Chidule cha Hepatitis C
Hepatitis C ndi matenda opatsirana a chiwindi chifukwa cha kachilombo ka hepatitis C (HCV) . Nthawi zambiri imafalikira kudzera mwa magazi omwe ali ndi kachilombo ka HIV, koma imatha kupatsirana pogonana pogwiritsa ntchito kugonana kapena kuperekedwa kuchokera kwa mayi kupita kwa mwana pamene ali ndi mimba .
Chiwindi cha matenda a chiwindi ndi matenda otupa pang'ono omwe angayambe kudwala chifukwa cha matenda ofanana ndi a chimfine, omwe amakhalapo kwa milungu ingapo, mpaka nthawi yayitali, yomwe imatha kuwononga chiwindi.
Mu maulendo asanu, kachilombo kamene kamangodziwika kamodzi kokha mutangotha matenda, kusonyeza kuti palibe zizindikiro za kachilombo ka magazi. Kwa omwe kachilomboka kamakhalapo, kawirikawiri zimakhala zochepa chabe, ngati ziripo, zizindikiro za matenda kwa zaka-ngakhale zaka makumi ambiri zikutsatira matenda oyambirira. Matenda ena, kwenikweni, sapita patsogolo.
Komabe, pakati pa 10 mpaka 30 peresenti ya matenda, chiwindi cha chiwindi cha matenda a chiwindi chimatha kupita ku chikhalidwe chotchedwa cirrhosis chimene chiwindi chawonongeka kwambiri kuti chichepetse mphamvu yake yogwirira ntchito bwino.
Izi zikhoza kupita ku siteji yotchedwa decompensated cirrhosis momwe chiwindi chimakhala chosagwira ntchito.
Hepatocellular carcinoma (mtundu wa khansara ya chiwindi) imadziwikanso kwambiri pa matenda akuluakulu a chiwindi cha mtundu wa C, omwe amakhala ndi maulendo 17 kuposa anthu ambiri.
Mitundu ya Virusi ya Hepatitis C
Kuyambira nthawi yomwe anapeza m'zaka za m'ma 1980, asayansi akhala akudziwa kusiyana kwa mitundu khumi ndi iwiri ya HCV, yotchedwa genotypes . Zina zisanu ndi ziŵiri zazikulu za HCV zimagawidwa zosagwirizana padziko lonse lapansi, ndipo zina zimakhala m'madera ena.
Ku United States, HCV genotype 1 imakhala pafupifupi 80 peresenti ya zofooka zonse, zotsatiridwa ndi majeremusi 2 ndi 3. Koma mosiyana, genotype 4 ndi mtundu waukulu kwambiri ku Africa ndi Middle East, pamene mabala 5 ndi 6 amapezeka nthawi zambiri kum'mwera kwa Africa ndi Asia, motero.
Kudziwika kwa genotype n'kofunika kwambiri osati kungotchula momwe matendawa akugwiritsidwire, koma pozindikira kuti ndi mankhwala ati amene angagwiritse ntchito bwino polimbana ndi mtundu wina wa tizilombo.
Zotsatira za matenda a Hepatitis C
Mchitidwe wa matenda a HCV sungadziŵike kwambiri chifukwa kachilombo kamene kamatha kufotokozera mwachangu mwa anthu ena, kukhala chiopsezo kwa ena, ndi kupita ku matenda aakulu kwa ena. Maphunziro a kachilombo ka HIV amakhalanso osiyana kwambiri ndipo amadziwika kuti amakhala ovuta, osatha, kapena otsiriza.
Matenda owopsa ndi omwe amapezeka atangoyang'ana ndipo amadziwika ndi kufulumira kwa zizindikiro . Ngati matenda a chiwindi a C, zizindikiro zimakhala "chete," ndipo ndi anthu ochepa okha omwe angakhale ndi matenda ofanana ndi a chimfine (nthawi zambiri mkati mwa masabata awiri mpaka asanu ndi atatu).
Pa matenda aakulu, HCV idzafuna makamaka maselo a chiwindi otchedwa hepatocytes. Pamene kachilombo kamene kamasintha mobwerezabwereza-kupanga makope oposa trilliyoni patsiku-ikhoza kuwononga chiwindi mwa kupha hepatocyte mwachangu ndi kuchititsa chitetezo cha mthupi kutulutsa zida zotchedwa lymphocytes, zomwe zimapha maselo omwe ali ndi kachilombo.
Kulikonse kuyambira 20 mpaka 25 peresenti ya milandu, HCV idzawonekera momveka mkati mwa miyezi isanu ndi umodzi. Mwa iwo omwe satero, HCV idzapitirira ndi kupita patsogolo ku zomwe zimatchedwa matenda aakulu .
Pa matenda aakulu, kutsegula kwa chitetezo cha mthupi kumayambitsa kutentha kwa thupi, komwe kumapangitsa kuti collagen ndi zinthu zina zikhalepo. Zinthu izi, zomwe zimatanthawuza kulimbikitsa chilengedwe cha chiwindi, pang'onopang'ono zimamangirira mofulumira kuposa momwe thupi lingathe kuzidula. Pakapita nthawi, njirayi imayambitsa minofu yowopsya, yomwe imayambitsa matenda a chiwindikiro pafupifupi 10 mpaka 15 peresenti ya anthu omwe ali ndi kachilombo ka HIV.
Gawo lotsiriza la chiwindi cha matenda a hepatitis C limatchulidwa ngati siteji ya matenda pomwe chiopsezo cha imfa chiwonjezeka chifukwa cha chiwindi chosalimba, khansa ya chiwindi, kapena mavuto osagwirizana ndi chiwindi monga matenda a impso. Kuwonongeka kwa cirrhosis ndi hepatocellular carcinoma ndizozigawo ziwiri zomwe zimakhala ndi mapeto a HCV. Zotsatira za onsewa ndizosauka, zomwe zimakhala ndi zaka zisanu zomwe zimakhalapo peresenti ndi 30 peresenti.
