Intsholongwane ye-Hepatitis C (i-HCV) idla ngokuxilongwa ngegazi. Uvavanyo lwe-antibody luyakwazi ukubona ukuba umzimba wakho ufanele ulwa ne-HCV. Uvavanyo lwegazi olulinganisa intsholongwane kwigazi lakho liqinisekisa ukuxilongwa, kodwa iziphumo zithatha ixesha elide. Ngamanye amaxesha, iimvavanyo zentsholongwane, izifundo zokucinga okanye i-biopsy zinokuxhasa okanye ziqinisekise ukuxilongwa kwakhona.
I-Self-Checks / Ukuvavanywa Kwekhaya
Ukuba ucinga ukuba unakho iHCV, kukho impawu ezimbalwa onokuzama ukuzijonga zona. Ingxaki, nangona kunjalo, ngokuzihlolisisa i-HCV, kukuba ezininzi iimpawu onokuzibona ziqhelekileyo kwiintsholongwane ezininzi zentsholongwane. Ezinye zeempawu onokuzijonga zibonakalisa izifo zesibindi, kodwa azicacanga kwiHCV.
Ikhumba kunye neEyes
Uphawu olona luphawu lweHCV luyi-jaundice, umbala ophuzi wesikhumba kunye namehlo. I-jaundice ichaphazela umzimba wonke kunye nenxalenye emhlophe yamehlo. Lo mbala ungabonakala njengotshani obumnandi, phantse nje nge-suntan, okanye, ukuba isifo sinefuthe elikhulu kumsebenzi wesibindi, amehlo akho nesikhumba kunokuba ngumbala ophuzi obomvu kakhulu.
I-Jaundice ibonisa ukungaphumeleli kwesibindi okanye ukungasebenzi kwesibindi, ngoko akucaci kwi-HCV.
UkuHlelwa kweBisu
Ukwandiswa kwendawo yesisu, okanye ngaphandle kokungazinzi, kuyaqheleka kwinqanaba leHCV.
Abantu abaninzi abanayo nayiphi na imiqondiso ye-HCV kumanyathelo okuqala okusuleleka, kwaye ukuvalelwa kwesisu kuya kuba yinkcazelo yokuqala enayo i-HCV.
Iimpawu ezinjenge-Flu
Ukuba unentsholongwane ekhuselekileyo yeHCV, unokuba ne-fever epholileyo, ukukhathala, ama-muscle aches, ukulahleka kwesidlo, isisulu sokusambisa isisu kunye nesisu esincinci. Unokukufumana oku malunga naluphi na usulelo lwentsholongwane, ngoko akuyona inkcazelo enamandla yokuba une-hepatitis.
Iimpawu zesisu
Ukuba unentsholongwane echaphazelekayo yeHCV, mhlawumbi ufumana isisu esicasulayo, isicathulo, ukuhlanza okanye uhudo. Njengazo iimpawu ezinjengomkhuhlane, oku akusiyo uphawu oluchanekileyo lwe-HCV ukusuleleka, njengoko kungenzeka nakwezinye izifo.
Izinto zobungozi
Uninzi lwexesha, awuyi kukwazi ngokukhawuleza ukuba usulelekile ngeHCV. Ukucinga ngokucophelela malunga nokuba unemiba yengozi yindlela efanelekileyo yokujonga ukuba unakho i-HCV.
Ukuba unomngcipheko okanye nayiphi na imiqondiso ye-HCV, kucetyiswa ukuba uvavanywe intsholongwane.
IiLabs kunye novavanyo
Kukho iimvavanyo ezininzi zegazi ezinokufumanisa ukusuleleka kwe-HCV, ukugqiba ikhondo elifanelekileyo lokunyanga, kwaye ulonge inkqubela yakho. Iimvavanyo zegazi zingakhangela i-HCV antibody, i-HCV ngokwalo, kunye neenguqu zentshintsho yomsebenzi wesibindi.
