Kufalikira kwachiwopsezo kwa chiwindi cha matenda a Hepatitis C
Panopa pali mitundu 11 yambiri ya ma genetic (genotypes) ya kachilomboka ka hepatitis C (HCV) padziko lonse lapansi, ngakhale kuti kuchuluka kwapadera kumawoneka ndi majeremusi 1 mpaka 7. Kuphatikiza apo, mtundu uliwonse wazinyalala ungathe kuphwanyidwa pang'ono, amawerengedwa pamtundu (mwachitsanzo, HCV genotype 1a kapena 1b).
Kujambula zithunzi kumatengedwa ngati kofunika chifukwa kumathandiza madokotala kudziwa kuti ndi mankhwala ati omwe angagwiritse ntchito bwino kwambiri kachilombo ka HIV (kapena mavairasi ngati muli ndi kachilombo koposa HCV).
Ndondomeko ya chidziwitso imafuna zambiri kuposa kuyesa magazi, zomwe zitsanzo zake zimagwiritsidwa ntchito pogwiritsa ntchito luso lamakono lotchedwa polymerase chain reaction (PCR) .
Genotype 1
Genotype 1 ndi yofala kwambiri ya mtundu wa HCV ku North America ndi ku Ulaya ndipo amawerengera pafupifupi 80 peresenti ya matenda onse ku US Genotype 1 matendawa amachitidwa kuti ndi ovuta kwambiri kuchipatala, ngakhale kuti mankhwala atsopano omwe akuwongolera mwamsanga (DAAs) akuchiritsidwa mitengo ya onse omwe angoyambe kuwachiritsidwa komanso ochiritsidwa kale. HCV genotype 1 ingakhale yowonjezeredwa kukhala subtypes 1a, 1b, ndi 1c.
Genotype 2
Genotype 2 ndi yachiwiri yambiri ya HCV genotype ku US, akuwerengera pafupifupi 10% mwa matenda onse. Asanayambe kuyika ma DAA, inali imodzi mwa njira zosavuta zochiritsira, ndi odwala omwe ali ndi mwayi wa 80% wokhala ndi kachilombo koyambitsa matendawa (SVR) mofanana ndi mankhwala. Masiku ano, chiŵerengerochi chiri pafupi ndi 90% mwa odwala ambiri omwe anachiritsidwa kale ndipo ndi 99% mwa odwala omwe angoyamba kumene kuchipatala.
Genotype 2 ili ndi magawo atatu akuluakulu: 2a, 2b, ndi 2c.
Genotype 3
Genotype 3 imapezeka kum'mwera chakum'mawa kwa Asia ndipo imagawidwa mopanda ku Australia, India ndi mbali zina za Far East. Akuti anthu pafupifupi 6% a ku America ali ndi HCV genotype 3, yomwe imatha kukhala awiri awiri: 3a ndi 3b.
Genotype 4
Genotype 4 imapezeka kwambiri ku Africa, Middle East, ndi mayiko ambiri akummawa kwa Ulaya. Igupto ali ndi chiwerengero chachikulu cha anthu omwe ali ndi kachilombo ka 4, komanso HCV yaikulu padziko lonse lapansi. Matenda apamwamba a ma HCV m'mabuku awa, makamaka mbali ya mavenda osiyanasiyana, omwe ali ndi subtypes 4a, 4b, 4c, 4d, ndi 4e.
Genotype 5
Genotype 5 imapezeka kawirikawiri kum'mwera kwa Africa ndipo imawonedwa kukhala ndi kusiyana pang'ono kwa chibadwa ndi gawo limodzi: 5a.
Genotype 6
Genotype 5 ikufala kumwera kwa China, Hong Kong, ndi mayiko ena akumwera chakum'mawa kwa Asia. Monga genotype 5, pali chimodzi chachikulu subtype: 6a.
Genotype 7
Genotype 7 inawonjezeredwa ku zidziwitso za anthu mu 2014 ndipo panopa zadziwika ku Thailand ndi Democratic Republic of Congo. Lili ndi subtype imodzi yaikulu: 7a.
Kuonjezera apo, matenda 9, 10 ndi 11 adapezeka, ngakhale kuti matendawa sakhala odziwika kwambiri ku Vietnam ndi mbali za Indonesia.
HCV Chithandizo cha Genotype
Pakufika ma antivirair, odwala ali ndi mitundu yambiri ya chithandizo cha mankhwala a HCV. Pakalipano, US Food and Drug Administration yavomereza DAA zotsatirazi kuti zigwiritsidwe ntchito kwa odwala omwe ali ndi kachilombo ka HCV 1-4 ndi 6:
- Daklinza (daclatasvir) : HCV genotype 3
- Harvoni (sofusbuvir + ledipasvir) : HCV genotype 1
- Sovaldi (sofusbuvir) : majeremusi a HCV 1, 2, 3 ndi 4
- Technivie (ombitasvir + paritaprevir + ritonavir) : HCV genotype 4
- Viekira Pak (ombitasvir + paritaprevir + ritonavir yogwirizanitsidwa ndi dasabuvir) : HCV genotype 1
- Olysio (simeprevir) : HCV genotype 1
- Zepatier (grazoprevir + elbasvir): majeremusi a HCV 1, 4 ndi 6
Zotsatira:
Rockstruh, J. "Chidule cha EASL 2015 cha Hepatitis C Onse olankhula HCV DAA chithandizo kuti athe kukwanitsa: pali zambiri zoti aphunzire." Msonkhano wa 50 wa European Association for The Study of Chiwindi (EASL). April 22-26, 2015; Vienna, Austria.
Zokonza Zowonongeka Zokhudza National Digestive Information. "Matenda a Hepatitis C: Matenda Omwe Akudwala Masiku Ano."
US Department of Veterans Affairs. "Hepatitis C Genotype."