IHarvoni: Enye iMichiza eyamangalisa i-Hepatitis C

by Naveed Saleh, MD, MS

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Yonke isichotho, Harvoni!

Bathi awukwazi ukubeka iteksi yentengo kwimpilo yakho. Ngaphezulu kwe-1000 iipilisi, i-new drug-drug, iHarvoni , mhlawumbi ibonisa ukuba yi-aphorism.

Ngo-Oktobha 10, 2014, i-FDA ivume iHarvoni esheshayo elandelwayo, isilwanyana esitsha esichengeni intsholongwane ye-hepatitis C engekho. Ngo-2014, iHarvoni yayisisigxina sesithathu esivunywe yi-FDA ukuba siphathe i-hepatitis C kunye nephawulekayo ngokusebenza kwayo ngendlela ephawulekayo kunye nokulawulwa komlomo ngomnye-ngosuku.

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Yintoni i-Hepatitis C?

I-hepatitis C yintsholongwane ye-RNA eyenza i-hepatitis okanye ukuvuvukala kwesibindi. Okwangoku, i-hepatitis C yimbangela ebangela ukusuleleka kwesifo sesibindi esingapheliyo e-United States kwaye ichaphazela ama-3 ekhulwini labemi behlabathi. I-Hepatitis C isasazeka ngegazi okanye kwimveliso yegazi, kwaye ngaphambi kokuba kufike ukuhlolwa okufanelekileyo kwintsholongwane, abantu abaninzi banokusuleleka emva kokunyelwa igazi. Okwangoku, abaninzi abantu bahlakulela i-hepatitis C emva kokubelana ngezilonda ngelixa basebenzisa iziyobisi ezingekho mthethweni.

I-Hepatitis C yindlela ephilileyo yokulwa neengcambu ezinokuthi zingabangela ukuba kubonakale kugula kakhulu. Esikhundleni saloo nto, abaninzi abantu bafunyaniswa emva kokunikezela ngesifo esingapheliyo-ngokuqhelekileyo, kwiminyaka eyi-10 ukuya kwe-18 emva kokusuleleka kwintsholongwane. Ukongeza, ukusuleleka kwintsholongwane ye-hepatitis C kubangela izifo ezingapheliyo kuma-85 ekhulwini abantu abanesifo.

I-Hepatitis C inomntu obhekene ne-hépatocytes okanye iiselingi zesibindi. Ukongezelela koko, intsholongwane iguquka ngokukhawuleza kwaye ngaloo ndlela yenza umsebenzi omhle okhusela umzimba womzimba. Ixesha elide okanye ukuvuvukala okungapheli ekugqibeleni kukukhokelela kwi-necrosis okanye ukufa kweeseli zesibindi kunye ne-cirrhosis. I-cirrhosis ibonakala njengengxube ebomvu exutywe neendununu ezivuselelayo ezenza isibindi sibe ngumbala wokukhanya "we-lumpy". Ekugqibeleni, i-hepatitis C ikhokelela ekunciphiseni umsebenzi wesibindi kunye nokungaphumeleli kwesibindi. Ekugqibeleni, ukusuleleka kwintsholongwane ye-hepatitis C kwandisa umngcipheko we-hepatocellular carcinoma okanye umdlavuza wesibindi. Inqaku, utywala, ukutshaya, ukunyameka kunye nokusuleleka kunye nezinye izifo ezinjenge-HIV (okanye kwintsholongwane ye-hepatitis B) yenza usulelo lwe-hepatitis C lubi kakhulu.

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Unyango Ngaphambi Kokufika Kwezidakamizwa NjengeHarvoni

Kulo nyaka odlulileyo, i-FDA iye yaqhawula kwaye ivunyiwe iziyobisi ezi-3 ezahlukeneyo kunyango lwe-hepatitis C: iHarvoni kunye nabazala bayo bamakhemikhali u-Olysio (simeprevir) kunye no-Sovaldi. Kodwa emva kwexesha, kodwa ke, unyango lweziyobisi kuphela olujoliswe kwintsholongwane ye-hepatitis C yi-interferon ye-pegylated edibene neRibavirin. Olu khetho, nangona lusebenza kakuhle, alusebenzisanga kangako ekucebiseni impendulo eqhubekayo ye-virologic ("unyango") kunoHarvoni kunye nabazala bakhe. Ngaphezulu, i-interferon kunye neRivirvirin kunzima ukulawula, kuthathe ixesha elide ukulawula kwaye ube nemiphumo embi ngakumbi kunezilwanyana ezifana neHarvoni.

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Ngoko Yintoni iHarvoni?