Iimvavanyo zegazi ze-HCV
Xa iintsholongwane ze-hepatitis C zihlasela iintsholongwane zakho, isistim somzimba sakho siphendula ngokusetyenziswa kwamagciwane okubhengeza iipirisi njengabangenayo. Ama-antibodies akhethekileyo kwi-HCV, ngoko ubukho babo bubonisa ukuba ube neHCV ngexesha elithile ebomini bakho. Uvavanyo lwe-Antibody alukwazi ukwahlula phakathi kokusuleleka kwintsholongwane yangoku okanye yangoku, ngoko ke ulwazi lwekliniki njengembali yezobugqirha, iimpawu, iimpawu okanye ezinye iimvavanyo zinganquma ukuba unentsholongwane esebenzayo okanye ususuleleko lwentsholongwane.
Enyanisweni, uvavanyo oluchanekileyo lwama-antibody lungathetha ukuba unesifo osukulwe ngempumelelo, kwaye ukuba unamandla okuzivikela kwi-HCV.
- Uvavanyo lwegazi: i-Enzyme-Linkedun ImmunoSorbent Assay (i-ELISA) ivavanya i-antibodies egazini lakho. Kukho iimvavanyo ezahlukeneyo ze-ELISA. Uvavanyo lwe-ELISA lwe-HCV lufuna isampuli yegazi kwi-HCV. Ukuba kuthe kwafunyanwa izifo-mzimba, oku kuthetha ukuba unokufumana usulelo lweHCV. Uvavanyo lwe-ELISA lubuhlungu kakhulu, kwaye lu-95% lwamaxesha athile ukuba unama-antibodies eHCV. Olu bulumko obuphezulu luthetha ukuba xa uvavanyo lwe-ELISA lubi, unokuqiniseka ukuba unayo i-HCV. Nangona kunjalo, iyancipha ukuba ingabonakalisa ngokuchanekileyo amachiza e-HCV, kwaye kukho ncinane ukuba umphumo ontle ungalunganga. Ngenxa yeso sizathu siphumo esiphuculisayo, uvavanyo lwesibini lunokufuneka ukuba uqinisekise imiphumo yokuqala.
- Uvavanyo olukhawulezayo: Uvavanyo olukhawulezayo lunokufumanisa i-HCV egazini okanye ematheni akho nge-89% ukuqonda kunye ne-100% ethile. Oku kuthetha ukuba akayikukhathazeka njengolu vavanyo lwe-ELISA, kwaye uyakuphosa ubukho beHCV ngezinye ixesha. Kodwa ukuba uvavanyo lukhangelekile, ngoko unokuqiniseka ukuba unayo okanye unayo i-HCV emzimbeni wakho ngexesha elithile.
Rpatitis C RNA
Ukufunyanwa kwe-HCV RNA, ebonakalayo yintsholongwane yegciwane, ibonisa ukuba intsholongwane ngokwayo ikhona emzimbeni wakho. Olu vavanyo olunamandla luvumela oogqirha ukuba babone indlela ophendula ngayo unyango ngenxa yokuba unokumisela inani lentsholongwane egazini lakho, elidla ngokuba ngumthamo wentsholongwane . Iyabona intsholongwane ngokusebenzisa iteknoloji ye- PCR (i-polymerase chain reaction reaction), yindlela yokufumana izinto eziphathekayo zofuzo.
Ukusebenzisa iimvavanyo ze-ELISA kunye ne-HCV RNA ndawonye:
- I-ELISA Negative = Akukho i-antibodies ye-hepatitis C efumaneka kwigazi. Cishe awusulelekile ngeHCV.
- I-ELISA = Inokuthi unako ukusuleleka kwe-HCV. Nangona kunjalo, kunokwenzeka ukuba lo buxoki. Kufuneka uvavanyo oluninzi.
- Hative HCV RNA = Akukho ntsho longwane lweHCV.
- I-HCV efanelekileyo ye-RNA = Ukusuleleka kwe- HCV .
