Umthamo wesandulela ngculaza, isigaba sokukhulelwa, ukutheleleka ngokutheleleka kuthonya ingozi
I-Hepatitis C yisifo esithathelwanayo segciwane lesibindi esithinta isibindi esasakazwa ngokusetshenziswa okwabelwana ngezinaliti nemivimbo. Kodwa akuyona indlela yodwa abantu abangayithola ngayo. Unyaka ngamunye e-US, abesifazane abangaba ngu-40 000 abane-hepatitis C ababeletha, okuyizinkulungwane ezingama-4 000 zabo ezizohlola ukuthi zinegciwane lesandulela ngculazi (HCV).
Nakuba amaphesenti angaphansi kwezingu-10 azoqhubekela phambili ekuthelelekeni okungapheli , lokho kusanele ukukhathazeka-ikakhulukazi njengoba kukhona ezimbalwa, noma kunjalo, izici ezandisa noma ezinciphisa ingozi yokudluliselwa kusuka kumama kuya komntwana.
Ngaphezu kwalokho, ukungabi khona kwe-HCV , kanye nokuntuleka kwedatha mayelana nokusetshenziswa kwezidakamizwa ze- hepatitis C ngesikhathi sokukhulelwa, kusho ukuthi izinketho zokuvimbela zivame ukulinganiselwa.
Kodwa lokho akusho ukuthi azikho izinto abazali abangayenza-noma imibuzo abangayicela-uma omunye noma bobabili benesifo sokushisa kwesibindi C futhi balindele (noma bahlela ukuba nabantwana).
I-Hepatitis C Infection ngeSite of Pregnancy
Nakuba kusakazwa izwi elikhulayo le-HCV ukuthi lidluliswe kusuka kumama kuya emntwaneni ngokusebenzisa izinqubo ezingavamile zezokwelapha, e-US nakwamanye amazwe athuthukile Ukudluliswa kwe-HCV ngokuvamile kwenzeka ngaphakathi kwesibeletho noma ngesikhathi sokubeletha.
Ucwaningo oluthile lubonisa ukuthi ingozi iyanda ngesikhathi sokugcina sokukhulelwa.
Lokhu kungase kudingeke, ngokwengxenye, ukuba kuvele inani legciwane ngesikhathi sezinyanga ezintathu nesithathu, okuvame ukwehla kwamasonto emva kokulethwa.
Ngokuvamile, i-amniotic fluid ngokwayo ngeke iqukathe igciwane. Kungenzeka ukuthi ukudluliselwa kwenzeka uma igciwane lingena kumaseli we-placenta kanye / noma ama-epithelial afaka isibeletho.
Asisaqiniseki ngokuphelele ukuthi kungani lokhu kwenzeka kwabanye besifazane hhayi kwabanye, noma yiziphi izici zenyama ezenza kube nokudluliselwa.
Ngenkathi ukutheleleka kungenzeka ngesikhathi sokubeletha ngenxa yokuchayeka kwegazi lomama kanye namanzi omzimba, ingozi ihluka kakhulu ngokususelwa ekutheni ukutheleleka kumama.
I-Hepatitis C Ingozi Yokukhulelwa
Esinye sezici ezihlobene kakhulu nokudluliselwa kwe-HCV kumama nomntwana yizinga legciwane egazini likaMama kanye namanzi omzimba. Lokhu kulinganiswa ngokuhlolwa okubizwa ngokuthi yi- HCV viral load , ebala inani lezinhlayiya ze-viral in milliliter yegazi. Inani lingabuka kusukela ezincane ezinjengezinhlayiyana eziyizinkulungwane eziningana ze-viral ezinamamiliyoni amaningi, enezindinganiso eziphakeme ezihambisana nengozi ephakeme.
Esinye isici esithinta ingozi yokudlulisela isandulela-ngculazi ekhona . Lokhu kuqakatheke ngokukhethekile ukuthi amazinga we-HCV / HIV okutheleleka angakwazi ukugijima aphezulu ngamaphesenti angu-20 emazweni athile.
Ngesikhathi sokukhulelwa, ukutheleleka nge-HIV okungalawuleki kungandisa amathuba okudluliselwa kwe-HCV ngamaphesenti angu-20, ngokusho kocwaningo oluvela kwi-National Institutes of Health. Ngaphezu kwalokho, omama abane-HCV ne-HIV bangaphezu kokuphindwe kabili ukudlulisela i-HCV kumntana wabo ongakazalwa uma bengabasebenzisa izidakamizwa zamanje.
I-Hepatitis C neChesarean Section
Kusobala ukuthi, cha. Ucwaningo oluningi alubonisi umehluko wesibalo ngesilinganiso sokudluliselwa uma umama ehambisa igciwane noma isigaba C. Kodwa lokho akusho ukusikisela ukuthi akukho okucatshangelwayo okumele kwenziwe lapho kunquma khona imodi kanye nesikhathi sokudiliva.
