Mankhwala Osokoneza Bongo Amatsopano Kwambiri Mankhwala Osokoneza Bongo Ambiri Oposa Matenda Oposa 90%
Mukawona kuti kachilombo ka hepatitis C (HCV) kanali koyamba kuzindikiritsidwa mu 1989 ndipo makamaka kuti imakhala yosachiritsika mpaka kumapeto kwa zaka za m'ma 1900, kupita patsogolo kwa mankhwala sikungakhale kosadabwitsa.
Zinangokhala mu December 2013, makamaka kuti masewerawo anasintha kwathunthu ndi kutulutsidwa kwa Sovaldi , kuteteza mwachindunji tizilombo toyambitsa matenda (DAA) zomwe zinapereka zotsatira zochepa, nthawi yayitali, ndi mankhwala ochiritsira omwe amakhala okwana 99 peresenti. anthu.
Mankhwalawa akhala othandiza kwambiri kuti mankhwala masiku ano aperekedwe kwa anthu onse omwe ali ndi matenda aakulu a HCV, komanso omwe ali ndi matenda akuluakulu a chiwindi.
Mwa kumvetsa bwino zolinga za matenda a hepatitis C-kuphatikizapo momwe mankhwalawa amasankhidwiritsidwira ndikugwiritsidwa ntchito-mungathe kupanga chisankho chodziwikiratu pochita zinthu zoyenera kwambiri kwa inu.
Zolinga za Hepatitis C Therapy
Monga chifuwa cha thumb, mankhwala oyamba a chiwindi chakumtunda C amatsutsana ndi zotsatira zabwino, osati pofuna kuthetseratu kachilomboka koma polepheretsa kuwonongeka kwa chiwindi ndi ziwalo zogonana.
Zolinga za chithandizo cha hepatitis C, choncho, ndi ziwiri:
- Pofuna kupeza chithandizo chamtundu wathanzi (SVR) , chomwe chimatanthauzidwa ngati kupezeka kwa kachilombo ka HIV m'magazi a munthu kwa milungu makumi awiri ndikutsata mankhwala
- Kupewa kupitirira kwa matenda a chiwindi, kuphatikizapo chitukuko cha khansa ya chiwindi ndi chiwindi
Panthawi yachipatala, kafukufuku wa ma labata amachitidwa kawirikawiri kuti aone momwe kachilombo ka HIV kamayambira m'magazi a munthu.
Zomwe zimatchedwanso kuti HCV , imayesero angathandize madokotala kuti adziwitse zotsatira zake (kapena kusalidwa) kwa mankhwala.
Mtundu wosawerengeka wa vutolo umayesedwa kuti ndiwopindulitsa kwambiri, ndipo masabata 24 a SVR amawoneka ngati "mankhwala."
Akatswiri a matenda a chifuwa amafotokoza momwe angayankhire njira izi:
| Nthawi | Meaning | Tanthauzo | Kuthamangitsani |
| RVR | Werenganinso mwamsanga | Matenda osadziwika omwe ali ndi masabata anayi akuchiritsidwa | Kawirikawiri amatha kupeza SVR |
| RVR | Kuyankha kwa virali mofulumira | Matenda osadziwika omwe ali pa sabata 12, motsatira RVR yoyamba | Kawirikawiri amatha kupeza SVR |
| EVR | Yankho lakumayambiriro kwa tizilombo | Nthenda yosaoneka yosawerengeka kapena kuchepa kwa 99 peresenti ya kuchepa kwa vutolo ndi sabata 12 | Kulephera kukwaniritsa EVR ndi sabata 12 mgwirizano mpaka osachepera 4 peresenti mwayi wofikira SVR |
| ETR | Kutha kwa kuyankhidwa kwa mankhwala | Matenda osadziwika omwe amaperekedwa kumapeto kwa sabata 12 | Sizothandiza pakulosera zotsatira za mankhwala |
| Werengankhani wapadera | Akhoza kukwaniritsa EVR koma sangathe kukhala ndi kachilombo kosawerengeka kwa masabata 24 pambuyo pomaliza mankhwala | Akumva kusalidwa kwa mankhwala | |
| Wosayankha wosamva | Simungathe kukwaniritsa EVR ndi sabata 12 | Chithandizochi chimathetsedwa ngati EVR sichikwaniritsidwa pa sabata 12 | |
| SVR | Yankho loteteza tizilombo | Zikhoza kuthandizira kuti asakhale ndi kachilombo kosawerengeka kwa masabata khumi ndi awiri (SVR-12) ndi masabata 24 (SVR-24) pamapeto pake. | SVR-24 ingatengedwe ngati "mankhwala," pamene odwala omwe ali ndi SVR-12 amakhala okhoza kukwaniritsa SVR-24 |
Masiku ano, anthu opitirira 99 peresenti ya omwe amapindula SVR-24 adzakhalabe opanda kachilombo kwa zaka zosachepera zisanu. Mwa iwo, pafupifupi theka adzapeza chisamaliro cha chiwindi mkati mwa chaka, pamene ambiri adzawona kusintha kwakukulu kwa chiwindi cha chiwindi ( fibrosis ).
