Mankhwala a Hepatitis C (HCV) amathandiza kwambiri pochiza matenda, ndipo mankhwala osokoneza bongo atsopano angathe kusintha mkhalidwe wa anthu odwala matenda opatsirana omwe amachititsidwa ndi HCV, ngakhale ngati mankhwala apitala atalephera.
Kawirikawiri, pakati pa 20% ndi 30% mwa ma HCV matenda amachotsedwa mosavuta popanda chithandizo chamankhwala. Pa otsala 70% mpaka 80%, matendawa amatha kupitirira patapita zaka zambiri ndipo pang'onopang'ono amawononga chiwindi.
Pafupifupi 30 peresenti ya anthu amene ali ndi kachilombo ka HCV amakhala ndi zotsatira zoopsa monga matenda a chiwindi , khansa ya chiwindi , kapena kutha kwa chiwindi, ndipo pamapeto pake amafunika kukhala ndi chiwindi.
Malemba
Cholinga cha chithandizo cha hepatitis C ndichotseketsa kachilomboka kuti asaoneke m'magazi. Pamene kachilombo kameneka sikakhala kosaoneka ndi kafukufuku wamagazi kwa nthawi yayitali, izi zikutanthawuzidwa ngati zokhudzana ndi virologic (SVR) .
Kafukufuku wasonyeza kuti anthu omwe ali ndi kachilombo ka HCV omwe ali ndi SVR kwa masabata makumi awiri ndi awiri pambuyo pa mankhwala a HCV ali ndi mwayi wokhala ndi kachilombo ka HIV mpaka 1% mpaka 2%. SVR-24 imaikidwa ngati mankhwala. Ngakhale anthu omwe ali ndi HCV omwe alibe matenda a SVR-24 amapita patsogolo ndikusintha zina za chiwindi cha chiwindi chomwe chimayambitsidwa ndi matenda.
Mankhwala Opatsa Mavitamini Odziletsa (DAAs)
Mankhwala otetezera mwachindunji (DAAs), ndi kalasi yatsopano ya mankhwala omwe amapindula ndi mankhwala opitirira 99%, pokhala ndi chithandizo chamankhwala pafupifupi masabata 12, ndipo ndi zotsatira zochepa komanso zochepa zomwe zimawopsa.
Mankhwalawa angagwiritsidwe ntchito pa matenda aakulu a HCV, komanso matenda aakulu a chiwindi.
Ma DAA amatha kuchulukitsa chiwerengero chowonjezereka cha matenda a ma HCV, ndipo DAA iliyonse imalimbikitsidwa ndi mavuto ena okhaokha.
Ma DAA otsatirawa avomerezedwa ndi a FDA kuti athe kuchiza matenda a chiwindi a C:
- Daklinza (daclatasvir) : kuvomerezedwa ku mtundu wa HCV 3. Kutengedwa ngati piritsi tsiku ndi tsiku ndipo sichivomerezedwa ngati muli ndi matenda a mtima.
- Harvoni, epclusa (sofusbuvir + ledipasvir ) : amavomerezedwa ku mtundu wa HCV 1. Amatengedwa ngati piritsi tsiku lililonse, nthawi zambiri kuphatikizapo ribavirin.
- Sovaldi (sofusbuvir ) : kuvomerezedwa kwa ma HCV genotype 1, 2, 3 ndi 4. Tengani ngati piritsi tsiku ndi tsiku ndi rbavirin kapena ribavirin ndi peginterferon.
- Technivie (ombitasvir + paritaprevir + ritonavir) : amavomerezedwa ku mtundu wa HCV 4. Mapiritsi awiri otengedwa tsiku ndi tsiku, ndipo amalepheretsa mankhwala osiyanasiyana.
- Viekira Pak (ombitasvir + paritaprevir + ritonavir yogwirizanitsidwa ndi dasabuvir) : ovomerezeka ku mtundu wa HCV 1. Amatengedwa ngati piritsi lachiwiri tsiku lililonse ndipo akhoza kutengedwa ndi ribavirin.