IHarvoni yile yeklasi yezilwanyana ezibizwa ngokuba yi-anti-anti-anti-anti. Ezi zi yobisi zichanekile kwaye zichanekileyo ekujoliseni ukuphindaphinda kwe-viral kune-intergyon ye-pegylated ne-Ribavirin. Ingqalelo, iHarvoni ibonakalise ukuba isebenze kakhulu kubantu abaxhatshazwa ngokukodwa kwi-hepatitis C unyango. Ngaphezu koko, iHarvoni ilawulwa njengentlangano yepilisi yomlomo kwaye iyona yokuqala kwiklasi yayo ukuba ilawulwe ngaphandle kwe-interferon ye-pegylated ne-Ribavirin. Kwiimvavanyo zesikliniki, abangaphezu kwama-90 ekhulwini abathathi-nxaxheba, bobabini kunye nangaphandle kwe-cirrhosis, abafumana iHarvoni bafumana impendulo eqhubekayo ye-virologic ("unyango") emva kweeveki ezili-12 zonyango.

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Yintoni Eyithetha Ngayo Harvonne Kuwe?

Ukuba wena okanye umntu owaziyo unesi-hepatitis C, iHarvoni yonyango elithembisayo. Okokuqala, uphando lubonisa ukuba unyango lwe-anti-virus olujoliswe ekupheliseni intsholongwane ye-hepatitis C inokuphucula i-hertology yesibindi kwaye ikhusele ukutshabalalisa kwesibindi. Okwesibini, iHarvoni, ezayo kwifom yehlanganisi yepilisi, iyasebenza ngakumbi kwaye kulula ukuyithatha ngaphezu kweerimim ejoliswe kwi-interferon ne-Ribavirin. Okwesithathu, iHarvoni ibonakalise ukuba isebenze kakhulu kubantu abaxhatshazwa ngokusesikweni kwi-hepatitis C unyango (izigulane ezine-cirrhosis okanye i-genotype 1).

Kwinqaku lokugqibela, iziyobisi ezinjengeHarvoni ziye zafumana i-press enkulu yokuba zibiza kakhulu. I-regimen yeeveki ezili-12 inokuhlawula i-$ 94,500 okanye ngaphezulu kwama-$ 1,000 ipilisi! (Okanye, ngokuxhomekeke kwindlela obujonga ngayo, intengo ye-Mercedes-Benz S550.) Ngaphezu koko, ezininzi iinkqubo ze-Medicaid zikarhulumente zinzima ukugubungela iindleko zonyango kwaye zifuna ukuba izigulane zihlangabezane neendlela ezichanekileyo zekliniki fumana imvume yangaphambili.

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KwiNqaku lokugqibela ...

Izidakamizwa ezifana neHarvoni ziye zafumana ukukhawuleza kwe-bum bum ngenxa yokubiza. Ngokuqinisekileyo bahlawula imali eninzi kodwa impilo karhulumente kunye neendleko zokuphila ngeyona ndlela enye - kungekho nonyango olufanelekileyo kulabo abanesifo esingapheliyo sesifo se-hepatitis C-sikhulu ngaphezu kwekhulu-yekhulu-yindleko yonyango. Ukuphuhliswa kweziyobisi ezifana neHarvoni yindlela yokwenene yezokwelapha (kwaye andisisebenzisi eli gama ngokulula). Eli liza lithembisa ukunceda abantu abanezifo eziphazamisekanga kakhulu ukuphepha ukuphila okungapheliyo, kwaye ke, umthwalo wokuba unzima ukufumana intsapho, abahlobo kunye nabathandekayo.

_{Imithombo ekhethiweyo}

_{Dienstag JL.} _{Isahluko 304. I-Hepatitis eyi-Virus.} _{Ku: Longo DL, Fauci AS, Kasper DL, Hauser SL, Jameson J, Loscalzo J. eds.} _{Imigaqo yeHarrison ye-Medicine yangaphakathi, i-18e.} _{New York, NY: McGraw-Hill;} _{2012. Kufumaneka ngo-Oktobha 14, 2014.}

_{Dienstag JL.} _{Isahluko 306. I-Hepatitis engapheliyo.} _{Ku: Longo DL, Fauci AS, Kasper DL, Hauser SL, Jameson J, Loscalzo J. eds.} _{Imigaqo yeHarrison ye-Medicine yangaphakathi, i-18e.} _{New York, NY: McGraw-Hill;} _{2012. Kufumaneka ngo-Oktobha 14, 2014.}

_{http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm376449.htm.} _{Fi kelelwa ngo-10/14/2014.}

_{"Simeprevir ekwenzeni unyango lwentsholongwane ye-hepatitis C" nguLaure Izquierdo et al ukusuka ku- Pharmacogenetics kunye neMicrosoft Personalized epapashwe ngo-Agasti 14, 2014. Ukufikelela kwi-10/14/2014}

_{"Iimpawu zokwelapha ze-Hepatitis C" nguYoung Kim et al waseGuit Liver opapashwe ngoSeptemba 2014. Ukufikelela kwi-10/14/2014.}

_{http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4164256 /}

_{URyan KJ, uRay C. Isahluko 13. Iintsholongwane ze-Hepatitis.} _{Ku: URyan KJ, uRay C. eds.} _{ISherris Medical Microbiology, 5e.} _{New York, NY: McGraw-Hill;} _{2010. Kufumaneka ngo-Oktobha 14, 2014.}

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