Ukunyangwa kweNtsholongwane ye-Virus Hepatitis
I-hepatitis evuthambileyo ichazwa njenge-inflammation yesibindi ebangelwa usulelo lwentsholongwane. Izizathu eziqhelekileyo zintlanu ezinxulumene neentsholongwane ezijolise ngqo kwiiseli zesibindi, ezibizwa ngokuthi i-hepatocytes. Ezi zintsholongwane ze-hepatotropic azifani ngendlela abadlula ngayo ukusuka kumntu ukuya kumntu, kodwa kunokuba bangayithintela okanye baphathwe ngendlela.
Kwezinye iimeko, ukusuleleka kwe-hepatitis kunokusombulula ixesha elifutshane kunye nembalwa, ukuba kukho na, iimpawu okanye iziphumo.
Ngamanye amaxesha, inokuthi iqhubeke inkqubela kwixesha leminyaka okanye kwamashumi eminyaka, kubangele ukutshatyalaliswa ngokuthe gqolo kweethambo zomzimba (fibrosis) ezingabangela ukulimala kwesibindi (i- cirrhosis ) okanye umhlaza wesibindi (i- hepatocellular carcinoma ).
> Jonga izilwanyana ezinobungozi ebusweni.
Kodwa, akumangalisi ukuba unyango lwe-hepatitis lufana neentlobo zegciwane. Ukusuka kwi-hepatitis A ukuya kwi-hepatitis E, iingcebiso zonyango zonyango zijolise ekutshintsheni ukusasazeka nokuqina kwesifo, namhlanje esabangela ukufa kwabantu abayi-1.5 million ngonyaka.
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U-Mavyret Unako Ukuphilisa I-Hepatitis C kwiiVeki ezili-8
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Ngaba Ufanele Ufumane Imithi Yakho Ye-Hepatitis C Evela eIndiya?
I-Hepatitis A
I-Hepatitis A ibangelwa yintsholongwane ye-hepatitis A (HAV) kwaye ixhaphake ngokutya okanye amanzi ayenakaliswe ngamagqabi aphethwe yi-HAV. Ibonisa ngokusasazeka (ukuzincipha), kunye neempawu ezibonakalayo ukusuka kwiiveki ezimbini ukuya kweyesithandathu emva kokuqala kokuqala. Kwiimeko ezininzi, kunokuba yinto engabonakaliyo, kwaye imbalwa, ukuba ikhona, impawu yokuba isifo senzeke.
Xa iimpawu ezinzima zivela, ziyakwazi ukubonakalisa nge-jaundice (ukuluphuka kwesikhumba kunye namehlo), i-choluria (ukubumnyama komchamo), izitulo ezinombala zobumba, kunye neemvakalelo zokunyaniseka kwamathambo okanye i-malaise.
Akukho ziphakamiso zonyango ezithile zonyango lwe-hepatitis A ngaphandle kokunciphisa ukukhathazeka komntu kunye nokuqinisekisa ukulungelelanisa okufanelekileyo kunye nokutya okunomsoco xa kwenzeka ukuhlanza okanye urhudo. Iimpawu ziyakwazi ukugqiba ngokupheleleyo kwiinyanga ezimbini, nangona zihlala zifikelela ezintandathu. I- vaccine iyafumaneka ukukhusela usuleleko lwe-HAV, olunikezwa ngejoza kwiikhosi ezintathu.
I-hepatitis B
I-Hepatitis B ibangelwa yi-virus ye-hepatitis B (i-HBV) kwaye isasazeka ngegalelo legazi okanye umzi womzimba. Ukusetyenziswa kweziyobisi kunye nokulala ngokwesondo ziqhelekileyo iindlela zokusuleleka usulelo oluvela kumama ukuya kumntwana ngexesha lokukhulelwa.
Njengoko i-hepatitis A, i-hepatitis B ingabonisa ngeempawu ezinzima, ngokuqhelekileyo kwiintsuku ezingama-30 ukuya kwi-80 zokuchithwa. Emva kokuba ezi zizimpawu zixazululwe, intsholongwane ingakwazi ukuqhubeka isithuli iminyaka kwiminyaka engapheliyo (esigxina) isifo sosulelo. Kule nqanaba ukuba ukuqhuma okuqhubekayo kungalimaza isibindi. Nangona uninzi lwabantu abane-hepatitis B luya kucima ngokukhawuleza intsholongwane emva kokuba usulele unyango, abo banokusuleleka sulele bangaphathwa ukunciphisa ingozi ye-cirrhosis kunye nomhlaza wesibindi.
