Umthamo wentsholongwane, isigaba sokukhulelwa, ukuthintela ukuthintela ukhuseleko
I-Hepatitis C yintlupheko yesifo esiyintsholongwane esichaphazela isibindi esasasazeka ngokusetyenziswa kwabelane kunye neesringana. Kodwa asiyindlela yodwa abantu abanokusuleleka ngayo. Unyaka ngamnye e-US, abasetyhini abangama-40 000 abane-hepatitis C bazala, apho abantwana abayi-4 000 baya kuhlola i-virus ye-hepatitis C (HCV).
Nangona iingaphantsi kweepesenti ezili-10 ziya kuqhuba ukusuleleka kwintsholongwane engapheliyo , oko kusenokuba kubangele ukukhathazeka-ngokukodwa kuba kukho ezimbalwa, ukuba kukho na, izinto ezinokunyusa okanye ukunciphisa umngcipheko wokusasazeka kumama ukuya kumntwana.
Ngaphezu koko, ukungabikho kwe-HCV yokugonya , kunye nokungabikho kwedatha ngokuphathelele ukusetyenziswa kwezidakamizwa ze- hepatitis C ngexesha lokukhulelwa, kuthetha ukuba ukhetho lokuthintela luhlala luncitshiswa.
Kodwa akuthethi ukuba akukho zinto abazali abangayenza-okanye imibuzo abanokuzibuza-ukuba omnye okanye bobabini bane-hepatitis C kwaye balindele (okanye baceba ukuba nabantwana).
Usulelo lwe-Hepatitis C ngeNqanaba lokukhulelwa
Ngelixa liqhelekile kwigama eliphuhlisayo le-HCV ukuba lidluliselwe ukusuka kumama ukuya kutshatyalaliswa kwenkqubo yezokwelapha engaqhelekanga, eU.S nakwamanye amazwe athuthukileyo Ukuhanjiswa kwe-HCV ngokuqhelekileyo kwenzeka kwi-uterus okanye ngexesha lomsebenzi.
Ezinye izifundo zibonisa ukuba umngcipheko ukwanda ngexesha lokugqibela lokukhulelwa.
Oku kunokwenzeka ukuba, ngenxa yecandelo, ukunyuka kwinani legciwane lesibini ngexesha lesibini neyesithathu, eliye lincipha kwiiveki ezilandelayo ukuhanjiswa.
Ukuthetha ngokuqhelekileyo, i-amniotic fluid ngokwayo ayiyi kubakho nentsholongwane. Kungenzeka ukuba ukusuleleka kwenzeka xa intsholongwane ingena kwi-placenta kunye / okanye iiseli ze-epithelial ezihambelana nesisu.
Sisaqinisekanga ukuba kutheni le nto yenzeka kwamanye amabhinqa kwaye kungekhona kwabanye, okanye iziphi izixhobo zomzimba ezibangela ukuhanjiswa.
Nangona usulelo luya kwenzeka ngexesha lokunikezelwa ngenxa yokuchazwa kwegazi lomama kunye namanzi omzimba, umngcipheko uhluka kakhulu ngokusekelwe kwintsholongwane yentsholongwane kumama.
I-Hepatitis C Ingozi yokukhulelwa
Enye into ehambelana nokudluliselwa komama kumntwana weHCV yinqanaba legciwane lesigciwane kwigazi lomama kunye namanzi omzimba. Oku kulinganiswa ngolu vavanyo olubizwa ngokuba ngumthamo wentsholongwane yeHCV , ebala inani leengqungquthela zentsholongwane kwi-milliliter yegazi. Ixabiso lingahluka ukusuka kwincinci elincinci yeengqungquthela zegciwane ezininzi kwiimitha ezininzi, ezinexabiso eliphezulu ezihambelanayo nomngcipheko ophezulu.
Enye into ebandakanyeka nomngcipheko wokudluliselwa kwe -HIV yintsholongwane kaGawulayo . Oku kubaluleke kakhulu ukuba i-HCV / HIV inokukhupha isantya-ntlawulo inokusebenza ngokuphakamileyo kuma-20 ekhulwini kwamanye amazwe.
Ngethuba lokukhulelwa, ukusuleleka kosuleleko okungalawulwa yi-HIV kunokunyusa amathuba okudluliselwa kwe-HCV ngamaphesenti angama-20, ngokutsho kophando kwiiNational Institutes of Health. Ukongezelela koko, oomama abane-HIV kunye ne-HIV banokuphindwa kabini ukuba bathumele i-HCV umntwana wabo ongakazalwa ukuba ngaba basebenzisi beziyobisi.
I-Hepatitis C kunye neCesarean Section
Ngokungaqhelekanga, akukho. Izifundo ezininzi azibonisi ulwahlulo lwamanani kwizinga lokusasazwa ukuba unina unika i-vaginally okanye ngeC-section. Kodwa oko akuthethi ukuba kuphakanyiswe ukuba akukho nto ingqalelo xa kwenziwa isigqibo malunga nemeko kunye nexesha lokuhambisa.
