I-Hepatitis C (i-HCV) yonyango ephumelelayo kakhulu ekuphiliseni intsholongwane, kwaye izidakamizwa zitsha ziza kuphucula imeko yabantu abane-cirrhosis obangelwa yi-HCV, nokuba ngaba uphezulu lwangaphambili luhlulekile.
Ngokuqhelekileyo, phakathi kwama-20% kunye no-30% we-HCV izifo zihlanjululwa ngaphandle kokungenelela kwezokwelapha. Kwama-70% ukuya kuma-80%, usulelo luyakwazi ukuqhubela phambili kwiminyaka eminci kwaye lonakalise ubunzima besibindi.
Phantse ama-30% abantu abasulelekileyo abane-HCV bavelisa iziphumo ezinzulu ezifana ne- cirrhosis , umdlavuza wesibindi , okanye ukuphelelwa kwesibindi sokuphela, kwaye ekugqibeleni kufuneka babe nokutsalwa kwesibindi.
Imigaqo
Injongo yonyango lwe-hepatitis C kukukhusela intsholongwane kwindawo ekungabonakali ngayo kwigazi. Xa intsholongwane ihlala ingabonakali ngeemvavanyo zegazi ngexesha elide, oku kuchazwa njengempendulo ye- virologic eqhubekayo (SVR) .
Uphando luye lwabonisa ukuba abantu abane-HCV abanesifo esingapheliyo ne-HVV abanama-SVR kwiiveki ezingama-24 emva kwe-HCV unyango bane-1% ukuya kwi-2% ithuba lokufumana intsholongwane. I-SVR-24 ibalwa njengonyango. Kwabanye abantu abane-HCV abangenayo i-SVR-24 abanamava okuqhubekayo okuqhubekayo kunye nokuguqulwa kwesinye isiqhamo sesibindi esichaphazelekayo.
I-Antivirals yokuSebenza ngokuthe ngqo (DAAs)
Ukusebenzisa i-anti-virus (DAAs) ngokukhawuleza, yile iklasi elitsha leyeza ukufumana amayeza angama-99%, kunye nexesha lokunyanga kweeveki ezili-12, kunye neempembelelo ezincinci kunye nexesha elifutshane.
Ezi zonyango zingasetyenziselwa ukusuleleka kwe-HCV enesifo esingapheliyo, kunye nesifo esiphezulu sesibindi.
I-DAA iyakwazi ukunyanga inani elinyukayo leengxaki ze-genetic HCV, kwaye i-DAA nganye inconywa kuphela kwimimandla ethile.
Ama-DAA alandelayo avunywe yi-FDA kunyango lwe-hepatitis C engapheliyo:
- I-Daklinza (daclatasvir) : ivunyiwe kwi-HCV ye-genotype 3. ithathwa njengetyulethi yansuku zonke kwaye ayikhuthazwa ukuba unesifo senhliziyo.
- Harvoni, Epclusa (sofusbuvir + ledipasvir ) : ivunyelwe i-HCV i-genotype 1. Ithathwa njengebhelethi yansuku zonke, kaninzi idibene ne-ribavirin.
- I-Sovaldi (sofusbuvir ) : ivunyiwe kwi-HCV i-genotypes 1, 2, 3 ne-4. Thatha njengetyulethi yansuku zonke ne-rbavirin okanye ne-ribavirin kunye ne-peginterferon.
- I-Technivie (ombitasvir + paritaprevir + ritonavir) : ivunyiwe kwi-HCV ye-genotype 4. Iipilisi ezimbini ezibanjwe imihla ngemihla, kwaye ziphazamise imithi emininzi yemithi.
- I-Viekira Pak (ombitasvir + paritaprevir + ritonavir ehlanganiswe ne-dasabuvir) : ivunyelwe i-HCV i-genotype 1. ithathwa njengetyebhulethi kabini imihla ngemihla kwaye ingathathwa kunye ne-ribavirin.
