I-virus ye-Hepatitis C (i-HCV) ivame ukuhlolwa ngegazi. Ukuhlolwa kwe-anti-antibody kungathola ukuthi umzimba wakho udinga ukulwa nokutheleleka kwe-HCV. Ukuhlolwa kwegazi okulinganisa igciwane egazini lakho kuqinisekisa ukuxilongwa, kodwa imiphumela ithatha isikhathi eside. Ngezinye izikhathi, ukuhlolwa kwesibindi, ukuhlola izithombe noma i-biopsy kungase kusekele noma kugcizelele ukuxilongwa.
Ukuhlola Ukuhlola / Ukuhlolwa Kwekhaya
Uma ucabanga ukuthi ungaba ne-HCV, kunezibonakaliso ezimbalwa ongazama ukuzibheka wena. Kodwa-ke, inkinga, ngokuzihlolisisa i-HCV, ukuthi eziningi zezibonakaliso ongayibona zivame ukutheleleka kakhulu kwezifo ezibangelwa amagciwane. Ezinye zezibonakaliso ongayibheka ziyizibonakaliso zesifo sesibindi, kodwa azicaci ku-HCV.
Isikhumba Namahlo
Isibonakaliso esinezici eziningi ze-HCV yi-jaundice, umbala ophuzi wesikhumba namehlo. I-jaundice ithinta wonke umzimba kanye nengxenye emhlophe yamehlo. Lo mbala ungavela njengombala ophuzi obumnene, cishe njenge-suntan, noma, uma ukutheleleka kuye kwaba nomthelela omkhulu ekusebenzeni kwesibindi, amehlo akho nesikhumba kungase kube umbala ophuzi ophuzi kakhulu.
I-Jaundice ibonisa ukwehluleka kwesibindi noma ukukhubazeka kwesibindi, ngakho-ke akucaci ku-HCV.
Ukuhlukaniswa kwesisu
Ukwandiswa kwendawo yesisu, noma ngaphandle kokuphazamiseka, kuvamile esikhathini seHCV sekwephuzile.
Abantu abaningi abanalo izimpawu ze-HCV ezinyathelweni zakuqala zokutheleleka, futhi ukuvinjwa kwesisu kungaba yinkomba yokuqala onayo i-HCV.
Izimpawu Ezifana Nezikhuhlane
Uma une-HCV ukutheleleka okusebenzayo, ungase ube nomkhuhlane omncane, ukukhathala, izihlungu zomzimba, ukulahlekelwa ukudla, isisulu sokunambitheka nesisu esingathandeki. Ungathola lokhu cishe cishe noma yikuphi ukutheleleka kwegciwane, ngakho akuyona inkinga enamandla yokuthi une-hepatitis.
Izimpawu zesisu
Uma une-HCV yokutheleleka esebenzayo, cishe uzobhekana nokucasuka kwesisu, isicashu, ukuhlanza noma isifo sohudo. Njengezibonakaliso ezinjenge-flu, lokhu akuwona uphawu olucacile lokutheleleka kwe-HCV, njengoba kungenzeka nezinye izifo.
Izingozi Zezingozi
Esikhathini esiningi, ngeke ukwazi ngokushesha uma usulelekile nge-HCV. Ukucabangela ngokucophelela ukuthi unayo yini ingozi yindlela engcono yokuhlola ukuthi ungaba ne-HCV.
Uma unezici zobungozi noma yiziphi izimpawu ze-HCV, kutuswa ukuba uhlolwe igciwane.
Ama-Labs nezivivinyo
Kunezivivinyo eziningana zegazi ezingakwazi ukuhlola ukutheleleka kwe-HCV, ukunquma indlela yokwelashwa engcono, nokuqapha intuthuko yakho. Ukuhlolwa kwegazi kungabheka i-HCV antibody, ye-HCV ngokwalo, kanye nezinguquko zomsebenzi wesibindi.