Kuika chiwindi ndi njira yokhayo yowonjezera kwa odwala omwe ali ndi mapeto a matenda a chiwindi, ngakhale kuti HCV imadziwika kuti imabweretsanso pafupifupi 80 peresenti ya milandu.
Kuzindikira ndi Chithandizo cha Hepatitis C
Matenda a hepatitis C amatsimikiziridwa ndi mayeso a magazi omwe amadziwika kuti amateteza mapuloteni otetezeka, otchedwa antibodies , omwe amatenga kachilombo ka HIV. Kawirikawiri, zimatenga masabata asanu ndi limodzi kapena asanu ndi atatu kuti thupi libale ma antibodies okwanira kuti ayesedwe kuti ali olondola. Kuphatikiza pa mayesero ofunika a chisamaliro, mayesero ofulumira alipo tsopano, omwe angathe kupereka zotsatira mu mphindi 30 zokha.
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Kutenga Harvoni (ledipasvir / sofosbuvir) kwa Hepatitis C
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Mapulogalamu Othandizira Omwe Sangathe Kuthetsa Mankhwala a Hepatitis C
Kuyesedwa kwa Hepatitis C pakali pano kulimbikitsidwa kwa onse akuluakulu omwe ali pachiopsezo chachikulu cha matenda , komanso munthu aliyense wobadwa pakati pa zaka za 1945 ndi 1965.
Chithandizo cha hepatitis C chimaperekedwa makamaka pamene munthu amasonyeza zizindikiro za kutupa kwa chiwindi. Maphunziro ndi nthawi ya mankhwala amatsimikiziridwa ndi kachilombo ka HIV, komanso matenda omwe amapezeka.
Kusintha kwaposachedwapa kwa mankhwala a chiwindi cha kutentha kwa chiwindi sikunadabwitsa kwenikweni, makamaka pamene mukuona kuti HCV inadziwika mwadzidzidzi mu 1989. Masiku ano, mankhwala oletsa kuteteza thupi lachilendo (DAAs) atsopano ndi ochepa kwambiri ndipo amafunika kuchizira nthawi yayitali, akuchiritsa mitengo yapamwamba yokwana 99 peresenti m'magulu ena.
Komabe, mosiyana ndi matenda a hepatitis A kapena hepatitis B , palibenso katemera woteteza matenda opatsirana ndi chiwindi.
Zachiwerengero cha National ndi Global Hepatitis C
Padziko lonse lapansi, pakati pa 150 ndi 200 miliyoni anthu ali ndi matenda aakulu a chiwindi cha C, kapena pafupifupi atatu peresenti ya anthu padziko lapansi. Matendawa amapezeka ku North Africa, Middle East, ndi Central ndi East Asia.
Pamene kugwiritsa ntchito mankhwala osokoneza bongo kumakhala njira yoyamba ya matenda m'mayiko otukuka, njira zamankhwala zosagwiritsidwa ntchito, makamaka jekeseni zopanda chitetezo-zimayesedwa kuti ndizo zifukwa zomwe zimayambitsa matenda a chiwindi cha chiwindi m'mayiko akutukuka.
Ku United States, matenda a hepatitis C ndi omwe amachititsa anthu ambiri kudwala matenda a magazi, omwe amachititsa anthu pafupifupi mamiliyoni 3.2 Achimereka (kapena pafupifupi 1.5 peresenti ya anthu akuluakulu). Kugwiritsira ntchito mankhwala osokoneza bongo kumawerengera pafupifupi 80 peresenti ya milandu yonse, kenako kumagonana (10 peresenti), kufalitsa kwa amayi ndi mwana (4 peresenti), ndi kuvulazidwa kwa singano (2 peresenti).
Pafupifupi anayi pa anayi a ku America omwe amakhala ndi chiwindi cha C hepatitis C lero anabadwa pakati pa 1945 ndi 1965, makamaka chifukwa cha kuikidwa magazi. Kupititsa patsogolo pa njira zofufuzira kunachepetsera chiopsezo chotere kuika magazi osakwana oposa awiri pa awiri.
Ngakhale kuti chiwerengero cha matenda a US chaka ndi chaka chikukhazikika kwa anthu pafupifupi 17,000 pachaka, chiŵerengero cha anthu akufa chawonjezeka, kupitirira HIV / AIDS monga chiwopsezo chachikulu cha imfa pakati pa akuluakulu.
Padziko lonse, matenda a chiwindi a mtundu wa C amachititsa kuti anthu azifa chaka chilichonse kuposa kachilombo ka HIV ndi chifuwa chachikulu.
> Zotsatira:
> Association of American for the Study of Chilwere Matenda (AASLD). Kuwonetsa Mliri Wonse wa Mdziko ndi Wachigawo Wolimbana ndi Matenda a Chiwindi. Washington, DC; ndondomeko yofalitsa yomwe inatulutsidwa pa November 3, 2013.
> Holmberg S, Ly K, Xing J, et al. Kukula Kowonjezereka kwa Imfa Yophatikizidwa ndi Viral Hepatitis ku United States, 1999-2007. Msonkhano Wakale wa 62 wa American Association for The Study of Chilwere Matenda (AASLD 2011); San Francisco; November 4-8, 2011, 243.
> Ma Institutes of Health. Matenda a Hepatitis C. Rockville, Maryland; idasinthidwa pa Oct 28, 2014.
> US Preventive Services Task Force. Kusintha Kwachidule Pomaliza: Kuchepa kwa Hepatitis C. Rockville, Maryland; inafalitsidwa mu June 2013.