Okwangoku e-US, kukho iziza eziyisixhenxe ezivuthiweyo ezivunyelwe ukuba zisebenzise kunyango lwentsholongwane engapheliyo ye-hepatitis B. Nangona la mayeza ayinakukucima intsholongwane, anokunciphisa ukuphindaphinda kwentsholongwane, ngaloo ndlela ukunciphisa ukuvuvukala kunye nomngcipheko wesifo sesibindi. Amachiza amaninzi asetyenziswayo, ahlukaniswe njenge-nucleoside reverse transcriptase inhibitors (NRTIs):
- Epivir (lamivudine)
- Hespera (adefovir)
- Viread (tenofovir)
- ITyzeka (telbivudine)
- Baraclude (entecavir)
Unyango luyabonakala ukuba unomsebenzi ophezulu wentsholongwane (njengokuba ulinganiswe uvavanyo lwe-HBV DNA) kunye ne-enzyme ezinobindi (phezulu ubuncinane kwinqanaba eliqhelekileyo). Abantu abaxilongwa nge-cirrhosis banikezelwa phambili. Ulwaphulo lwe-antiviral lungabasebenzi kangangoko kulabo abanesifo esiqatha okanye sesigxina sesibindi.
Iingonyama i-Intron A (i-interferon i-alpha-2B) ibuye isetyenziswe ngamanye amaxesha, ngokukodwa kubantu abancinci okanye kulabo balindele ukukhulelwa. Ifom ye-interferon (iprotheni yokulwa nesifo) ilawulwa yilenki ngaphezulu kweeveki ezingama-24 ukuya kuma-48.
Nangona ixesha lokunyanga lifutshane kunezinye iindlela zokwenza iziyobisi, imiphumo engaphantsi iya kuba yinto ebalulekileyo. Kukho nesitofu esinokuthintela usulelo lweHBV, kunye nokugonya okuhlanganyelweyo oku kunokuthintela kokubili i-hepatitis A kunye ne-hepatitis B.
I-Hepatitis C
I-Hepatitis C ibangelwa yintsholongwane ye-hepatitis C (i-HCV) kwaye isasazeka ngokuyinhloko ngokusebenzisa ukusetyenziswa kweziyobisi. Ukutshatyalaliswa ngokwesondo kunye nokudluliselwa komama ukusuka kumama ukuya kumntwana ngexesha lokukhulelwa ziindlela eziqhelekileyo. Izimpawu eziqhelekileyo, xa zikhoyo, zingabonakala naphi na kwiiveki ezimbini ukuya kwiinyanga ezintlanu emva kokuqala ukukhanya. Ngelixa uninzi lwabantu abachaphazelekayo luya kuhlengahlengisa intsholongwane ngeenyanga ezintandathu zentsholongwane, ubuninzi beepesenti ezingama-30 zalabo abanesifo esingapheliyo baya kutshintsha kwi-cirrhosis.
Ukunyanga kwesifo esingapheliyo sesifo sengqondo sesifo sengqondo sesifo sengqondo sesibindi sithathwa njengento yenkqubela yempumelelo kunye nesizukulwana esitsha esisebenza ngokuthe ngqo kwi-anti-virus (DAAs) ezinokukwazi ukuphumeza amazinga okunyanga angaphezulu kwama-95 ekhulwini kwezinye iindawo. "I-" cure "ichazwa njengokuba ikwazi ukugcina ingabonakali amanqanaba e-HCV egazini lakho (elikwaziwa nangokuthi i- viral response) okanye i-SVR ) kwiiveki ezingama-24 emva kokugqitywa kweyeza.
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Indlela yokwenza isigqibo sokuba ingaba i-Entecavir Ngaba yiyobisi olufanelekileyo kuwe
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Imishanguzo ye-HCV: Yonke into ofuna ukuyifumana
Uphando lwezonyango lubonise ukuba abantu abangama-92 ekhulwini abakwazi ukuphumeza le mpendulo baya kuhlala bengenayo i-virus nangethuba eliyiminyaka emihlanu.
