Imithi emisha ye-HCV enamandla
Imithi eqinisekisiwe ye-FDA ye-hepatitis C isukela ekuqaleni kwawo-1990 lapho i-interferon-alfa itholakale njengemjovo yeviki kathathu ngeHCV. Eminyakeni engamashumi amabili ezayo, i-interferon noma i-derived modified, i-peginterferon noma ngaphandle kwe-ribavirin yomlomo, kwakuyisilinganiso sokunakekela ukwelashwa kwesifo sofuba C. I-Interferon yayisebenza ngokungaqondile igciwane ngokunyusa izimpendulo zemvelo zomshoshaphansi womuntu onegciwane.
Lokhu kwakwelashwa kwakunzima ukubekezelela, kuhileleka injection njalo kuze kube unyaka owodwa, futhi kwaba nesilinganiso sokuphumelela kuphela 6% -54% kuphela. Ngokusobala, kwakudingeka ukwelashwa okungcono.
Ngo-2011, i-FDA yavuma imithi yokuqala eyenzeka ngqo kwimishini yokuphindaphinda igciwane. Lawa yi-HCV protease inhibitors: i-boceprevir ne-telaprevir. Babesebenza ngokuphumelelayo ekuvimbeleni ukuphindaphinda kwamagciwane, kodwa ngenxa yokuvela kwamagciwane emithi, kwakudingeka kuhanjiswe kanye ne-peginterferon ne-ribavirin. Ngakho-ke naphezu kokuthi izinga lokuphumelela likhuphukele kuma-69% -74%, imiphumela emibi yehlanganisi yezidakamizwa ezintathu yayingenakuxolisa iziguli eziningi. Le mithi ayisisetshenzisiwe e-United States namuhla.
Ukuqhuma kokuqala okukhulu kwafika ngo-2013 ngokuvunyelwa kwe-sofosbuvir kanye ne-simeprevir. Yilowo nalowo ekuqaleni wayevunyelwe ukusebenzisa ne-peginterferon ye-genotype 1, ukusetshenziswa kwelebuli ngaphandle kwelebula kokubili ngaphandle kokuphuma kwe-peginterferon , ngokushesha kusetshenziswe kakhulu.
Amanani okuphumelela afika ku-90% noma ngaphezulu; futhi ukugwema i-interferon kwakusho ukuthi ukwelashwa kwakunakekelwa kahle emasontweni angu-12 kuya kwangu-24 okwelashwa. Kodwa-ke, lezi zithunywa zazibiza kakhulu kanti ezinye izifo ezingavamile kakhulu nezimo ze-hepatitis C namanje zidinga i-peginterferon (IMIBUZO EYEMPAKATHI).
Lokho kwasala isimo se-HCV ukwelashwa kuze kube ngu-Okthoba 2014 ngokuvunyelwa kwe-tablet eyodwa yokwakhiwa kwe-sofosbuvir ne-ledipasvir (HARVONI). Le nhlanganisela yethebulethi yayiphumelela kakhulu kuma-genotypes 1 no-4 ngaphandle kokudingwa kwe-peginterferon noma i-ribavirin. Ihlala yindlela yokwelapha ephakeme kakhulu ye-hepatitis C e-United States. Nokho, kukhona ezinye izixwayiso ezibalulekile. Njengoba i-sofosbuvir ingafanele ihanjiswe iziguli ezinezinkinga ezinkulu zezinso (ukususwa kwe-creatinine engaphansi kwe-30 mL / min), lokhu kuhlanganiswa kwethebula elilodwa kunomkhawulo ofanayo. Futhi, imithi akufanele ihanjiswe kulabo abathatha futhi i-Amiodarone, imithi yomculo we-cardiac. I-Proton pump inhibitors (i-Prevacid, i-Neium, njll) inganciphisa ukusebenza kahle kwalo muthi futhi kufanele ilawulwe ngokufanayo.
Embalwa ezimbalwa ngonyaka ka-2014, u-AbbVie umemezele i-FDA imvume yokuhlanganiswa kwezidakamizwa ezintathu ezithi Viekira Pak (VIEKIRA PAK). Le nhlanganisela iqukethe imithi emibili, kanye ngosuku, imithi eyenziwe ngokubambisana: i-Ombitasvir ne-Paritaprevir kanye ne-Dasabuvir yemithi emibili yansuku zonke. I-Paritaprevir nayo ihlelwe ngokuvumelana nemithi ye-booster, i-ritonavir, ukuthuthukisa amandla weParitaprevir.
Okokugcina, nge-genotype 1a izifo, lokhu kuhlanganiswa kunikezwa nge-ribavirin kabili nsuku zonke. Le nhlanganisela inamandla kakhulu ku-genotype 1 izifo noma ngaphandle kwe-cirrhosis. Le nhlanganisela iphephile futhi isebenza kahle ezigulini ezine-cirrhosis ezikhokhelwa kahle, kodwa kungenzeka ukuthi zingaphephile kulabo abanesiqinisekiso sokukhokha ( Isexwayiso ) ( Yini ebulala iziguli ezine-cirrhosis? ). Izinselele eziyinhloko kulolu cwaningo yizixazululo ezithile zezidakamizwa-izidakamizwa ngenxa ye-ritonavir nenani lamaphilisi okudingeka athathwe nsuku zonke.
Ngasekupheleni kuka-2015, imishanguzo emisha eyamukelwa yi-FDA i-Daclatasvir (DACLATASVIR).
Lona imithi ene-HCV ye-genotype reactivity efana ne-sofosbuvir kepha isigaba semithi ehlukile, ngakho ukunikeza imithi emibili ndawonye kungavumela cishe wonke ama-genotypes e-HCV ukuthi aphendule ngaphandle kokusetshenziswa kwe-peginterferon noma i-ribavirin, kodwa kunconywa ukuthi i-genotype 3 ngokukhethekile . Kodwa-ke, kukhona ukusebenzisana kwezidakamizwa nezidakamizwa neDaclatasvir, ngakho-ke ukubonisana nodokotela noma wemithi kunconywa.
Iminye imithi emibili ye-hepatitis C entsha ikulindeleke ekuqaleni kuka-2016. Lezi zizobe zithinta umbiko ozayo.Ungathola futhi ulwazi nge-hepatitis C evela eMelika Liver Foundation (ALF)