Izivivinyo zegazi ze-HCV Antibody
Lapho i-hepatitis C igciwane ihlasela amangqamuzana akho wesibindi, isimiso sakho somzimba sokuzivikela siphendula ngokusebenzisa ama-antibodies ukuphawula ama-virus njengabalingisi abayingozi. Ama-antibodies aqondile nge-HCV, ngakho ukubonakala kwabo kubonisa ukuthi ube ne-HCV ngesikhathi esithile empilweni yakho. Ukuhlolwa kwe-Antibody akukwazi ukuhlukanisa phakathi kokutheleleka okudlule noma okwamanje, ngakho-ke ulwazi lomtholampilo olunjengomlando wezokwelapha, izimpawu, izimpawu noma ezinye izivivinyo zinganquma ukuthi unesifo sokutheleleka noma ukutheleleka kwangaphambilini.
Eqinisweni, ukuhlolwa okuhle kwama-antibody kungasho ukuthi unesifo sokutheleleka osilwe ngokuphumelelayo, nokuthi uvikelekile eHCV.
- Ukuhlolwa kwegazi: Ukuhlolwa kwe-Enzyme-Linked ImmunokuSorbent Assay (ELISA) ukuhlola amasosha omzimba egazini lakho. Kunezivivinyo eziningi ze-ELISA eziningi. Isivivinyo se-ELISA se-HCV sifuna isampula segazi ku-anti-HCV. Uma kutholakala ama-antibodies, lokhu kusho ukuthi ungase ube nokutheleleka kwe-HCV. Isivivinyo se-ELISA sibucayi kakhulu futhi sinama-95% wesikhathi uma unama-antibodies e-HCV. Lokhu ukuzwela okukhulu kusho ukuthi uma ukuhlolwa kwe-ELISA kungalungile, ungazizwa uqiniseka kakhulu ukuthi awunayo i-HCV. Kodwa-ke, ibucayi kangangokuthi ingabonakalisa ngokungalungile amasosha omzimba we-HCV, futhi kukhona okuncane ukuthi umphumela omuhle ungase ungalungile. Ngenxa yengozi emanga emihle, ukuhlolwa kwesibili kungadingeka ukuqinisekisa imiphumela yokuqala.
- Ukuhlolwa okusheshayo: Ukuhlolwa okusheshayo kungathola i-HCV egazini noma ematheni akho nge-89% ukuzwela kanye ne-100% ethize. Lokhu kusho ukuthi akuyona into ebucayi njengesivivinyo se-ELISA, futhi ungaphuthelwa ukuba khona kwe-HCV ngesinye isikhathi. Kodwa uma uvivinyo luhle, ungaqiniseka ukuthi une-HCV emzimbeni wakho ngesikhathi esithile.
I-hepatitis C RNA
Ukutholakala kwe-HCV RNA, okuyizinto eziphathekayo zegciwane, kubonisa ukuthi igciwane ngokwalo likhona emzimbeni wakho. Lokhu kuhlolwa okunamandla kuvumela odokotela ukuba babone ukuthi uphendula kanjani kahle ukwelashwa ngoba kungabonisa inani legciwane egazini lakho, okuvame ukubizwa ngokuthi umthamo wegciwane . Ithola igciwane ngokusebenzisa ubuchwepheshe be- PCR (i-polymerase chain reaction), okuyinto indlela yokuthola izinto eziphilayo.
Ukusebenzisa ukuhlolwa kwe-ELISA ne-HCV RNA ndawonye:
- I-Negative ELISA = Ayikho ama-antibodies e-hepatitis C etholakala egazini. Cishe awusenwe igciwane le-HCV.
- I-ELISA enhle = Ungase ube nokutheleleka kwe-HCV. Noma kunjalo, kungenzeka ukuthi lokhu kungamanga. Ukuhlolwa okuningi kuyadingeka.
- I-Negative HCV RNA = Akukho ukutheleleka kwe-HCV esebenzayo.
- I-HCV enhle ye-RNA = Ukutheleleka okusebenzayo kwe- HCV .