Nthawi Yoyamba Kuchiza Chithandizo
Umboni umathandiza kwambiri anthu onse omwe ali ndi matenda a hepatitis C, omwe ali ndi zaka 18 kapena kuposerapo. Okhawokha ndiwo omwe amakhala ndi moyo wa miyezi yosachepera 12 chifukwa cha zifukwa zosagwirizana ndi chiwindi.
Komabe, ngati mankhwala sangathe kupezeka kwa odwala onse (chifukwa cha mtengo kapena malingaliro a inshuwalansi), chofunikira chiyenera kuperekedwa kwa iwo omwe ali ndi chosowa chofunika kwambiri. Izi zimaphatikizapo anthu omwe ali ndi fibrosis yapamwamba, omwe amapereka chifuwa chachikulu, matenda opatsirana ndi chiwindi, kapena mavuto akuluakulu osagwirizana ndi chiwindi a HCV.
Kuwunika kumaperekanso kwa anthu omwe ali pachiopsezo chachikulu cha matenda a chiwindi cha chiwindi, kuphatikizapo omwe ali ndi mphamvu zochepa za kachilombo ka HIV , kachilombo ka HIV , kachilombo ka HIV, mtundu wa shuga, ndi matenda ena a chiwindi.
Ndikoyenera kudziwa kuti anthu omwe ali ndi mwayi woyenera kuchipatala angathe kupindula kwambiri, osati pochepetsa chiwindi koma powonjezera nthawi ya SVR.
Kafukufuku wasonyeza kuti anthu omwe amachiritsidwa kale pamtundu wa fibrosis (monga momwe amayesedwa ndi mapepala a METAVIR ) ali ndi mwayi wokwana 92 ​​peresenti yokhala ndi kachilombo kwa zaka zosachepera 15.
Musanayambe njira iliyonse yothandizira, ndikofunika kuti muyese kudzipereka kwanu komanso kuthandizira kuchipatala. Ngati muwona mavuto aliwonse, kuphatikizapo ntchito kapena zaumwini, kugwiritsa ntchito mowa / mankhwala, kapena mantha pa mankhwala enieni-onetsetsani kuti mukambirane ndi dokotala musanayambe kumwa mankhwala. Ntchito zothandizira zingakhale zothandiza kuthandizira kuthetsa nkhanizi.
Mankhwala Ovomerezeka a Hepatitis C
Mankhwala a Hepatitis C ali ndi amodzi kapena ambiri omwe amagwiritsa ntchito mankhwala osokoneza bongo, omwe amalembedwa pamaphunziro a milungu 12.
Nthawi zina, nthawi ya mankhwala imatha kupitirira 24 kapena ngakhale milungu 48, nthawi zambiri anthu omwe ali ndi chiwindi kapena ena omwe sanagwiritse ntchito mankhwalawa.
Kuphatikiza pa DAA yolamulidwa, mankhwala ena awiri angagwiritsidwe ntchito ngati gawo limodzi la mankhwala othandizira:
- peginterferon , mapangidwe opangidwa ndi anthu opangidwa ndi interferon, omwe amachititsa mwa kusonyeza thupi kuti likhalepo ndi odwala omwe amawopsa ngati HCV
- ribavirin , mankhwala osokoneza bongo omwe amalepheretsa kubwezeretsa kachilomboka
Peginterferon, yoperekedwa ndi jekeseni, imaperekedwa ndi ribavirin. Ribavirin, mosiyana, nthawi zambiri amagwiritsidwa ntchito payekha pokhudzana ndi mankhwala oyamba a DAA.
