I-Harvoni iyi-dose ehleliwe yokuhlanganiswa kwezidakamizwa ezisetshenziswa ekwelapheni ukutheleleka okungapheli kwe- hepatitis C (HCV) . Imithi emibili ehlanganisa iHarvoni (ledipasvir, sofosbuvir) ngokuvimbela kokubili amaprotheni (NS5A) kanye ne-enzyme (i-RNA polymerase) ebalulekile ekuphindaphindiwe kwegciwane.
I-Harvoni yamukelwa ngo-Okthoba 10, 2014, yi-US Food and Drug Administration (FDA) yokusetshenziswa kubantu abadala kweminyaka engu-18 noma ngaphezulu nge-HCV genotypes 1 ukutheleleka, kufaka nalabo abane- cirrhosis .
I-Harvoni ivunyelwe ukusetshenziswa kuma-patient ("treatment-naïve") angaphathwa kabi, kanye nalabo abangenayo impendulo engakapheli noma engekho ngaphambi kwe-HCV yokwelapha ("ukwelashwa-okuhlangenwe nakho").
I-Harvoni yisidakamizwa sokuqala se-HCV esamukelwe i-FDA engadingeki kuthathwe nge-interferon ye-pegylated (i-peg-interferon) noma i-ribavirin (izidakamizwa ezimbili ezisetshenziselwa ukwelashwa kokuhlanganiswa kwe-HCV, zombili zazo zazinamaphrofayli aphezulu kakhulu).
I-Harvoni ibikwa ukuthi inezinga lokuphulukisa phakathi kuka-94% no-99%, kuyilapho izivivinyo zeSigaba II zibike ukuthi izinga lokuphulukisa i-100% ezigulini ezihlanganisiwe ne-HIV ne-HCV.
Isilinganiso
Ithebhulethi eyodwa (90mg / 400mg) ithathwe nsuku zonke noma ngaphandle kokudla. Amaphilisi e-Harvoni ane-diamond enamehlo, i-ginger-colored, nefilimu eqoshiwe, ene "GSI" ehlangothini olulodwa futhi "7985" ngakolunye uhlangothi.
Ukubeka izincomo
I-Harvoni inqunywe ngaphezu kohlelo lwezinyanga ezingu-12 kuya ku-24, njengalezi zincomo ezilandelayo:
- Ukwelashwa-naïve noma ngaphandle kwe-cirrhosis: amasonto angu-12
- Ukwelashwa-okuhlangenwe nakho ngaphandle kwe-cirrhosis: amasonto angu-12
- Ukwelashwa-okuhlangenwe nakho nge-cirrhosis: amasonto angu-24
Ukwengeza, inkambo yezinsuku ezingu-8 ingacatshangwa ngeziguli zokwelapha ngaphandle kwe-cirrhosis ezinama-HCV amakhophi angaphansi kwezigidi eziyisithupha / mL.
Imiphumela Ejwayelekile Ejwayelekile
Imiphumela emibi kakhulu ehlobene nokusetshenziswa kwe-Harvoni (eyenzeka ngo-10% noma ngaphansi kweziguli) yi:
- Ukukhathala
- Izinwele
Okunye eminye imiphumela engase ibe khona (ngaphansi kuka-10%) ifaka i-nausea, isifo sohudo, nokulala.
Ukusebenzisana kwezidakamizwa
Lokhu okulandelayo kufanele kugwenywe uma usebenzisa iHarvoni:
- Imithi elwa namagciwane e-Rifampin: I-Mycobutin, i-Rifater, i- Rifamate, i-Rimactane, i- Rifadin, i-Priftin
- Anticonvulsants: Tegretol, Dilantin, Trileptal, phenobarbital
- I-Aptivus (tipranavir / ritonavir) esetshenziselwa ukwelashwa kwe-antiretroviral ye-HIV
- Wort St. John's Wort
Ukungafani nokucabangela
Azikho ukuphikiswa kokusetshenziswa kwe-Harvoni kuziguli ezine-HCV genotype 1.
Kodwa-ke, iziguli ezine- HIV zisebenzisa i-tenofovir yezidakamizwa (kuhlanganise i-Viread, i- Truvada , i-Atripla, i-Complera, i- Stribild ), kufanele kunakekelwe okwengeziwe ekuqapheleni kwanoma yimiphi imiphumela emibi ehlobene ne-tenofovir, ikakhulukazi ukulimala kwezinsolo.
Ama-antacids kufanele athathwe ngokwehlukana amahora amane ngaphambi noma ngemuva kwe-Harvoni dose, kuyilapho izilinganiso zeproton pump inhibitors kanye ne-H2 receptor inhibitors (aka H2 blockers) zingadinga ukunciphisa ukuze zivimbele ukuncipha kwe-ledipasvir.
Nakuba kungekho ukuphikisana kokusetshenziswa kweHarvoni ekukhulelwe, idatha encane yomtholampilo iyatholakala. Kodwa-ke, izifundo zesilwane ekusetshenzisweni kokubili kwe-ledipasvir ne-sofosbuvir azibonisi umphumela ekuthuthukiseni ukukhulelwa.
Ukubonisana okhethekile kunconywa ngesikhathi sokukhulelwa ukuhlola ukuphuthuma kwe-Harvoni therapy, ikakhulukazi ukuthi uqale ngokushesha noma ulinde kuze kube ngemva kokubeletha.
Kunconywa ukuthi bonke abesifazane abaneminyaka yobudala ababelethwe yingane kumele bahlolwe njalo ngenyanga ngokukhulelwa ngesikhathi sokulashwa. Kunconywa ukuthi isiguli nomlingani wakhe wesilisa banikezwe okungenani izindlela ezimbili ezingekho ze-hormonal zokuvimbela ukukhulelwa kanye nokuthi zisetshenziswe ngesikhathi sezokwelapha kanye nezinyanga eziyisithupha emva kwalokho.
Umthombo:
I-US Food and Drug Administration (FDA). "I-FDA ivumela ukuhlanganiswa kokuqala kwezidakamizwa ukuze kutholakale isifo sokushisa kwesibindi C." I-Silver Spring, e-Maryland; ukushicilelwa okukhishwe ngo-Okthoba 10, 2014.