I-Newer Antitiviral Izidakamizwa Ukuxhamla ngaphezu kwama-90%
Xa ucinga ukuba i-virus ye-hepatitis C (i-HCV) yabonakala kuqala ngo-1989 kwaye ngokuyininzi ithathwa njengingenakuphulukiswa kuze kube yindawo ekugqibela yekhulu lama-20, ukuqhubela phambili kwonyango akuzange kumangalise.
Kwakuphela ngoDisemba 2013, eqinisweni, ukuba umdlalo watshintshi ngokupheleleyo ngokukhutshwa kweSovaldi , i-anti-virus (DAA) echaphazelekayo eyenza imiphumo emibini, ixesha elifutshane lokunyanga, kunye neqondo lokunyanga eliphezulu njengama-99 ekhulwini kwezinye abantu.
Ukusebenza ngokugqithiseleyo ukuba iziyobisi ziye zatshatyalaliswa kubantu bobabini abanentsholongwane ekhuselekileyo ye-HCV, kunye nalabo abanesifo esiphambili sesibindi.
Ngokuqonda kangcono iinjongo zesifo se-hepatitis C-kuquka ukusetyenziswa kwezidakamizwa kwaye zisetyenziswe-unokwenza ukhetho olunolwazi malunga nenkqubo yesenzo efanelekileyo kakhulu kuwe.
Iinjongo ze-Hepatitis C Therapy
Njengomthetho wesithupha, unyango lwangaphambili lwe-hepatitis C lubhekiselele kwiziphumo ezingcono, kungekhona nje ngokucima intsholongwane kodwa ekuthintela nayiphi na umonakalo omde kwisibindi kunye nezitho ezinxulumene nazo.
Iinjongo zonyango lwe-hepatitis C ngoko ke, ziphindwe kabini:
- Ukufezekisa impendulo yentsholongwane engapheliyo (SVR) , ichazwa ngokungabikho kokusulela kwintsholongwane egazini lomntu ixesha elizayo emva kweeveki ezingama-24
- Ukuthintela ukunyuka kwesifo sesibindi, kubandakanywa nophuhliso lwe- cirrhosis kunye nomhlaza wesibindi
Ngethuba lekhosi, iimvavanyo zesebhu ziqhutyelwa rhoqo ukuvavanya inqanaba legciwane kwigazi lomntu.
Eyaziwa ngokuba ngumthwalo we- HCV , loo mvavanyo inokunceda oogqirha baxelele umphumo (okanye ukuxela).
Umthwalo wentsholongwane ongabonakali uyabonwa njengempendulo efanelekileyo, ngeeveki ezingama-24 ze-SVR ziqwalaselwe ngokufanelekileyo "ngonyango."
Iipathologists zichaza ngokucacileyo impendulo yonyango ngale ndlela:
| Ixesha | Nentsingiselo | Inkcazo | Prognosis |
| RVR | Impendulo yeVIV | Umthwalo ongenakubonakali wentsholongwane emva kweeveki ezine zonyango | Ngokubanzi amathuba okufikelela eSVR |
| eRVR | Ukuphendula ngokukhawuleza kwintsholongwane | Umthwalo ongenakulinganiswa wentsholongwane kwiveki 12, emva kweRVR yokuqala | Ngokubanzi amathuba okufikelela eSVR |
| EVR | Impendulo yokuqala yegciwane | Umthwalo ongenakulinganiswa wentsholongwane okanye i-99 ekhulwini yokunciphisa umthamo wentsholongwane ngeveki 12 | Ukungaphumeleli ukufezekisa i-EVR ngeveki ezili-12 kunye neepesenti ezili-4 ithuba lokufikelela kwi-SVR |
| ETR | Ukuphela kwempendulo yonyango | Umthwalo wentsholongwane ongabonakali owenziwe ekupheleni kweveki 12 | Akukho luncedo ekuqikeleleni iziphumo zonyango |
| Mphendula | Iyakwazi ukufezekisa i-EVR kodwa ayikwazi ukugcina umthwalo wentsholongwane engabonakaliyo kwiiveki ezingama-24 emva kokupheliswa kweyeza | Kucatshangwa ukuhluleka kokonyango | |
| Umphenduli weNull | Ayikwazi ukufikelela kwi-EVR ngeveki 12 | Unyango lupheliswa ngokuqhelekileyo ukuba i-EVR ayiphumeli ngeveki 12 | |
| SVR | Impendulo yesifo segciwane | Iyakwazi ukugcina umthwalo wentsholongwane engabonakaliyo kwiiveki ezili-12 (i-SVR-12) kunye neeveki ezingama-24 (SVR-24) emva kokugqitywa kweyeza | I-SVR-24 ingaqwalaselwa "yonyango," ngelixa izigulane ezineSVR-12 zikwazi ukuphumeza i-SVR-24 |
Namhlanje, abangaphezu kwama-99 ekhulwini abo bafezekisa i-SVR-24 baya kuhlala bengenayo i-virus engenani iminyaka emihlanu. Kulabo, phantse isiqingatha kuya kubakho isisombululo se-cirrhosis ngaphakathi konyaka, ngelixa abaninzi baya kubona ukuguquka okuphawulekayo kwinqabu yesibindi ( fibrosis ).