Esinye isici esaziwa ukwandisa ingozi yokudlulisela ingozi yesikhukhula isikhathi eside ngesikhathi sokubeletha. Ukuphakama kwamahora angaphezu kwamahora ayisithupha kuhlanganiswa nengxenye engamaphesenti angama-30 kwanda ingozi, okuphakamisa ukuthi yonke imizamo kufanele kwenziwe ukuze kugcinwe isigaba sesibili somsebenzi esincane ngangokunokwenzeka. Lokhu kuyiqiniso ikakhulu uma umama enesisindo segciwane eliphezulu leHCV.
Ngokufanayo, noma iyiphi inqubo yezokwelapha engavumelekile eyenza ukutholakala kwegazi-kuya-igazi kungakwandisa amathuba okudluliselwa. Lokhu kubandakanya i-amniocentesis, ephethe ingozi ephansi yokudluliselwa, nokuqapha kwangaphakathi kwe-fetal, okumele kugwenywe ngesikhathi sokubeletha.
I-Hepatitis C ne-Breastfeeding
Akukhobufakazi bokuthi ukubeletha kungakwandisa ingozi yokudlulisela i-HCV kusuka kumama kuya kwengane. Kungenxa yalesi sizathu ukuthi ama-Centers for Disease Control and Prevention (CDC) kanye ne-American Congress of Obstetrics kanye ne-Gynecologists (i-ACOG) ivumela ukondla omama abane-HCV. Uma kuthiwa, omama abanezinsipho eziphukile noma eziphuza kufanele bacabange ezinye izindlela, ikakhulukazi uma benesifo segciwane eliphezulu.
Abomama abathintekayo nge-HCV ne-HIV kufanele bagweme ukuncelisa ngoba kuqhubeka ingozi yokudlulisela i-HIV emntwaneni . Lokhu kuyiqiniso ikakhulukazi kumama abangakabi ukwelashwa ngezidambisigciwane noma abakwazi ukufeza imithwalo engavamile yegciwane lesandulela ngculazi.
Kwenzekani Uma Ukuhlolwa Kwezingane Kuhle
Cishe zonke izingane ezizalelwe omama abane-HCV zizobonisa amagciwane okulwa negciwane. Lokhu akusho ukuthi ingane isulelekile. Ama-antibodies ama-immune amaprotheni akhiqizwa umzimba ngokuphendula ama-agent abangela izifo afana ne-HCV.
Ezinganeni, ama-antibodies e-HCV avame ukuzuza njengefa (okusho ukuthi akhiqizwa ngumama futhi adluliselwe kumntwana). Njengoba kunjalo, ukuba khona kwabo akusho ukuthi ingane igciwane. Ezimweni eziningi, inani lama-antibodies liyokwehla ngokuhamba kwesikhathi, futhi noma yikuphi okuvela kumaphesenti angu-90 kuya kwangu-96 ezingane ngokuzenzekelayo kususe igciwane phakathi kwezinyanga ezingu-18 no-24.
Ngakho-ke, kunconywa ukuthi izingane zihlolwe i-HCV kungakapheli izinyanga ezingu-18 ubudala. Uma ukuhlolwa kwangaphambili kuyadingeka, ukuhlolwa okubizwa ngokuthi i- HCV RNA isayili ingenziwa ngemva kweminyaka eyi-1-2 futhi iphindwe ngosuku oluthile ukuze kuhlolwe ukuthi kukhona ubufakazi bokufuzeka kwesifo. Lapho ukuxilongwa ngokushesha kungashintshi ukwelashwa kwengane, kungasiza ukunciphisa ukukhathazeka kwabazali.
Uma ingane isifo esiqinisekisiwe sokuthi une-hepatitis C, lokho akusho ukuthi ingane izogula. I-Hepatitis C iyaqhubeka ihamba kancane kakhulu ezinganeni kunabantu abadala, kanti amaphesenti angaba ngu-80 abonisa ukuthi kuncane kakhulu ukubhuka kwesibindi (i-fibrosis) eneminyaka engu-18.
Ngaphezu kwalokho, izingane nezinsana ezine-HCV zivame ukusabela ngokuthethelela ku-therapy ye-hepatitis C, uma kudingekile, ukufeza izinga eliphezulu lokuphulukisa kanye nemiphumela emibi kakhulu kunabantu abadala.
Ukuvimbela I-Hepatitis C ekukhulelweni
Uma une-hepatitis C engapheli futhi uhlose ukukhulelwa, khuluma nodokotela wakho mayelana nezinketho zokwelashwa ezitholakalayo. Namuhla, ama- anti-virus asebenzayo ngokuqondile (DAAs) athola amazinga okuphulukisa amazinga angaphezu kwamaphesenti angama-95 kwezinye izindawo, ngezikhathi zokwelashwa ezihlala isikhathi esingangamaviki angu-12 kuya kwangu-16.