- I-Olysio (simeprevir) : ivunyiwe kwi-HCV ye-genotype 1. ithathwe njengepilisi rhoqo ngosuku kwaye inokudibaniswa namayeza okusuleleka kuGawulayo.
- I-Zepatier (grazoprevir + elbasvir) : ivunyiwe kwi-HCV i-genotypes 1, 4 ne-6, ithathwe njengebheyilethi yansuku zonke ene-ribavirin.
Inani lamachiza amadala, njenge-Incivek kunye neVictrelis, babesethathe umhlala phantsi ngabakhiqizi, kuba bebengasadingeki xa ii-DAA ezintsha zivunyiwe.
Peginterferon kunye neRibavirin
I-Peginterferon , kunye ne- ribavirin , sele ithathwa njengonyango oluqhelekileyo lwe-HCV engenasifo ngaphambi kokuba kuvele ii-DAA.
Akunjalo unyango oluqhelekileyo kwakhona, kodwa bajongwa njengabalulekile kubantu abanezifo eziphambili, kuquka i-cirrhosis, okanye ezinye iindlela ukuba ii-DAA zingasebenzi. Ngokubanzi, ukuphumelela kwe-peginterferon, kunye ne-ribavirin i malunga ne-90%, engekho ephakamileyo njengaleyo i-DAA entsha, ezinye ii-DAA zinconywa ukuba zithathwe nge-ribavirin efanayo okanye unyango lwe-peginterferon.
Phakathi kweempembelelo ze peginterferon kunye ne-ribavirin yimiphumo emibi yeyeza. Imiphumo ibandakanya:
- IAnemia
- Intloko
- Ukutshatyalaliswa, ukuxhalaba, ukudandatheka nokuzibulala
- Ukulahleka kweenwele
- Ukuhlamba kunye nokugqithisa kwesikhumba
- Ukungazinzi kunye nokukhathala
- Intlungu ehlangeneyo kunye neentlungu
- Isihlunu kunye nokuhlanza
- Umkhuhlane, ukubola
Impendulo kwi-DAA okanye enye inyango ye-anti-virus ichazwa ngale ndlela ilandelayo:
- Impendulo yegciwane le-viral Rapid (RVR) - Umthwalo ongenakulinganiswa wentsholongwane emva kweeveki ezine zonyango
- Ukwandiswa kwe-viral response (eRVR) ngokukhawuleza. kulandela iRVR yokuqala
- Impendulo yokuqala ye-viral (EVR) - Umthwalo wentsholongwane engabonakaliyo okanye ukuncipha kwepesenti ezingama-99 kumthwalo wentsholongwane ngeentsuku ezili-12
- Ukuphela kokuphendula kwonyango (ETR) - Umthwalo wentsholongwane ongabonakali ufikelele kwiiveki ezili-12
- Umphendula-nxaxheba-Ufezekisa i-EVR, kodwa akakwazi ukugcina umthwalo wentsholongwane engabonakaliyo iiveki ezingama-24 emva kokuba unyango lugqitywe
- Umphenduli weNull- Awukwazi ukufikelela kwi-EVR ngeveki eziyi-12
- Impendulo enesifo se-viral response (SVR) - Unako ukugcina umthwalo wentsholongwane engabonakaliyo kwiiveki ezili-12 (i-SVR-12) kunye neeveki ezingama-24 (SVR-24) emva kokugqitywa kweyeza
Ukuhlinzwa
I-HCV inokubangela isifo esiqinileyo sesibindi, kwaye sinokuqhubeka isifo sesibindi sokugqibela. Lo ngummo wokusongela ubomi obangela ukuba isibindi sonakaliswe kangangokuba asikwazi ukusebenza ngendlela efanele. Ukunyanga okutyunjelwayo kwisifo sokugqibela sesibindi kubandakanya ukuphathwa ngokuphawulekayo kwaye mhlawumbi ukufakelwa kwesibindi.