Ukuqala nini Ukwelashwa
Ubungqina buxhasa kakhulu unyango lwabantu bonke abane-hepatitis C, abaneminyaka eyi-18 okanye ngaphezulu. Okukuphela kokungabikho ngabantu abanomdla wokuphila kweenyanga ezingaphantsi kwe-12 ngenxa yezizathu ezingenayo isibindi.
Nangona kunjalo, njengokuba unyango lungenakufumaneka kuzo zonke izigulane (ngenxa yeendleko okanye ukunciphisa i-inshorensi), kufuneka kubekwe phambili kubantu abanesidingo esiphuthumayo. Ezi ziquka abantu abane-fibrosis ehamba phambili, i-cirrhosis ehlawulwe, ukufakelwa kwesibindi, okanye iingxaki ezinzulu ezinxulumene nesibindi zentsholongwane ye-HCV.
Ukuqwalaselwa kwakhona kunikwa abantu abasengozini enkulu yokuxhatshazwa kwe-hepatitis C, ezibandakanya abo abane-modrositi ephantsi, ukusuleleka kwintsholongwane kaGawulayo , ukusuleleka kwintsholongwane ye- hepatitis B, uhlobo lwesifo sikashukela, kunye nezinye izifo zesibindi.
Kuyafaneleka ukuphawula ukuba abantu abanokufumana unyango lokuqala bangenelwa kakhulu, kungekhona ngokunciphisa umonakalo wesibindi kodwa ngokunyusa ixesha le-SVR.
Uphando lubonise ukuba abantu abaphathwayo kwiindlela zokuqala ze-fibrosis (njengoko kulinganiswa ngamanqaku e- METAVIR ) banethuba elingamaphesenti angama -92 lokungenayo igciwane lesandulela ngculaza iminyaka engama-15.
Ngaphambi kokuba uqalise nayiphi na inkatho yokonyango, kubalulekile ukuba uvavanye kokubili ukuzimisela kwakho kunye nokukwazi ukunamathela kunyango. Ukuba ubona phambili iingxaki-kubandakanywa nemiba yomsebenzi okanye imicimbi yobuqu, ukusetyenziswa kotywala / ukusebenzisa iziyobisi, okanye ukwesaba malunga namachiza ngokwabo-qiniseka ukuxoxa ngale ngagqirha ngaphambi kokuqala unyango. Iinkonzo zenkxaso zinokufumaneka ukufumana uncedo olungcono kwiinkalo.
Ukunikezelwa kwemithi ye-Hepatitis C
Ulwaphulo lwe-Hepatitis C luqukethe elinye okanye ezinye iifayili zonyango, eziqhelekileyo kwi-eveki ezili-12.
Kwezinye iimeko, ubude bexesha lonyango luya kufikelela kuma-24 okanye kwiiveki ezingama-48, ngokuqhelekileyo kubantu abane-cirrhosis okanye abo baye bahluleka ukunyanga.
Ukongeza kwi-DAA echanekileyo, ezinye izilwanyana ezimbini zingasetyenziselwa njengenxalenye yonyango:
- i-peginterferon , inguqu eyenziwe ngumntu we-interferon, eyenza ngokutyhilela umzimba kwi-agent echaphazela izifo ezifana ne-HCV
- i-ribavirin , isilwanyana somlomo esaziwayo ukuphazamisa ukuphindaphinda kwentsholongwane
I-Peginterferon, ekhutshwe nge-injection, ibhalwe ngokuqhelekileyo nge-ribavirin. I-Ribavirin, ngokuchaseneyo, isetyenziswa ngokubodwa ngokubambisana nenkunkuma ye-DAA ephambili.
