitanga o te kapinga ārai mate.

Kāore pea e taea e tētahi huarahi ōrite puta noa i te ao te aro katoa ki te kanorau o te HIV-1 e horapa ana puta noa i te ao.

Whakamutunga

E whakaatu ana tēnei tātaritanga nui ā-ao mō te mate urutā ngota HIV-1, ko te āhua o te huaketo o te ao whānui he haere tonu, he rerekē hoki.

Ahakoa tata tonu te haurua o ngā mate HIV-1 o te ao e pā ana ki te momo C, kei te tere whanake haere ngā tauira ngota ngota ā-rohe, me ngā momo recombinant e hanga ana i ngā mate urutā i ngā rohe pēnei i a Āhia ki te Rawhiti me Ūropi.

E whakaū ana ngā kitenga i te hiranga o te aroturukitanga ngota ngota tonu, te whakamana tātaritanga momo-iti, me ngā huarahi ira whakauru hei tautoko i te aukati HIV whai hua, te aroturukitanga maimoatanga, me te whakawhanaketanga kano kano ā-muri.

Tohutoro

1. Te mate urutā ngota ā-ao me ā-rohe o te HIV-1 i te tau 1990–2024: arotake pūnaha, rangahau ā-ao, me te tātari i te horapa. Ngā Mate Pirau a te Lancet, 2026.