Ukusakazeka okusheshayo kwe-Hepatitis C Izifo Zama-Infect for Broad Genetic Variation
Kukhona okwamanje izinhlobo ezingu-11 ezahlukene zofuzo (i-genotypes) yesifo se-hepatitis C (i-HCV) emhlabeni, nakuba ukukhula okuphezulu kunabonwa nge-genotypes 1 kuya ku-7. Ngaphezu kwalokhu, i-genotype ngayinye ingaphinde iphuke ibe yi-subtypes ethize, zihlukaniswa ngezibalo (isib. i-HCV genotype 1a noma i-1b).
I-genotyping ibhekwa njengento ebalulekile njengoba isisiza odokotela ukuba banqume ukuthi yiziphi izidakamizwa ezizosebenza ngempumelelo kakhulu ngegciwane lakho elithile (noma amagciwane uma unesifo esingaphezu kweyodwa ye-HCV genotype).
Inqubo yokuhlonza idinga lutho ngaphandle kokuhlolwa kwegazi elula, isampula yayo ehlaziywa besebenzisa ubuchwepheshe obubizwa ngokuthi i- polymerase chain reaction (PCR) .
I-Genotype 1
I-Genotype 1 iyona ejwayelekile kunazo zonke ze-HCV genotype eNyakatho Melika naseYurophu futhi kubalwa cishe amaphesenti angama-80 azo zonke izifo ezitholakala e-US Genotype 1 zokutheleleka kubhekwa kunzima kakhulu ukuphatha, nakuba ama-antiviral asebenzayo ngqo (DAAs) athola ukwelashwa okuphakeme amazinga kulabo abasha abasanda kuphathwa kanye neziguli eziphathwa ngaphambilini. I-HCV i-genotype 1 ingabuyekezwa ibe yi-subtypes 1a, 1b, no-1c.
I-Genotype 2
I-Genotype 2 yi-HCV yesibili ye-genotype ejwayelekile kunazo zonke e-US, ebheka cishe u-10% wabo bonke ukutheleleka. Ngaphambi kokwethulwa kwama-DAA, kwakungenye ye-genotypes ephathwa kalula, iziguli ezine-80% nethuba lokuthola impendulo egciniwe yegciwane lesandulela ngculazi (SVR) ehambisana nesifo. Namuhla, leso sibalo sisondela kuma-90% kwabaningi abagulayo ngaphambilini futhi baphakamise u-99% kulabo abasanda kuphathwa.
I-Genotype 2 inezigaba ezintathu eziyinhloko: 2a, 2b, no-2c.
I-Genotype 3
I-Genotype 3 isendaweni engaseningizimu-ntshonalanga ye-Asia futhi isatshalaliswa ngokungahambisani kulo lonke elase-Australia, eNdiya nakwezinye izingxenye zeMpumalanga Ekude. Kulinganiselwa ukuthi cishe abantu abangu-6% baseMelika bane-HCV genotype 3, engakwazi ukwehla zibe yizigaba ezimbili eziyinhloko: 3a no-3b.
I-Genotype 4
I-Genotype 4 ivame kakhulu e-Afrika, eMpumalanga Ephakathi, nakwamanye amazwe amaningi aseMpumalanga Yurophu. IGibhithe inezinombolo eziphezulu kakhulu zabantu abathintekayo nge-genotype 4, kanye ne-HCV enkulu kunazo zonke emhlabeni. Izinga eliphakeme lama-HCV ukutheleleka kulawa ma-akhawunti, ikakhulukazi, ngenxa yokuhlukahluka kohlobo lwegciwane, oluhlanganisa ama-subtypes 4a, 4b, 4c, 4d, no-4e.
I-Genotype 5
I-Genotype 5 ibonakala kakhulu eningizimu ye-Afrika futhi ibhekwa njengendlela yokushintshashintsha kofuzo oluncane nge-subtype eyodwa eyinhloko: 5a.
I-Genotype 6
I-Genotype 5 ivame kakhulu eningizimu yeChina, eHong Kong, nakwamanye amazwe aseNingizimu-mpumalanga Asia. Njenge-genotype 5, kunesigcawu esisodwa esikhulu: 6a.
I-Genotype 7
I-Genotype 7 yanezelwa emininingwaneni yolwazi ngonyaka ka-2014 futhi kuye kwabonakala manje eThailand naseDemocratic Republic of Congo. Ine-subtype eyodwa eyinhloko: 7a.
Ukwengeza, ama-genotypes 9, 10 no-11 aye abonakala, nakuba izifo ziye zahlukaniswa kakhulu naseVietnam nasezingxenyeni zase-Indonesia.
I-HCV Ukwelashwa ngu-Genotype
Ngokuzalelwa kwama-antiviral ngokuqondile, iziguli zinezinhla zokukhula zokwelashwa kwe-HCV. Okwamanje, i-US Food and Drug Administration iye yavuma ukuthi i-DAA elandelayo isebenzise iziguli ezine-HCV genotypes 1-4 no-6:
- I-Daklinza (daclatasvir) : i-HCV genotype 3
- I-Harvoni (sofusbuvir + ledipasvir) : i-HCV genotype 1
- I-Sovaldi (sofusbuvir) : i-HCV genotypes 1, 2, 3 no-4
- I-Technivie (ombitasvir + paritaprevir + ritonavir) : i-HCV genotype 4
- Viekira Pak (ombitasvir + paritaprevir + ritonavir ehlanganiswe ne-dasabuvir) : i-HCV genotype 1
- I-Olysio (simeprevir) : i-HCV genotype 1
- I-Zepatier (grazoprevir + elbasvir): ama-HCV genotypes 1, 4 no-6
Imithombo:
Rockstruh, J. "Isifinyezo esivela ku-EASL 2015 nge-Hepatitis C Yonke inkulumo ye-HCV ye-DAA eya endleleni yokwenza ngcono: kusadingeka ukuthi ufunde okuningi." Umhlangano wama-50 we-European Association for the Study of the Liver (EASL). Ngo-Ephreli 22-26, 2015; I-Vienna, e-Austria.
I-National Digestive Diseases Information Clearinghouse. "I-Hepatitis C engapheliyo: Ukuphathwa Kwamanje Kwezifo."
Umnyango we-US of Veterans Affairs. "I-Hepatitis C Genotype."