I-Harvoni: Enye Imithi Emangalisayo Ebhekene Nesifo Se-Hepatitis C

by I-Naveed Saleh, MD, i-MS

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Yonke Isichotho, Harvoni!

Bathi awukwazi ukubeka amanani entengo empilweni yakho. Ngaphezulu kwe $ 1000 iphilisi, isidakamizwa esisha esimangalisayo, i- Harvoni , cishe sibonisa lokhu ku-aphorism.

Ngo-Okthoba 10, 2014, i-FDA ivumile i-Harvoni esheshayo elandelwayo, isidakamizwa esisha esihloswe ngegciwane lesifo sofuba esiphephile. Ngo-2014, i-Harvoni yayiyisidakamizwa sesithathu esivunywe yi-FDA ukuze siphathe isifo sofuba esiphezulu seC hepatitis C futhi sibonakale sisebenziseka ngendlela ephawulekayo kanye nokuphathwa komlomo kanye kanye nosuku.

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Kuyini I-Hepatitis C?

I-Hepatitis C iyisandulela se-RNA esibangela ukushisa kwesibindi noma ukuvuvukala kwesibindi. Okwamanje, isibindi C isifo esiholela ekubhebhethekeni kwesibindi esingapheli e-United States futhi sithinta amaphesenti angu-3 omphakathi womhlaba. I-Hepatitis C isakazwa ngegazi noma imikhiqizo yegazi, futhi ngaphambi kokuba kutholakale ukuhlolwa okwanele kwegciwane, abantu abaningi banesandulela ngculazi ngemva kokumpompela igazi. Njengamanje, abantu abaningi bathuthukisa i-hepatitis C ngemuva kokuhlanganyela izinaliti ngenkathi basebenzisa izidakamizwa ezingekho emthethweni.

I-Hepatitis C iyinhlamba emangalisa ukuthi ngokuvamile ayibangela ukugula okuphawulekayo emitholampilo. Esikhundleni salokho, abantu abaningi bathola ukuthi ngemva kokuletha isifo esingelapheki - ngokwesilinganiso, eminyakeni eyishumi kuya kweyishumi nesishiyagalolunye emva kokutheleleka ngegciwane. Ukwengeza, ukutheleleka ngegciwane le-hepatitis C kubangela izifo ezingapheli ezingxenyeni ezingaba ngu-85 zalabo abathintekayo.

I-Hepatitis C ine-affinity ye-hepatocytes noma amaseli wesibindi. Ngaphezu kwalokho, igciwane liyashintsha ngokushesha futhi ngaleyo ndlela lenza umsebenzi omuhle oqeda isimiso somzimba sokuzivikela emzimbeni. Ukuvuvukala isikhathi eside noma okungapheli ekugcineni kuholela ku-necrosis ephezulu noma ukufa kwamangqamuzana nesibindi nesibindi. I-cirrhosis ibonakala njengezicubu ezibomvu ezixutshwe nama-nodules avuselelayo anika isibindi ukubukeka okuvamile "kwe-lumpy". Ekugcineni, i-hepatitis C ibangela ukwehlisa ukusebenza kwesibindi nokuhluleka kwesibindi. Ekugcineni, ukutheleleka okungapheli nge-hepatitis C kwandisa ingozi ye-hepatocellular carcinoma noma umdlavuza wesibindi. Inothi, utshwala, ukubhema, ukukhuluphala kanye nokutheleleka kokunye nezinye izifo ezifana ne-HIV (noma ngisho negciwane lesifo sofuba) kwenza ukutheleleka kwe-hepatitis C kubi kakhulu.

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Ukwelashwa Ngaphambi Kokufika Kwezidakamizwa NjengeHarvoni

Kulo nyaka odlule, i-FDA ibilokhu ikhale futhi ivume izidakamizwa ezihlukene ezintathu zokwelashwa kwesifo sofuba (i-hepatitis C): i-Harvoni kanye nomzala wakhe wamakhemikhali u-Olysio (simeprevir) no-Sovaldi. Nokho, ngesikhathi esisodwa, ukwelashwa okuwukuphela kwezidakamizwa okubhekiswe kugciwane le-hepatitis C kwakuyi-interferon e-pegylated ehlangene ne-Ribavirin. Lolu khetho, nakuba lusebenza kahle, aluphumelelanga kakhulu ekucebiseni impendulo ye-virologic eqhubekayo ("ukwelashwa") kunoHarvoni kanye nomzala wakhe. Ngaphezu kwalokho, i-interferon ne-Ribavirin kunzima ukuphatha, kuthatha isikhathi eside ukuphatha futhi kube nemiphumela emibi kakhulu kunezidakamizwa ezifana ne-Harvoni.

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Ngakho Kuyini Harvoni?