I-Hepatitis C ye-Virus Genotyping
Iintsholongwane ze-Hepatitis C azifani. Ngokuqinisekileyo, zonke zichongwa njenge-virus ye-hepatitis C kwaye zonke zinokubangela ukusuleleka kwe-hepatitis C enesifo esingapheliyo, kodwa asiyiyo imfuyo efanayo. Zineendlela ezahlukeneyo zohlobo lwezofuzo, kwaye ziqokelelwe kwii-genotype ezahlukeneyo (iifomethi zezofuzo). Ukwazi i-genotype yakho inokunciphisa kakhulu ubude bonyango lwakho kuba ugqirha wakho unokukhetha unyango olulungileyo uhlobo lwe-HCV onayo.
Ii-genotype zibalulekile kuba iintsholongwane ze-hepatitis C ezihlukeneyo zohlobo lwezofuzo zifuna iindlela ezahlukeneyo zonyango. Oogqirha banquma i-genotype yakho ye-HCV kunye novavanyo lwebhubhoratri olusebenzisa indlela ebizwa ngokuba yi-transverse transcription polymerase chain reaction (RT-PCR). Olu vavanyo luhlalutya izinto eziphilayo zentsholongwane ukuba zichane ngokulandelelana kwazo, ezichaza i-genotype yegciwane.
ImiSebenzi yeBindi (i-LFTs)
Izilingo zomsebenzi zentsholongwane zingabi ziqhelo ukuba intsholongwane kunye nokuvuvukala kubangela ukulimala esibindi. Ezi mvavanyo ngokuqhelekileyo azikulindelekanga ukuba zingavumelekanga kude kube sezantsi. Kwaye, unyango lweHCV lunokuguqula amanqanaba e-LFT.
I-LFTs eziguqulwayo xa unobungozi benesibindi ziquka:
- Albumin
- Bilirubin
- Ixesha leProthrombin (PT)
- I-International Ratio Ratio (INR)
I-LFTs ezinokutshintshwa xa unokubumba kwesibindi kubandakanya:
- Alanine aminotransaminase (ALT)
- Aspartate aminotransferase (AST)
- I-Gamma-glutamyl transaminase (GGT)
Ukucinga
Imvavanyo yokucinga ingabonakalisa ukuvuvukala kwesibindi, ukwandiswa kwesibindi, ukwehla kwesibindi okanye iimvumba esibindi. Iziphumo zokucinga azikwazi ngokuchanekileyo ukuchithwa kwe-HCV. Naliphi na le miphumo ingenzeka ngenxa yentsholongwane yeHCV, nangona ingaba nayo nayiphi na isifo sesibindi. Unokufuna ukuba neemvavanyo zokucinga xa unesisu esiswini, i-jaundice enamandla okanye iimpawu ezibonisa ukuba unomdlavuza. Kananjalo ungadinga iimvavanyo zengqondo xa ugqirha wakho uxhalabele ngezinye izifo ezifumanekayo ezinokufunyanwa kwiimvavanyo zengqondo zesisu, ezifana ne-appendicitis okanye i-gallstones.
- I-Ultrasound yesisu: Olu vavanyo lunokuphonononga ukungaqhelekanga kwisibindi kunye nesisu, kwaye luyakwazi ukubona ukwakheka kwamanzi kwisisu, ezinokuthi zenzeke ngokungafezeki kwesibindi.
- I-Computer Axial Tomography (CT) ihlola: I-CT scan isisu iyakwazi ukutshintsha utshintsho nobungakanani besibindi kwaye ikwazi ukubona iimbalo okanye iimpawu zomhlaza wokuqala.
- Ukufanekisa Ukuhlaziywa KweMagnetic (MRI): I-MRI iyakwazi ukuthabatha ukungaqhelekanga okubonisa ukungasebenzi kwesibindi okanye umhlaza.
- I-Biopsy ye-Liver: I-biopsy yesibindi yicandelo lesicu esithathwe kwisibindi kwaye sivavanywa phantsi kwe-microscope ukukhangela iziganeko zezifo. Inkqubo ihlala ikhokelwa izilonda ezingavumelekanga ezichazwe kwizifundo zokucinga.