Enye into eyaziwayo ukwandisa umngcipheko wokudlulisela umonakalo yinto yokukhuba kwexesha elide ngexesha lokunikezelwa. Ukugqithisa ixesha elingaphezu kweeyure ezintandathu lidibaniswe neepesenti ezingama-30 kwandisa umngcipheko, kubonisa ukuba yonke imizamo kufuneka yenziwe ukuba kugcinwe isigaba sesibini sezabasebenzi ngokufutshane. Oku kuyinyani ngakumbi ukuba unina unomthamo ophezulu we-HCV.
Ngokufanayo, nayiphi na inqubo yonyango engenayo eyenza ukuba ukunyuka kwegazi kuya kwigazi kungakwandisa amathuba okudluliselwa. Ezi zibandakanya i-amniocentesis, enomngcipheko ophantsi wokuthunyelwa, kunye nokubeka iliso lwangaphakathi lomntwana, okumele kugwenywe ngexesha lobasebenzi.
I-Hepatitis C kunye nokuxilwa
Akukhokho ubungqina bokuthi ukuncelisa ibele kunokunyusa umngcipheko wokudluliselwa kwe-HCV ukusuka kumama ukuya kumntwana. Kungenxa yesi sizathu sokuba amaziko okuLawula nokuVimbela (i-CDC) kunye ne-American Congress ye-Obstetrics kunye ne-Gynecologists (ACOG) avunyelwe ukuncelisa unina ngeHCV. Xa kuthethwa ukuba, oomama abaneenambuzane eziqhekekileyo okanye eziphaphazelekayo kufuneka baqwalasele ezinye iindlela, ngokukodwa ukuba banomthwalo omninzi wentsholongwane.
Ama-Mothers aphethwe yi-HCV kunye ne-HIV kufuneka aphephe ukuncelisa ibele ngenxa yokuba kusekho umngcipheko wokudlulisela i-HIV kwintsana . Oku kuyinyani ngokukhethekileyo koomama abangakabikho unyango lwe-antiretroviral okanye abangakwazi ukufikelela kwimithwalo engapheliyo ye-HIV.
Yintoni eyenzekayo Ukuba iilingo zeNtsana zichanekile
Phantse bonke abantwana abazalelwe oomama abane-HCV baya kubonisa iintsholongwane zentsholongwane. Oku akuthethi ukuba umntwana unesifo. Ama-antibodies nje ngama- proteine omzimba aveliswa ngumzimba ekuphenduleni izifo ezibangelwa zizifo ezifana ne-HCV.
Kwiintsana ezizalwayo, ii-antibodies ze-HCV zidla ngokuba nefa (intsingiselo yokuba ziveliswa ngumama kwaye zidluliselwe umntwana). Ngaloo ndlela, ukuba khona kwabo akuthethi ukuba umntwana unesifo. Kwiimeko ezininzi, inani le-antibodies liza kunqanda ngaphezu kwexesha, kunye nanye ukusuka kuma-90 ukuya kuma-96 ekhulwini kwabantwana abakhulula ukususa intsholongwane phakathi kweminyaka eyi-18 neye-24.
Ngaloo ndlela, kucetyiswa ukuba abantwana bahlolwe i-HCV kungekudala kweenyanga ezili-18. Ukuba ukuhlolwa kwangaphambili kuyadingeka, uvavanyo olubizwa ngokuba yi- HCV RNA i-assay ingenziwa emva kweminyaka engama-1-2 kunye nokuphindaphinda emva komhla ukuvavanya ukuba kukho ubungqina bofuzo. Nangona ukuxilongwa kwangaphambili akuyi kuguqula inkqubo yokhathalelo lwezonyango kumntwana, kunokunceda ukunciphisa uxhalaba kubazali.
Ukuba umntwana uxilongwe ngokuqinisekileyo ukuba une-hepatitis C, oko akuthethi ukuba umntwana uya kugula. I-Hepatitis C iyaqhubeka ihamba ngokukhawuleza kubantwana kunabantu abadala, kwaye ngaphezulu kwama-80 ekhulwini kubonisa ukuba kuncinci ukubhubha kwesibindi (i-fibrosis) eneminyaka eyi-18.
Ukongezelela, abantwana kunye nabaselula kunye ne-HCV bavame ukuphendula ngokuthe tye kwi-hepatitis C yonyango, ukuba kuyimfuneko, ukufikelela kumazinga aphezulu okunyanga kunye nemiphumo embalwa kakhulu kunezikhulile.
Ukukhusela i-Hepatitis C ekukhulelweni
Ukuba unesifo esibangelwa yi-hepatitis C kwaye unenjongo yokukhulelwa, thetha nodokotela wakho malunga neendlela zokwelapha ezikhoyo. Namhlanje, ama- anti-virus (DAAs) asebenza ngokukhawuleza afikelela kumazinga okunyanga kuma-95 ekhulwini kwezinye iindawo, kunye nexesha lokunyanga elihlala ixesha elingaphantsi kweeveki ezili-12 ukuya kwezi-16.