- Ukutshintshwa kwesibindi: Ukutshintshwa kwesibindi kuthathwa njengonyango olukhuselweyo lwezifo zesibindi sokugqibela. Nangona kunjalo, i-HCV inokuphinde ibuye emva kokutshintshwa ngenxa yokuba intsholongwane iyakwazi ukuphila kwigazi. Ngokuqhelekileyo, ukufakelwa kwesibindi kwenziwa ngokusetyenziswa kwesibindi kumntu oshonile. Ukutshintshwa kwesibindi kunokwenziwa ngokusetyenziswa kwesibindi esincinci kumniki wokuphila. Ukuba ufumana isibindi kumntu ophilileyo, isibindi sakho esitsha sokulindela kulindeleke ukuba sivuselele ngokukhawuleza. Isibindi esincinane esihlala emzimbeni womniki-mali ophilayo silindeleke ukuba sivuselele ngokukhawuleza. Nangona utyando luyinkqubo enkulu kubini nomnikeli, ngamnye umntu kulindeleke ukuba aphile kwaye abe nesibindi esisebenza ngokupheleleyo.
- I-Esophageal Banding: Ukuphuhliswa kwezilwanyana ezingapheliyo, ukuxhamla kwezifo zesibindi zesigxina, ukukhukhumeza kwemithambo yegazi yesifo esibangelwa ziziingxaki zokuhamba kwegazi kwisibindi esifubeni. Ama-varice angagcina aphuma. Inqubo ebizwa ngokuba yi-banding inokumisa ukuphuma kwamagciwane okuxhamla ngokubeka iinqwelo zerabha kwiinqanawa.
Ukunyamekela / Indlela yokuphila
Ukuba unayo i-HCV, kukho izinto ezibalulekileyo ezifunekayo ukuba uzigcine engqondweni njengoko uphila. Ukuqinisekisa ukuba ugwema nayiphi na into enokulimaza isibindi sakho.
- Gwema utywala: Ukusetyenziswa kakubi kotywala kungabangela ukuhluleka kwesibindi. Ukumodareyitha, utywala akufanele kubangele ukungabikho kwesibindi kumntu onesibindi esinempilo. Kodwa, ukuba sele unesimo esichaphazela umsebenzi wakho wesibindi, awukwazi ukuxilisa utywala ngokuqhelekileyo, ngoko ke inkolelo encinci ingaba yingozi.
- Musa ukusebenzisa i-Acetaminophen: Amachiza amaninzi aqhutyelwa esibindi , kwaye awukwazi ukuthatha ukuba unobungozi besibindi kwi-HCV. Uninzi lwala mayeza ludinga imithi, ngoko akunakwenzeka ukuba ugqirha wakho okanye ikhemistiya uya kukuvumela ukuba uthathe ukuba uwazi i-HCV. Nangona kunjalo, i-acetaminophen (i-Tylenol) ingaphezu kwe-counter, iyeza eliqhelekileyo elisenokuba usenakho ekhaya. Awukwazi ukuyithatha ukuba unesifo sesibindi naliphi na isizathu, kuquka i-HCV. Ukuba unempawu zentlungu okanye umkhuhlane, cela udokotela wakho ukuba acetyise elinye iyeza elingaziphazamisi ezinye iyeza ozithathayo okanye ezifuna ukusebenza kwesibindi esihle.
- Ukulawula uxinzelelo lwegazi: Ukungaphumeleli kwesibindi kungabangela imeko ebizwa ngokuba yi-portal yongcinezelo yongcinezelo, eyinyuselo kwingcinezelo yegazi yesibindi. Nangona oku akuhambelani ngqo nomfutho wakho wegazi jikelele, ukugcina uxinzelelo lwegazi oluqhelekileyo kuyindlela ebalulekileyo yokuphepha ukungongeza kwiinkathazo zengxowankulu yokuxinzelelo.