Ukukhethwa kwezidakamizwa kusekelwe kwi- genetic type (genotype) yesifo somntu umntu osulelekileyo, kunye nokuhlolwa kwimo yempilo yomntu kunye nembali yonyango yangaphambili.
Kukho izidakamizwa ze-DAA zisibhozo ezivunyiweyo yi-US Food and Drug Administration:
| Iziyobisi | Kuvunyelwe | U myalelo | Ukukhetha | Ubude |
| I-Epclusa (sofosbuvir + valpatasvir) | i-genotypes 1, 2, 3, 4, 5, ne-6 kunye okanye ngaphandle kwe-cirrhosis | kunye nathi ngaphandle kwe ribavirin, kuxhomekeke kwi-genotype kunye nembali yonyango | iipilisi enye imihla ngemihla ngaphandle kokutya | 12-16 iiveki |
| I-Zepatier (elbasvir + grazoprevir) | i-genotypes 1 ne-4 kunye okanye ngaphandle kwe-cirrhosis | kunye nathi ngaphandle kwe ribavirin, kuxhomekeke kwi-genotype kunye nembali yonyango | iipilisi enye imihla ngemihla ngaphandle kokutya | 12-16 iiveki |
| Daklinza (daclatasvir) | i-genotype 3 ngaphandle kwe-cirrhosis | noSovaldi | Iipilisi enye imihla ngemihla ngokutya | Iiveki ezili-12 |
| I-Technivie (ombitasvir + paritaprevir + ritonavir) | i-genotypes 4 ngaphandle kwe-cirrhosis | ne ribavirin | ezimbini iipilisi imihla ngemihla ngokutya | Iiveki ezili-12 |
| Viekira Pak (ombitasvir + paritaprevir + ritonavir, ehlanganiswe ne-dasabuvir) | i-genotype 1 kunye okanye ngaphandle kwe-cirrhosis | kunye okanye ngaphandle kwe ribavirin, njengoko kubonisiwe | Iipilisi ezimbini ze-ombitasavir + paritaprevir + ritonavir ezithathwa kanye ngosuku ngokutya, kunye nesibhebhe enye yedasavuvir ithathwa kabini imihla ngemihla ngokutya | 12-24 iiveki |
| Harvoni (sofosbuvir + ledispasvir) | i-genotype 1 kunye okanye ngaphandle kwe-cirrhosis | ngokwabo | iipilisi enye imihla ngemihla okanye ngaphandle kokutya | 12-24 iiveki |
| Sovaldi (sofosbuvir) | i-genotypes 1, 2, 3, kunye ne-4 kunye okanye ngaphandle kwe-cirrhosis | kudibene ne ribavirin, Olysio, peginterferon + ribavirin, okanye i-Olysio + ribavirin, njengoko kubonisiwe | iipilisi enye imihla ngemihla okanye ngaphandle kokutya | 12-24 iiveki |
| Olysio (simeprevir) | i-genotype 1 kunye okanye ngaphandle kwe-cirrhosis | ngokunxulumene neSovaldi okanye peginterferon + ribavirin, njengoko kubonisiwe | i-capsule enye imihla ngemihla ngokutya | 24-48 iiveki |
Uthintano lweengcali kufuneka lufunwe ngabantu abathile baphinde baphucuke ngenxa ye-hepatitis C emva kokusweleka kwonyango kwangaphambili. Izigqibo zokubanjwa kwakhona kufuneka zisekelwe kuvavanyo lweentlobo kunye nokudibanisa kweziyobisi ezisetyenziswe ngaphambili, kunye nokuhlolwa kwesibindi somntu.
Kwezinye iimeko, ukuhlolwa koxinzelelo lwezofuzo, ezinokubangela ukuphuculwa kwe-HCV ukuxhathisa iziyobisi, kunokunceda ekukhetheni izidakamizwa, ngokukodwa kubantu abane-infection ye-genotype 1 abaye bavezwa kwi-DAAs.
> Umthombo:
> Umbutho waseMerika wokuFundisisa iSifo seMiyo (AASLD) kunye ne-Infectious Diseases Society of America (IDSA). "Isikhokelo se-HCV: Iingcebiso zoVavanyo, ukuLawula nokuPhatha i-Hepatitis C." Ihlaziywe ngoJulayi 6, 2016.