- Olysio (simeprevir) : kuvomerezedwa kwa mtundu wa HCV 1. Wotengedwa ngati piritsi kamodzi pa tsiku ndipo akhoza kuphatikizidwa ndi mankhwala pa kachirombo ka HIV.
- Zepatier (grazoprevir + elbasvir) : amavomerezedwa kuti apange ma HCV 1, 4 ndi 6, Atengedwa ngati piritsi tsiku ndi tsiku popanda kapena ribavirin.
Mankhwala achikulire angapo, monga Incivek ndi Victrelis, adapuma pantchito ndi opanga, chifukwa sadakakamizidwa pamene ma DAA atsopano anavomerezedwa.
Peginterferon ndi Ribavirin
Peginterferon , ndi ribavirin , akhala akuonedwa kuti ndi mankhwala ochizira a matenda akuluakulu a HCV musanayambe kupezeka kwa DAAs.
Sizitsulo zofanana, komabe zimakhala zofunikira kwa anthu omwe ali ndi matenda akuluakulu, kuphatikizapo chizungulire, kapena njira zina ngati ma DAA sakugwira ntchito. Kawirikawiri, mphamvu ya peginterferon, ndi ribavirin ndi pafupifupi 90%, zomwe sizingafanane ndi za DAA zatsopano, Zina za DAA zimalimbikitsidwa kutengedwa ndi chithandizo cha ribavirin kapena chithandizo cha peginterferon.
Zina mwa zovuta za peginterferon ndi ribavirin ndi zotsatira za mankhwala. Zotsatirapo zimaphatikizapo:
- Anemia
- Mutu
- Kukhumudwa, nkhawa, kupsinjika maganizo ndi kudzipha
- Kutaya tsitsi
- Kulira ndi khungu khungu
- Kusagona ndi kutopa
- Kuphweteka kumodzi ndi kumaliseche
- Nsowa ndi kusanza
- Fever, chills
Yankho la DAA kapena mankhwala ena oletsa tizilombo toyambitsa matenda amatanthauzidwa ndi zotsatirazi:
- Kachilombo kamene kamayankhidwa (RVR) - Matenda osadziwika omwe amatha patatha milungu inayi
- Kuthamanga kwa tizilombo toyambitsa matenda mofulumira (eRVR) - Matenda osadziwika omwe ali ndi masabata 12. kutsatira RVR yoyamba
- Kuyankha kwa tizilombo toyambitsa matenda (EVR) - Matenda osadziwika omwe ali ndi 99 peresenti ya kuchepa kwa chiwerengero cha mavitamini ndi masabata khumi ndi awiri
- Mapeto a kuyankha kwa mankhwala (ETR) - Mtundu wosawerengeka wa tizilombo womwe umapezeka pakatha masabata 12
- Werengankhani wapadera - Akukwaniritsa EVR, koma sangathe kulandira chiwerengero cha mavairasi osadziwika 24 milungu itatha kutsirizidwa kwa mankhwala
- Wosayankha-Wosatha kukwaniritsa EVR ndi masabata 12
- Yankho loteteza tizilombo toyambitsa matenda (SVR) - Likhoza kuthetsa vuto la vutolo losayembekezereka kwa masabata 12 (SVR-12) ndi masabata 24 (SVR-24) kumapeto kwa mankhwala
Opaleshoni
HCV imayambitsa matenda aakulu a chiwindi, ndipo imatha kupita ku mapeto a matenda a chiwindi. Ichi ndi chiopsezo chowopsa chomwe chimawopsa pamene chiwindi chawonongeka moti sichitha kugwira ntchito moyenera. Matenda opangira opaleshoni kwa matenda oteteza chiwindi ndi matenda oyambitsa matenda komanso mwina kuika chiwindi.