I-Harvoni ingokwalabo ekilasini lemithi eyaziwa ngokuthi i-antiviral yokuphatha ngokuqondile. Lezi zidakamizwa ziqondile futhi zisebenza kahle ekubhekeleni ukuphindaphinda kwegciwane kune-interferon ne-Ribavirin. Okuphawulayo, i-Harvoni iye yafakazela ukuthi iphumelela kakhulu kubantu abahlukunyezwa ngokwedlulele ekwelapheni kwe-hepatitis C. Ngaphezu kwalokho, iHarvoni ilawulwa njengenhlanganisela yempilisi yomlomo futhi iyona yokuqala eklasini layo okufanele yenziwe ngaphandle kwe-interferon ye-pegylated ne-Ribavirin. Ekuvivinyweni kokwelashwa, abangaphezu kwamaphesenti angama-90 abahlanganyeli, kokubili abangenawo ngaphandle kwe-cirrhosis, abathola iHarvoni bathola impendulo ye-virologic eqhubekayo ("ukwelapha") ngemva kwamasonto angu-12 kuphela yokwelashwa.

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Yini I-Harvoni Ekushoyo Kuwe?

Uma wena noma umuntu owaziyo ene-hepatitis C, i-Harvoni iyindlela yokwelapha ethembisayo kakhulu. Okokuqala, izifundo zibonisa ukuthi ukwelashwa kwe-antiviral okuhloswe ngayo ukuqeda igciwane lesifo sofuba lesi-hepatitis C kungathuthukisa i-hertology yesibindi futhi kuvimbele ukuwohloka kwesibindi. Okwesibili, i-Harvoni, efika efomini elihlanganisiwe lephilisi, liyasebenza kakhulu futhi kulula ukuyithatha kunezinhlawulo ezigxile kwi-interferon ne-Ribavirin. Okwesithathu, i-Harvoni iboniswe ngempumelelo kakhulu kubantu abahlukunyezwa ngokweqile ekwelapheni kwe-hepatitis C (iziguli ezine-cirrhosis noma i-genotype 1).

Ngombhalo wokugcina, izidakamizwa ezifana neHarvoni zithole okuningi wezindaba ukuze zibize kakhulu. Isivivinyo samaviki angu-12 singabiza imali engama $ 94,500 noma ngaphezulu kwepilisi engu-$ 1,000! (Noma, kuye ngokuthi uyibheka kanjani, intengo ye-Mercedes-Benz S550.) Ngaphezu kwalokho, izinhlelo eziningi ze-Medicaid zesimo sinezikhathi ezinzima zokumboza izindleko zokwelashwa okunjalo futhi zidinga ukuthi iziguli zihlangabezane nesimo esiqinile semigomo yezokwelapha ukuze thola ukugunyazwa kwangaphambili.

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On Note Final ...

Izidakamizwa ezifana neHarvoni sezilokhu zithola imfucumfucu ngoba ibiza kakhulu. Ngokuqinisekile badla imali eningi kepha impilo yomphakathi kanye nezindleko zokuphila ngezinye izindlela - akukho ukwelashwa okusebenzayo kulabo abanesifo esibindile socansi esingapheli C - sikhulule kakhulu izindleko zokwelapha ezingaba yikhulu namakhulu. Ukuthuthukiswa kwezidakamizwa ezifana neHarvoni kuyiphutha langempela lezokwelapha (futhi angilisebenzisi leli gama kalula). Lesi sidakamizwa sithembisa ukusiza abantu abanesifo esingenakunyakazeka kakhulu ukugwema ukuphila okungapheli, kanti-ke, umonakalo wokuthi ukugula okunjalo kuthatha umndeni, abangane nabathandekayo.

_{Imithombo ekhethiwe}

_{Dienstag JL.} _{Isahluko 304. I-Hepatitis Eyingozi Yama-Virus.} _{Ku: Longo DL, Fauci AS, Kasper DL, Hauser SL, Jameson J, Loscalzo J. eds.} _{I-Harrison's Principals of Internal Medicine, 18e.} _{ENew York, NY: McGraw-Hill;} _{2012. Kufinyelelwe ngo-Okthoba 14, 2014.}

_{Dienstag JL.} _{Isahluko 306. Isifo Esithathelwanayo Sengculaza.} _{Ku: Longo DL, Fauci AS, Kasper DL, Hauser SL, Jameson J, Loscalzo J. eds.} _{I-Harrison's Principals of Internal Medicine, 18e.} _{ENew York, NY: McGraw-Hill;} _{2012. Kufinyelelwe ngo-Okthoba 14, 2014.}

_{http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm376449.htm.} _{Ifinyelele ngo-10/14/2014.}

_{"I-Simeprevir yokwelashwa kwegciwane lesifo se-hepatitis C" nguLaure Izquierdo et al kusuka ku- Pharmacogenetics kanye ne-Personaled Medicine eshicilelwe ngo-Agasti 14, 2014. Ukutholakala ngo-10/14/2014}

_{"Izindlela Eziphuthumayo Ze-Hepatitis C" yi-Young Kim et al waseGuit Liver eyanyatheliswa ngo-September 2014. Ufinyelele ngo-10/14/2014.}

_{http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4164256 /}

_{URyan KJ, Ray C. Isahluko 13. Ama-Virus we-Hepatitis.} _{Ku: Ryan KJ, Ray C. eds.} _{I-Sherris Medical Microbiology, 5e.} _{ENew York, NY: McGraw-Hill;} _{2010. Kufinyelelwe ngo-Okthoba 14, 2014.}

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