Kugwiritsa ntchito mankhwala osokoneza bongo kumachokera ku mtundu wa jini (genotype) wa kachilombo komwe munthuyo ali ndi kachilombo ka HIV, komanso kuyembekezera zaumoyo wa munthu komanso mbiri yakale ya mankhwala.
Panopa pali mankhwala asanu ndi atatu a DAA omwe amavomerezedwa ndi US Food and Drug Administration:
| Mankhwala | Zavomerezedwa | Olemba | Kusankha | Nthawi |
| Epclusa (sofosbuvir + valpatasvir) | genotypes 1, 2, 3, 4, 5, ndi 6 omwe ali ndi kapena popanda chibwibwi | ndi opanda ribavirin yathu, malingana ndi mbiri ya genotype ndi mankhwala | piritsi limodzi tsiku ndi tsiku popanda chakudya | Masabata 12-16 |
| Zafiti (elbasvir + grazoprevir) | genotype 1 ndi 4 ali ndi kapena popanda chiwindi | ndi opanda ribavirin yathu, malingana ndi mbiri ya genotype ndi mankhwala | piritsi limodzi tsiku ndi tsiku popanda chakudya | Masabata 12-16 |
| Daklinza (daclatasvir) | genotypes 3 popanda cirrhosis | ndi Sovaldi | piritsi limodzi tsiku ndi tsiku ndi chakudya | Masabata 12 |
| Technivie (ombitasvir + paritaprevir + ritonavir) | genotype 4 popanda chibwibwi | ndi ribavirin | mapiritsi awiri tsiku ndi tsiku ndi chakudya | Masabata 12 |
| Viekira Pak (ombitasvir + paritaprevir + ritonavir, yogwirizanitsidwa ndi dasabuvir) | genotypes 1 ndi kapena popanda cirrhosis | ndi wopanda ribavirin, monga momwe akusonyezera | mapiritsi awiri a ombitasavir + paritaprevir + ritonavir amatengedwa kamodzi tsiku ndi tsiku ndi chakudya, kuphatikizapo piritsi limodzi la dasavuvir yomwe imatengedwa kawiri tsiku ndi tsiku ndi chakudya | Milungu 12-24 |
| Harvoni (sofosbuvir + ledispasvir) | genotype 1 ndi kapena popanda cirrhosis | palokha | piritsi limodzi tsiku ndi tsiku kapena opanda chakudya | Milungu 12-24 |
| Sovaldi (sofosbuvir) | genotypes 1, 2, 3, ndi 4 ali ndi kapena popanda cirrhosis | kuphatikizapo ribavirin, Olysio, peginterferon + ribavirin, kapena Olysio + ribavirin, monga momwe | piritsi limodzi tsiku ndi tsiku kapena opanda chakudya | Milungu 12-24 |
| Olysio (simeprevir) | genotype 1 ndi kapena popanda cirrhosis | kuphatikizapo Sovaldi kapena peginterferon + ribavirin, monga tawonetsera | kapsule imodzi tsiku ndi tsiku ndi chakudya | Masabata 24-48 |
Kuyankhulana kwapadera kumafunidwa kwa anthu omwe adatengedwanso ku matenda a chiwindi a C pambuyo polephera kusamalira mankhwala. Zosankha zobwezeretsa ziyenera kukhazikitsidwa poyendera mitundu ndi mankhwala omwe amagwiritsidwa ntchito kale, komanso kuyesa chiwindi cha munthu.
Nthawi zina, kuyezetsa magazi, komwe kungayang'anitse chitukuko cha mankhwala osokoneza bongo, kungakhale kothandiza pakusankha mankhwala, makamaka kwa anthu omwe ali ndi matenda a genotype 1 amene kale anali ndi DAAs.
> Chitsime:
> Association of American for the Study of Liver Diseases (AASLD) ndi Infectious Diseases Society of America (IDSA). "Malangizo a HCV: Malangizo a Kuyezetsa, Kusamalira, ndi Kuchiza Kutupa kwa Chiwindi C." Idasinthidwa pa July 6, 2016.