Ukuxilongwa okuhlukeneyo
Iingxaki ezininzi zezokwelapha ezahlukeneyo zingabangela ii-LFTs ezingaqhelekanga kwaye zivelise iimpawu ezifana nezo zintsholongwane yeHCV. Nangona kunjalo, akukho nenye yale miqathango inokubangela ukuba uvavanyo lwe-HCV lwe-antibody blood test okanye uvavanyo lwe-HCV RNA.
- Utywala lwe-Hepatitis: Ukusela utywala kunokubangela iingxaki ezinzulu kwisibindi, kubandakanywa nesibindi esinamafutha, i-cirrhosis nomhlaza. Ukuphuhliswa kwesifo sesibindi sokunxila kubonakala ngokukhawuleza ngexesha elide, kwaye izifundo zokucinga zibonisa iintlobo ezahlukeneyo kunokuba zikulindelwe ngeHCV.
- I-Hepatitis B (i-HBV): Umzekelo wokugula ne-HBV unzima kakhulu kunokuba yi-HCV, nangona kukho ukufana kuba zibini iintsholongwane ezichaphazela isibindi.
- I-Hepatitis A (i-HAV, i-Ap A) : Enye intsholongwane ebangela i-hepatitis, njenge-HCV, i-hep A, ingabangela umkhuhlane njengempawu. Le ntsholongwane iyadluliselwa ngokutya okungcolileyo. Isasazeka ngenxa yokuba intsholongwane ikhoyo kwisigxina (i-poop) kwaye isenokusasazeka kumntu ukuya kumntu ngenxa yokuhlamba izandla.
- I-Cholecystitis (ukuvuvukala kwe-gallbladder) okanye i-Coledocholithiasis (amatye ensimbi): Amatye e-gall okanye ukuvuvukala kwe-gallbladder kungabangela i-jaundice, isicupunu, ukuhlanza kunye neentsholongwane. I-cholecystitis kunye ne-choledocholithiasis inokuba yintlungu.
- I-Appendicitis: Ukuvuthwa okanye ukusuleleka kwesihlomelo kuyabangela ubuhlungu obukhulu besisu kunye namafiva, kwaye lukhula ngokukhawuleza. Ngamanye amaxesha, i-appendicitis inokuphosakela ngosulelo lweHCV xa intlungu ye-appendicitis ilula. Ukusuleleka kwe-HCV kunokuphambuka nge-appendicitis ukuba intlungu kunye nesisu esiswini sebi kakhulu kunempawu eziqhelekileyo ze-HCV.
- I-Hepatocellular Carcinoma: I-Cancer yesibindi ingabangela ukuvama kwesisu, i-jaundice kunye ne-LFTs engavamile. I-Cancer yesibindi ingahlakulela ngenxa yesiphumo seHCV. Kubalulekile ukuchonga ukuba i-HCV yintoni ebangela umhlaza ngenxa yokuba intsholongwane kunye nomhlaza kuya kufuneka ziphathwe.
> Imithombo:
> Ukumisa iK, uHöner Zu Siederdissen C, iPort K, et al. Ukuphuculwa kweeparitha zomsebenzi wesibindi kwi-cirrhosis ehambelana ne-HCV ehambelana ne-IFN-free anti-infiral treatments. I-Pharmacy Ther. 2015 Oct; 42 (7): 889-901. i-doi: 10.1111 / apt.13343. Epub 2015 Aug 6.
> Lee SJ, Cho YK, Na SY, et al. Ukunyanzeliswa kwamagciwane okuxinwa kunye ne-splenomegaly kwizigulane ezimbini ezine-cirrhosis ezinobungozi be-hepatitis-C emva kwe-interferon kunye ne-ribavirin yonyango. Clin Mol Hepatol. 2016 Sep; 22 (3): 390-395. Epub 2016 Aug 30
> Pallarés C, iCarvalho-Gomes, iHontangas V, et al. Ukusebenza kovavanyo lwe-OraQuick ye-virus ye-Hepatitis C kwi-virus yomlomo kunye negazi le-fingerstick ngaphambi nangemva kokususwa kwe-viral-induced viral clearance. J Clinic Virol. Ngo-2018 ngoMeyi; 102: 77-83. i-doi: 10.1016 / j.jcv.2018.02.016. Epub 2018 Feb 24.