- Kuwedza kwa chiwindi: Kuwedza kwa chiwindi kumatengedwa kuti ndi mankhwala ochizira othetsera matenda a chiwindi. Komabe, HCV ikhoza kubwereranso ngakhale mutatha kukopera chifukwa kachilomboka kamatha kukhalabe mwazi. Kawirikawiri, kuwedza kwa chiwindi kumachitika pogwiritsa ntchito chiwindi kuchokera kwa wakufa wakufa. Kuika chiwindi kungagwiritsidwe ntchito pogwiritsira ntchito chiwindi chapadera kuchokera kwa wopereka moyo. Ngati mumalandira chiwindi kuchokera ku wamoyo, chiwindi chanu chochepa chiyenera kuyambiranso mwamsanga. Chiwindi chapakati chomwe chimakhalabe mu thupi la wopereka moyo chiyeneranso kuti chibwererenso mofulumira. Ngakhale opaleshoniyi ndi njira yaikulu kwa wopereka ndi wolandira, aliyense ayenera kuyembekezera kukhala ndi chiwindi.
- Kuthamanga kwa Esophageal: Kukula kwa nthendayi, kutanthauzira kwa mapeto a chiwindi cha matenda a chiwindi, ndiko kutupa kwa mitsempha ya mitsempha ya mthendayi yomwe imayambitsa mavuto a magazi m'matumbo. Mankhwalawa amatha kutuluka. Ndondomeko yotchedwa banding ingalepheretse kutaya magazi kwa mitsempha mwa kuika mipiringidzo pa zitsulo.
Kusamalira / Kukhalira moyo
Ngati muli ndi HCV, pali zofunika zina zomwe mukufunikira kukumbukira pamene mukuchira. Kuonetsetsa kuti mutha kupewa chilichonse chomwe chingasokoneze chiwindi chanu.
- Pewani Kumwa Mowa: Kumwa mowa kwambiri kungayambitse chiwindi. Mwachidziwitso, mowa sayenera kuchititsa chiwindi kuperewera kwa munthu wodwala chiwindi. Koma, ngati muli ndi vuto lomwe limakhudza chiwindi chanu, simungathe kumwa mowa mopitirira muyezo, choncho ngakhale pang'ono zingakhale zoopsa.
- Musagwiritse ntchito Acetaminophen: Mankhwala ambili amachitidwa m'chiwindi , ndipo simungathe kuwatenga ngati muli ndi chiwindi kuchokera ku HCV. Ambiri mwa mankhwalawa amafunikira mankhwala, choncho sizingatheke kuti dokotala wanu kapena wamankhwala amakulolani kuti mutenge nawo ngati mwadziwa HCV. Komabe, acetaminophen (Tylenol) ndi yapamwamba pa mankhwala, mankhwala omwe nthawi zambiri amagwiritsidwa ntchito kunyumba. Simungakhoze kutenga ngati muli ndi matenda a chiwindi ndi chifukwa china chilichonse, kuphatikizapo HCV. Ngati muli ndi zizindikiro za ululu kapena malungo, funsani dokotala kuti akuuzeni mankhwala ena omwe simungasokoneze mankhwala ena omwe mukuwatenga kapena kuti mukhale ndi chiwindi.
- Kusamalira Mliri wa Magazi: Kulephera kwa chiwindi kungayambitse vuto lotchedwa portal hypertension, lomwe ndi kuwonjezeka kwa mavuto m'mitsempha ya chiwindi. Ngakhale kuti izi sizikugwirizana kwambiri ndi kuthamanga kwanu kwa magazi, kukhala ndi mphamvu yeniyeni ya magazi ndi njira yofunika yopewa kuwonjezera zovuta za pangozi.
Mankhwala Othandizira Ena
Mavitamini ena amapezeka pakati pa anthu omwe ali ndi HCV. Kulephera kwa vitamini sikungayambitse HCV, chifukwa ndi chifukwa cha matenda. Chiwindi cholephera kutero chimayambitsa mavitamini ena.
- Vitamini D: Vitamini D, makamaka, yawonedwa kuti ndi yoopsa kwambiri kwa matenda a HCV, ndipo chifukwa cha mgwirizanowu sichidziwika bwino. Vitamini D ndi vitamini wosasungunuka, kutanthauza kuti amafunika kuti mafuta azigwiritsidwa bwino. Ngati muli ndi chiwindi cholephera chifukwa cha HCV, izi zingakulepheretseni kuti mupeze vitamini D. Zimalimbikitsidwa kutenga zakudya zowonjezerapo ngati vitamini D yanu ili yochepa.