Kuyafana nokuba unayo i-HCV, kodwa umlingane wakho wenza. Nangona kungekho ndlela yokuba indoda ingenelele ngqo kwi-fetus, kukho umngcipheko wokusuleleka kumlingani wesetyhini. (Naphezu kweendleko eziphezulu ze-HCV unyango, ukufikelela kufana nokwandisa njengabanini-mshwalense baqaphela ukugcinwa kwexesha elide elinxulumene nokuthintela umdlavuza wesibindi kunye ne -cirrhosis ehlawulwe .)
Kubalulekile ukuba uqaphele, nangona kunjalo, ukuba unyango lweHCV aluqhelwanga ngokuqhelekileyo ngokungabikho kwanoma yimuphi umqondiso wokonyango. Ukuba i-fibrosis yesibindi iyancinci ukuba ingekho kwaye umthamo wentsholongwane uphantsi, mhlawumbi bekungekho mfuneko ukuqala unyango. Ikhefu elilodwa lingaba yilapho abasebenzisa iziyobisi be-injection bavuma ukusebenzisa ulawulo lokuzalwa kuze kufikelelwe unyango.
Ngakolunye uhlangothi, ukuba unayo i-hepatitis C kwaye sele sele ukhulelwe, qi niseka ukuba udibana neengcali ze-hepatologist okanye i-gastroenterologist ukuqinisekisa ukuba uyaphepha amaninzi emingcipheko enxulumene nokudluliselwa komama kosana.
Kubaluleke kakhulu unyango olushushu lwe-HIV , nokuba ukhulelwe okanye awukho. Ngokunciphisa i-HIV kumanqanaba angabonakaliyo, unciphisa kakhulu ukutshabalalisa okungapheliyo okunxulumene nosulelo. Oku, kunokunciphisa umsebenzi we-HCV ngexesha lokukhulelwa kwaye emva kokuzalwa.
Uphando olutsha luye lwabonisa ukuba oomama kwi- antiretroviral therapy kunye nemithwalo engabonakaliyo yentsholongwane yentsholongwane inomngcipheko ofanayo wokudluliselwa kwe-HCV njengomama abangenayo i-HIV.
Ngaba Ukukhulelwa Kuya Kucelwa I-Hepatitis C?
Mhlawumbi akunjalo. Nangona kunjalo, iinkcukacha zangoku zihlala ziphikisana, kunye nezinye iingcamango ezibonisa ukuba ukukhulelwa kuqhubela i-fibrosis yesibindi kubasetyhini abane-HCV xa abanye bebika ukucotha ukukhula kwesifo.
Xa kuthethwa ukuba, abafazi abane-HCV basenokuba yingozi enkulu yokukhulelwa kwengxaki. Olunye uphando olusekelwe eWashington lubonisa ukuba iintsana ezizalwe ngabafazi abane-HCV zinokuthi zibe nesisindo sokuzalwa esincinane, ngoxa oomama benomngcipheko wokwanda kwesifo sikashukela (ngokuqhelekileyo ngokudibanisa nokufumana ubunzima obukhulu).
Kodwa oku kubonakala ngathi yinto ehlukile ngaphandle komgaqo. Uninzi lwabaomama abane-HCV, ukukhulelwa kuya kuba nzima ngokungabikho kwesifo sesibindi kwaye kungabikho miphumo embi kumntwana.
> Imithombo:
> Dunkelberg, J .; Berkeley, E; Thiel, K .; okqhubekayo. "I-Hepatitis B kunye no-C ekukhulelweni: ukuphononongwa nokucebisa ukunakekelwa." Umbhalo wePerinatology. Disemba 2014; 34 (12): 882-891.
> Pergam, S .; Wang, C .; Gardella, C .; okqhubekayo. "Ingxaki yokukhulelwa echaphazelekayo ne-hepatitis C: idatha ukusuka ku-2003-2005 yaseHashington." I- American Journal ye-Obstetrics. 2008; 199: 38 (e 1-9).
> Isebe lezeMpilo laseMzantsi Afrika kunye neNkonzo zoLuntu. Ukuqwalaselwa kwe-Antiretroviral Usetyenziso kwizigulane ezine-Coinfection: I-Hepatitis C (i-HCV) / i-HIV Coinfections. "UBetdada, eMaryne; hlaziywa ngoJulayi 14, 2016.
> Isebe lezeMpilo laseMzantsi Afrika kunye neNkonzo zoLuntu. "Iziphakamiso zokusetyenziswa kwezidakamizwa ze-Antiretroviral Izidakamizwa kwi-HIV-1-abafazi abachaphazelekayo kwiMpilo kaMama kunye neNguqulelo ekunciphiseni ukuhanjiswa kwe-HIV kwi-United States." Rockville, Maryland; hlaziywa ngoMeyi 21, 2013.
> Yeung, C; Lee, H .; Chan, W .; okqhubekayo. "Ukutshatyalaliswa ngokuthe ngqo kwintsholongwane ye-hepatitis C: Ulwazi olukhoyo kunye nombono." I- World Journal yeHepatology. NgoSeptemba 27, 2014; 6 (9): 643-651.