Iipilisi ezintsha zeHCV
I-FDA evunyiweyo yonyango ye-hepatitis C ibuyele ekuqaleni kwee-1990 xa i-interferon-alfa yafumaneka njengamajova amathathu ngeveki nganye kwiHCV. Ngaphezulu kweminyaka engamashumi amabini ezayo, i-interferon okanye i-derivative yayo eguquliwe, i-peginterferon kunye okanye ngaphandle kwe-oral ribavirin, yayinomgangatho wokunyamekela unyango lwe-hepatitis C. I-Interferon yasebenza ngokuthe ngqo kwintsholongwane ngokunyusa iimpendulo zemvelo zomntu onentsholongwane.
Le ngonyango yayinzima ukunyamezela, ibandakanya i-injections rhoqo ukuya kunyaka, kwaye ibe nezinga eliphumelelayo le-6% -54% kuphela. Kucacile ukuba kukho unyango olungcono.
Ngo-2011, i-FDA yavuma imithi yokuqala eyenze ngokuthe ngqo kumatshini wokubuyisela intsholongwane. Ezi ziyi-HCV protease inhibitors: boceprevir kunye ne-telaprevir. Babesebenzayo ekumiseni ukuphindaphinda kwintsholongwane, kodwa ngenxa yokuchasana nentsholongwane yamachiza, kwakufuneka kulawulwe kunye ne-peginterferon kunye ne-ribavirin. Ngoko nangona ixabiso lokuphumelela likhuphukela kuma-69% -74%, iziphumo ezichaphazelekayo zesisombululo sesithathu sezixinzeleleke kwizigulane ezininzi. La mayeza ayasasetyenziselwa e-United States namhlanje.
Intsebenzo yokuqala yokuqala yafika ngo-2013 ngokuvunyelwa kwe-sofosbuvir kunye ne-simeprevir. Nangona ngasinye saqale savunyelwa ukuba sisetyenziswe nge-peginterferon ye-genotype 1, ukusetyenziswa kweleyile ngaphandle kokubhaliweyo kokubambisana ngaphandle kwe-peginterferon , ngokukhawuleza yaba yinto enkulu.
Iingeniso zempumelelo ziye zafikelela kwi-90% okanye ngaphezulu; kwaye ukuphepha i-interferon kwakuthetha ukuba unyango luye lwaxhomekeka kakuhle kwiiveki ezili-12 ukuya ku-24 zonyango. Nangona kunjalo, ezi zithunywa zixabisa kwaye ezinye iintlobo eziqhelekileyo kunye neemeko zesifo se-hepatitis C zisadingeka i-peginterferon (IMISEBENZI YEMISEBENZI).
Oku kwahlala kwimeko ye-HCV unyango de ku-Oktobha 2014 ngokuvunyelwa kwefomathi enye yokuhlanganiswa kwe-sofosbuvir kunye nedipasvir (HARVONI). Le ipilisi yehlanganisi yayisebenziseka kakhulu kwii-genotypes 1 kunye ne-4 ngaphandle kokufuneka kwe-peginterferon okanye i-ribavirin. Lihlala lonyango oluchanekileyo kakhulu lwe-hepatitis C e-United States. Kukho ke, ezinye izilumkiso ezibalulekileyo. Ekubeni i-sofosbuvir ayifanele ilawulwa zizigulane ezineentsholongwane ezinzima (i-creatinine imvume engaphantsi kwe-30 mL / min), eli qulunqa elilodwa lethebhulethi linomqobo ofanayo. Kwakhona, amachiza akufanele alawulwe kwalawo athatha i-Amiodarone, imirhumo yesifo senhliziyo. Iproton pump inhibitors (i-Prevacid, i-Neium, njl.) Inokunciphisa ukusebenza kolu gama kwaye kufuneka ilawulwe ngokubambisana.
Eminye kamva ngo-2014, u-AbbVie wamemezela ukuvunyelwa kwe-FDA yezixube zabo zonyango ezibizwa ngokuba yiVikira Pak (VIEKIRA PAK). Olu dibana luqulethe ezimbini, kanye ngosuku, amayeza adibeneyo: Ombitasvir kunye neParitaprevir kunye neyeza zemihla ngemihla yeDasabuvir. I-Paritaprevir nayo iququzelelwe nge-booster yeyeza, i-ritonavir, ukuphucula ubuchule beParitaprevir.
Ekugqibeleni, nge-genotype 1a izifo, le nhlanganisela inikwa i-ribavirin yimihla ngemihla. Olu nxu lumandla kakhulu kwi-genotype 1 izifo kunye okanye ngaphandle kwe-cirrhosis. Olu nxu lumano olukhuselekileyo nolunempumelelo kwizigulane ezine-cirrhosis ezihlawulwa kakuhle, kodwa zingenakukhuseleka kwabo bafaka ubungqina bembuyekezo ( Isilumkiso ) ( Yintoni ebulala izigulane nge-cirrhosis? ). Iingxaki ezingundoqo kule nyikirha zibandakanyeka ukusebenzisana kweziyobisi ngenxa ye-ritonavir kunye nenani leepilisi ezifuneka zithathwe ngosuku ngalunye.
Ekupheleni kuka-2015, iyeza elitsha livunyiwe yi-FDA yi-Daclatasvir (DACLATASVIR).
Le yile myeza ene-HCV ye-genotype reactivity efana ne-sofosbuvir kodwa iklasi ehlukeneyo yemithi, ngoko ke ukunikezela ngamachiza amabini ndawonye kunokuvumela ukuba zonke ii-genotype ze-HCV ziphendule ngaphandle kokusetyenziswa kwe-peginterferon okanye i-ribavirin, kodwa icetyiswa ukuba i-genotype 3 ngokukodwa . Kukho, ke, ukusebenzisana kweziyobisi kunye neDaclatasvir, ngoko ke ukubonisana nogqirha okanye kumachiza kuyaphakanyiswa.
Eminye imithi emibini ye-hepatitis C entsha inokulindeleka ekuqaleni kwe-2016. Ezi ziza kuxhomekeka kwingxelo ezayo.Ungaphinda ufumane ulwazi malunga ne-hepatitis C evela kwi-American Liver Foundation (ALF)