Ulwaphulo lulawulwa yimizimba yemfuza (i-genotype) yintsholongwane umntu osulelekileyo-ochazwe njenge-genotype 1, 2, 3, 4, 5 okanye 6-kunye nesigaba sesifo sesibindi. Nangona unyango lunokumiselwa ngexesha lokusuleleka kwintsholongwane, kubonakala ngokubanzi kubantu abasulelekileyo, ikakhulukazi abo abane-cirrhosis.
- Daklinza (daclatasvir): avunyelwe i-genotype 3
- I-Epclusa (sofosbuvir + velpatasvir): ivunyiwe kwii-genotypes 1, 2, 3, 4, 5 ne-6
- IHarvoni (i-sofusbuvir + ledipasvir): ivunyelwe i-genotype 1
- Sovaldi (sofusbuvir): avunyelwe i-genotype 1, 2, 3 ne-4
- I-Technivie (ombitasvir + paritaprevir + ritonavir): ivunyelwe i-genotype 4
- Viekira Pak (ombitasvir + paritaprevir + ritonavir ehlanganiswe ne-dasabuvir): ivunyelwe i-genotype 1
- U-Olysio (simeprevir): avunyelwe i-genotype 1
- I-Zepatier (grazoprevir + elbasvir): ivunyelwe i-genotype 1, 4 ne-6
Ngamanye amaxesha ii-DAA zisetyenziselwa ukudibanisa neziyobisi ze- peginterferon kunye / okanye i- ribavirin , ngokuqhelekileyo kulabo abaye balahleka unyango lwangaphambili okanye baye bafumanisa ukuba bane-cirrhosis eziphambili.
I-hepatitis D
I-Hepatitis D ibangelwa yi-virus ye-hepatitis D (i-HDV) kwaye inokuthi yenzeke kuphela xa umntu enesifo esinjengesifo se-hepatitis B. Ngokubanzi isasazwa ngokusetyenziswa kweziyobisi kunye neyona nto ibonakala ngokubanzi kwi-Afrika engaphantsi kwe-Sahara, eMbindi Mpuma, kunye nendawo esenyakatho yeMzantsi Melika.
Izinyango zokwelapha zilinganiselwe. Izifo ezithintekayo ziphathwa ngokukodwa ngenkxaso yondlo kunye / okanye i-hydration engena-intravenous when required. Ukusuleleka kwe-HDV engapheliyo kunokuba nzima kakhulu ukunyanga. Nangona okwangoku akukho zikhetho zonyango ezivunyiweyo ze-FDA, isixhobo se-Intron A (i-interferon alpha-2B) siboniswe ukufezekisa ukunyanzeliswa kwe-viral kwisifo esingama-20 kuya ku-25 ekhulwini labantu abasulelekileyo. Ekubeni i-HDV ingasasaza kuphela phambi kwe-HBV, ukugonywa kwe- hepatitis B kuthathwa njengento efanelekileyo ekukhuseleni intsholongwane ka-hepatitis D.
I-hepatitis E
I-Hepatitis E ibangelwa yintsholongwane ye-hepatitis E (HEV) kwaye isasazeka ngokubanzi ngamanzi angcolileyo kwimimandla enokuhlambulula ucoceko. Nangona iimeko ezininzi ezikhuselekileyo zizisombulula ngokwabo okanye zingekho ncedo olungonyango, abantu abaneenkqubo zokuzivikela ezikhuselekileyo (kubandakanywa nabo abaneentsholongwane zentsholongwane okanye i-HIV ephambili ) banokuthi baqhubele phambili kwintsholongwane engapheliyo.
Njengoko i-hepatitis E, iindlela zokonyango ze-hepatitis D zilinganiselwe. Nangona kunjalo, kuye kwaba yimpumelelo ekufezeni imvume ye-viral kunye nokusetyenziswa kwe-drug ribavirin . Akukho gonti ekhoyo ukukhusela i-hepatitis E.
> Imithombo:
> Umbutho waseMerika wokuFundisisa iSifo seNtsholongwane (AASLD). "Ukuvavanya iMithwalo ye-Global and Regional Burden of Liver Disease." IWashington, DC Inkcazelo yokukhululwa kweeNkcazo ezikhutshwa ngoNovemba 3,
> Amasebe okuLawula nokuVimbela (iCCDC). "I-Hepatitis e-Viral." E-Atlanta, eGeorgia; fi kelele ngoJulayi 19, 2016.