I-Hepatitis C Virus ye-Genotyping
Ama-virus we-Hepatitis C awafani. Ngokuqinisekile, zonke zikhonjiswe njengegciwane lesifo sohlobo lwe-hepatitis C futhi bonke bangabangela ukutheleleka okunomsoco futhi okungapheli kwesifo se-hepatitis C, kodwa akuzona neze ezifana nezakhi zofuzo. Zinezohlukahluka zofuzo ezihlukile, futhi zihlukaniswe zibe yi-genotypes ezahlukene (izinhlobo zofuzo). Ukwazi i-genotype yakho kunganciphisa kakhulu isikhathi sokwelapha kwakho ngoba udokotela wakho angakhetha ukwelashwa okulungile ngohlobo lwe-HCV onayo.
I-genotypes ibalulekile ngoba amagciwane e-hepatitis C anezici ezahlukene zofuzo adinga izindlela ezahlukene zokwelashwa. Odokotela banquma i-genotype yakho ye-HCV nge-test laboratory esebenzisa indlela ebizwa ngokuthi i-reverse transcription polymerase chain reaction (RT-PCR). Lokhu kuhlolisisa kuhlaziya izici zesifo sofuzo ukucacisa ukulandelana kwayo, okukhomba ukuthi i-genotype yegciwane.
Izivivinyo Zezinsizakalo Ze-Liver (LFTs)
Izivivinyo zomsebenzi we-fover zingavamile uma igciwane nokuvuvukala kubangelwa ukulimaza isibindi. Lezi zivivinyo ngokuvamile azilindelekile ukuba zingavamile kuze kube sezingeni elide. Futhi, ukwelashwa kwe-HCV nakho kungashintsha amazinga e-LFT.
I-LFTs ezishintshwayo uma unezinkinga zesibindi zifaka:
- I-albhamu
- I-Bilirubin
- I-Prothrombin Time (PT)
- Ukulinganisa Okujwayelekile Kwamanye amazwe (INR)
I-LFTs engashintshwa uma une-isibindi sesibindi ihlanganisa:
- I-Alanine aminotransaminase (ALT)
- I-Aspartate aminotransferase (AST)
- I-Gamma-glutamyl transaminase (GGT)
Ukucabanga
Ukuhlola ukuhlolwa kungabonisa ukuvuvukala kwesibindi, ukwandiswa kwesibindi, ukwehla kwesibindi noma izicubu esibindi. Imiphumela yokucabanga ayikwazi ukukhomba ukutheleleka kwe-HCV ngokuqondile. Noma yimuphi wale miphumela ingenzeka ngenxa yokutheleleka kwe-HCV, nakuba ingaba khona nanoma yikuphi ukugula kwesibindi. Kungase kudingeke ube nokuhlolwa kwe-imaging uma uvalelwe esiswini, i-jaundice enzima noma izimpawu ezibonisa ukuthi unomdlavuza. Ungase futhi udinga ukuhlolwa kwe-imaging uma udokotela wakho ekhathazekile ngamanye ama-diagnostic angase abonakale ekuhlolweni kwe-imaging esiswini, njengokufaka i-appendicitis noma i-gallstones.
- I-ultrasound yesisu: Lesi sivivinyo singakwazi ukuhlola okungavamile esibindi nesisu, futhi singase sibone uketshezi okwakhiwe ngaphakathi esiswini, okungenzeka kube nokuhluleka kwesibindi.
- I-Axial Tomography (CT) yekhompiyutha ihlola: I-scan scan yesisu ingathola izinguquko ngobukhulu nobuningi besibindi futhi ingabone ngeso lengqondo izixuku noma izimpawu zomdlavuza wokuqala.
- Ukufaniswa Kwama-Magnetic Resonance (MRI): I-MRI ingakwazi ukubhekana nokungajwayelekile okukhombisa ukukhubazeka kwesibindi noma umdlavuza.
- Ukuphikisana Kwebindi: I-biopsy yesibindi iyisigaba sezincuba esithathwe esibindi futhi sihlolwe ngaphansi kwe-microscope ukuze sibheke izici zesifo. inqubo ivame ukuqondiswa izilonda ezingavamile ezikhonjisiwe kwizifundo ze-imaging.