- Vitamini A, Vitamini E: Mavitamini osakanizika ndi mafuta omwe sungatheke bwino ngati muli ndi chiwindi. Zowonjezera zingakhale zofunika, koma ngati zigawo zanu zili zochepa.
Pali njira zina zothandizira zosiyanasiyana zomwe zakhala zikuperekedwa m'madera osiyanasiyana kuti azitha kulandira ndi kusamalira HCV, koma palibe maphunziro omwe amasonyeza chitetezo cha mphamvu. Chifukwa chakuti zitsamba zambiri ndi mavitamini zimayambitsidwa pachiwindi, njira zina zomwe zingakhale zopindulitsa ngati muli ndi chiwindi chamoyo zingapweteke ngati chiwindi chanu sichili bwino. Ndikofunika kuti mukhale osamala ngati mutagwiritsa ntchito mavitamini kapena zitsamba, zomwe simungathe kuzikonzanso ngati muli ndi HCV.
Zina zowonjezera zowonjezera zomwe ziri zoopsa ngati muli ndi chiwindi cholephera kuchokera ku HCV:
- Vitamini K: Vitamini amphamvu yomwe imathandiza magazi anu kuti aphimbe, zingayambitse magazi ochulukitsa chifukwa cha kusayenerera kwa magazi chifukwa cha chiwindi chosalimba.
- Ginkgo Biloba: Chitsamba chomwe chimayambitsa magazi, izi zingayambitse magazi oopsa ngati muli ndi chiwindi, chifukwa chakuti kulephera kwa chiwindi kumachititsa kuti magazi asasokonezeke.
- Zosakaniza Zosakaniza: Kafukufuku waposachedwapa amasonyeza kuti mankhwala a zitsamba angayambitse kuopsa kwa chiwindi. Izi zikutanthauza kuti muyenera kukhala osamala ngati muli ndi HCV. Ndi bwino kuyang'ana ndi dokotala kapena wamankhwala musanayambe kumwa mankhwala, ngakhale mutakhala mutatenga nthawi yayitali.
> Zotsatira:
> Beig J, Orr D, Harrison B, Gane E. HCV Kuwonongedwa ndi Chithandizo Chatsopano cha IFN Kulimbitsa Mbiri Yopangidwira M'thupi Muzilumikizidwe zokhudzana ndi chiwindi cha HCV. Chiwindi cha Chiwindi. 2018 Mar. 25. Chitani: 10.1002 / lt.25060. [Epub patsogolo pa kusindikiza]
> Buonomo AR, Zappulo E, Scotto R, et al. Kulephera kwa Vitamini D ndi chiwopsezo cha matenda opatsirana odwala omwe ali ndi chiwindi cha chiwindi cha HCV. Int J Inayambitsa Dis. 2017 Oct; 63: 23-29. lembani: 10.1016 / j.ijid.2017.07.026. Epub 2017 Aug 10.
> Caicedo LA, Delgado A, Garcia VH, ndi al. Kutentha kwa chiwindi mu matenda a Hepatitis C-Odwala Odwala: Zochitika ku South American Transplant Center. Kusindikiza Proc. 2018 Mar; 50 (2): 493-498. lembani: 10.1016 / j.transproceed.2017.11.046.
> Jing J, Teschke R. Chikhalidwe cha Chinese Chinese Medicine ndi Herb-inachititsa Chiwindi Kuvulaza: Kuyerekezera ndi mankhwala osokoneza bongo amachititsa Chiwindi. J Clin Translator Hepatol. 2018 Mar 28; 6 (1): 57-68. lembani: 10.14218 / JCTH.2017.00033. Epub 2017 Oct 27.
> Nookala AU, Crismale J, Schiano T, et al. Mankhwala oletsa kuteteza tizilombo toyambitsa matenda ndi otetezeka komanso othandiza pochiza matenda a chiwindi (C). Kutola Kachilombo. 2018 Mar; 32 (3): e13198. lembani: 10.1111 / ctr.13198. Epub 2018 Feb 1.