I-Medicine eQinisiweyo kunye neyanye
Ezinye iintswelo ze-vitamin ziye zaphawulwa phakathi kwabantu abane-HCV. Ukungaphumeleli kwe-Vitamin ayikwazi ukubangela iHCV, kuba kubangelwa isifo. Ukuhluleka kwesibindi ngokwayo kubangela ukungabikho kwamavithamini athile.
- I-Vitamin D: I-Vitamin D, ngokukodwa, ithathwa njengengozi ye-HCV yesifo esichengileyo, kwaye imbangela yalo mbutho ayicacanga. I-Vitamin D iyinvitham e-mafutha ehlaziyiweyo, oku kuthetha ukuba kufuna ukuba amafutha afakwe ngokufanelekileyo. Ukuba unesibindi sokungabikho kwesibindi ngenxa ye-HCV, oku kunokukwenza kube nzima ukuba ufumane i-vitamin D. Kunconywa kuphela ukuba uthathe isongezelelo xa izinga lakho le-vitamin D liphantsi.
- I-Vitamin A, iVithamini E: zombini iithamini ezinamafutha anelulweyo ezingenakunyulwa ngokufanelekileyo xa unesibindi sokuhluleka kwesibindi. Ukongezwa kunokufuneka, kodwa kuphela ukuba amazinga akho aphantsi.
Kuye kwaphakanyiswa ezinye iindlela zokwelapha kwezinye iindlela kwiindawo ezahlukahlukeneyo unyango nolawulo lwe-HCV, kodwa akukho zifundo ezibonisa ukhuseleko lokusebenza. Ngenxa yokuba ezininzi izityalo kunye neivithamini ziqhutyelwa esibindi, ezinye iindlela zonyango ezingenokuba luncedo xa unesibindi sempiliso singabangela ingozi ukuba isibindi sakho singasimpilo. Kubalulekile ukuba uqaphele ngakumbi ukuba sele usebenzisa i-vitamin okanye i-herb supplement, njengoko ungeke ukwazi ukuwenza kwakhona xa unayo i-HCV.
Ezinye izixhaso eziqhelekileyo ezinobungozi xa unesibindi sokuhluleka kwe-HCV:
- I-Vitamin K: I-vitamin enamandla enceda igazi lakho ukuba livale, lingabangela ukugqithisa kwegazi ngokugqithiseleyo ngenxa yokungalingani kwemisebenzi yokuqhafaza igazi ngenxa yokungafezeki kwesibindi.
- I-Ginkgo Biloba: Imifuno edala igazi elincinci, le nto ingabangela ukuphuma kwegazi xa unesibindi sokuhluleka kwesibindi, kuba ukuhluleka kwesibindi kubangele kubangele ukuphazamiseka kwegazi.
- Iingxube ezixubileyo: Uphando olutshanje lubonisa ukuba izilwanyana zamachiza zingabangela ukulimala kwesibindi. Oku kuthetha ukuba kufuneka uqaphele xa unayo i-HCV. Kukulungele ukujonga ngogqirha wakho okanye kumachiza wamanzi ngaphambi kokuthatha isongezelelo semfuyo, nangona sele sele uyithatha ixesha elide.
> Imithombo:
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> Buonomo AR, Zappulo E, Scotto R, et al. Ubunzima be-Vitamin D bubangela umngcipheko kwizifo kwizigulane ezichaphazelekayo nge-cirrhosis ezinxulumene ne-HCV. Int J I-Dis Disfect. Ngo-2017 Okthoba; 63: 23-29. i-doi: 10.1016 / j.ijid.2017.07.026. Epub 2017 Aug 10.
> Caicedo LA, Delgado A, Garcia VH, et al. Ukugqithiswa kwesibindi kwi-Hepatitis C-Izigulane ezichaphazelekayo: Iivela ezivela kwiziko lokuThumela eMzantsi Afrika. Ukutshintshwa kwePro. Ngo-2018 Mar; 50 (2): 493-498. i-doi: 10.1016 / j.transproceed.2017.11.046.
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