Ukuhlonza okuhlukile
Izinkinga eziningi zezokwelapha ezihlukene zingabangela i-LFTs engavamile futhi zikhiqize izimpawu ezifana nezifo zokutheleleka kwe-HCV. Kodwa-ke, ayikho yalezi zimo ezingakusiza ukuba ube nokuhlolwa kwegazi elihle le-HCV noma ukuhlolwa kwe-HCV RNA.
- U-Hepatitis ophuza utshwala: Ukuphuza utshwala kungabangela izinkinga eziningana ezibindi esibindi, kuhlanganise nesibindi se-fat, i-cirrhosis nomdlavuza. Ukuthuthukiswa kwezifo zesibindi sokuphuza utshwala kwenzeka kancane kancane ngokuhamba kwesikhathi, futhi izifundo zokucabanga zingabonisa amaphethini ahlukene kunalokho okulindeleke nge-HCV.
- I-Hepatitis B (HBV): Isibonelo sokugula ne-HBV sinzima nakakhulu kunaleyo ye-HCV, nakuba kungase kube nokufana ngoba kokubili amagciwane anithinta isibindi.
- I-Hepatitis A (i-HAV, i-Hep A) : Enye igciwane elibangela ukushisa kwesibindi, njenge-HCV, i-hep A, ingabangela umkhuhlane njengezimpawu. Leli gciwane liyadluliselwa ngokudla okungcolile. Itsakazeka ngoba igciwane likhona esitokisini (poop) futhi lingasakazeka kusuka komunye umuntu kuya komuntu ngenxa yokuwasha ngesandla.
- I-Cholecystitis (ukuvuvukala kwe-gallbladder) noma i-Coledocholithiasis (amatshe ensimbi): Amatshe aseGall noma ukuvuvukala kwe-gallbladder kungabangela i-jaundice, i-nausea, ukuhlanza nemifudlana. I-Cholecystitis ne-choledocholithiasis ingaba buhlungu futhi.
- I-Appendicitis: Ukuvuvukala noma ukutheleleka kwesithasiselo kubangela ubuhlungu obukhulu besisu kanye namafiva, futhi kukhula ngokushesha. Ngezinye izikhathi, ukufakelwa kwesisu kungaphazamiseka nge-HCV ukutheleleka uma ubuhlungu be-appendicitis bubumnene. Ukutheleleka kwe-HCV kungaphutha nge-appendicitis uma ubuhlungu nobuhlungu besisu bubi kakhulu kunezimpawu ezijwayelekile ze-HCV.
- I-Hepatocellular Carcinoma: I-Cancer yesibindi ingabangela ukuhlukaniswa kwesisu, i-jaundice ne-LFTs engavamile. I-Cancer yesibindi ingahle ibe nemiphumela yesikhashana seHCV. Kubalulekile ukucacisa ukuthi i-HCV iyimbangela yomdlavuza ngoba igciwane nomdlavuza kuzodinga ukuphathwa.
> Imithombo:
> Ukuqeda K, uHöner Zu Siederdissen C, Port K, et al. Ukuthuthukiswa kwemigomo yokusebenza kwesibindi ku-cirrhosis ehambisana ne-HCV ehambisana ne-IFN-free anti-virus. Ukudla Pharmacol Ther. 2015 Okthoba; 42 (7): 889-901. i-doi: 10.1111 / apt.13343. Epub 2015 Aug 6.
> Lee SJ, Cho YK, Na SY, et al. Ukunciphisa ama-varicos andal spellomegaly ezigulini ezimbili ezine-cirrhosis ezibangelwa yi-hepatitis-C emva kwe-interferon no-ribavirin. I-Clin Mol Hepatol. 2016 Sep; 22 (3): 390-395. I-Epub 2016 Aug 30
> Pallarés C, Carvalho-Gomes Â, Hontangas V, et al. Ukusebenza kwe-OraQuick I-virus ye-virus ye-virus ye-Hepatitis C e-oral fluid kanye ne-fingerstick igazi ngaphambi nangemva kokususwa kwegciwane lesandulela ngculazi. I-J Clin Virol. I-2018 Meyi; 102: 77-83. doi: 10.1016 / j.jcv.2018.02.016. Epub 2018 Feb 24.