Kusebenza okufanayo uma ungenawo i-HCV, kodwa oshade naye uyakwenza. Ngenkathi kungekho ndlela yokuthi owesilisa angenelele ngqo embungeni, kusengcupheni yokutheleleka kumlingani wesifazane. (Naphezu kwezindleko eziphezulu ze-HCV, ukutholakala kunweba njengezinkampani zomshuwalense kuqaphela ukugcina isikhathi eside okuhlobene nokuvimbela umdlavuza wesibindi kanye ne- cirrhosis ekhokhelwayo .)
Kubalulekile ukuthi uqaphele ukuthi ukwelashwa kwe-HCV akuvamile ukululekwa ngokungabikho kwanoma iyiphi enye inkomba yokwelapha. Uma isibindi se-foster fibrosis sincane kakhulu ukuba singekho futhi umthamo wegciwane wehle, cishe ngeke kudingekile ukuqala ukwelashwa. Okuwukuphela kwendawo okungenzeka kube yilabo abasebenzisa izidakamizwa zangaphambili abavame ukusebenzisa inqubo yokubeletha kuze kube yilapho ukwelashwa kuqediwe.
Ngakolunye uhlangothi, uma une-hepatitis C futhi kakade ukhulelwe, qiniseka ukuthi uhlangana nesazi se-hepatologist noma i-gastroenterologist ukuze uqiniseke kangcono ukuthi ugwema izinto eziningi ezibangelwa ukudluliselwa komama nomntwana.
Okubaluleke kakhulu ukuthi ukwelashwa ngokushesha kwe-HIV , ngabe ukhulelwe noma cha. Ngokunciphisa i-HIV kumazinga angabonakali, ukunciphisa kakhulu ukuvuvukala okungapheli okuhlobene nokutheleleka. Lokhu nakho kunganciphisa umsebenzi wegciwane lesandulela ngculaza ngesikhathi sokukhulelwa futhi emva kokuzalwa.
Ucwaningo lwamuva luye lwabonisa ukuthi omama mayelana nokwelashwa kwama-antiretroviral nemithwalo engavumelekile yegciwane lengculazi banengozi efanayo yokudluliselwa kwe-HCV njengomama abangenayo i-HIV.
Ingabe Ukukhulelwa Kuyokwenza I-Hepatitis C Yami?
Cishe cha. Kodwa-ke, idatha yamanje ivame ukuphikisana, kanti ezinye izifundo zikhomba ukuthi ukukhulelwa kuqhubekisela phambili i-fox fibrosis kwabesifazane abane-HCV kanti abanye babika ukwehlisa ukukhula kwezifo.
Ngalokho kuthiwa, abesifazane abaneHCV bangase babe engozini enkulu yokucindezeleka kokukhulelwa. Isifundo esisodwa esisekelwe eWashington sibonisa ukuthi amantombazane azalwa ngamama-HCV anempilo ayengaba nesisindo esincane, kanti omama ngokwabo babeneengozini enkulu yokuthola isifo sikashukela sokugaya (ngokuvamile kuvumelana nokuzuza ngokweqile).
Kodwa lezi zibonakala zihlukile kakhulu kunomthetho. Kwabaningi omama abane-HCV, ukukhulelwa kuyoba nzima ngokungabi nakakhulu kwesifo sesibindi futhi akukho miphumela emibi enganeni.
> Imithombo:
> Dunkelberg, J .; Berkeley, E .; Thiel, K .; et al. "I-Hepatitis B no-C ekukhulelwe: ukubuyekezwa nokunconywa kokunakekelwa." I- Journal of Perinatology. Disemba 2014; 34 (12): 882-891.
> Pergam, S .; Wang, C .; I-Gardella, iC .; et al. "Izinkinga zokukhulelwa ezihlobene ne-hepatitis C: idatha kusukela ngonyaka ka 2003-2005 wase Washington Washington." I- American Journal of Obstetrics. 2008; 199: 38 (e 1-9).
> UMnyango wezeMpilo waseMelika kanye nezinsizakalo zabasebenzi. "Ukucubungula Ukusetshenziswa Kwe-Antiretroviral Kuziguli Ezinezifo Zokubhekana Nezifo: I-Hepatitis C (HCV) / Ukubambisana kwe-HIV." ibuyekezwe ngo-July 14, 2016.
> UMnyango wezeMpilo waseMelika kanye nezinsizakalo zabasebenzi. "Izincomo zokusetshenziswa kwezidakamizwa zokulwa negciwane lesandulela ngculaza abakhulelwe abanegciwane lesandulela ngculazi nengculazi abakhulelweyo ngenxa yokugula komama kanye nokunciphisa ukunciphisa ukuhanjiswa kwe-HIV e-United States." I-Rockville, e-Maryland; ibuyekeziwe ngoMeyi 21, 2013.
> Yeung, C .; Lee, H .; Chan, W .; et al. "Ukudluliswa okuqondile kwegciwane le-hepatitis C: Ulwazi nolwazi lwangoku." I- World Journal of Hepatology. Septemba 27, 2014; 6 (9): 643-651.