Qondisisa Izimpawu Nezibonakaliso Ze-Hepatitis
Ukutheleleka kwesifo sokushisa kwesibindi yigama elisemtholampilo elisetshenziselwa ukuchaza ukuvuvukala kwesibindi. Ukuvuvukala kungabangelwa izici eziningana ezihlanganisa imithi, amagciwane athile, ukutholakala kwamakhemikhali, i-poisoning yemvelo, ukuphazamiseka kwe-autoimmune nokusetshenziswa kotshwala.
Ngaphakathi komongo we-HIV, kunesilinganiso esiphakeme sokutheleleka kokuthelelana ngezinhlobo ezithile ze-hepatitis yegciwane, ikakhulukazi i-hepatitis C (HCV).
Empeleni, ucwaningo oluthile lwe-epidemiological lubonisa ukuthi abaningi abangama-20-30% baseMelika abane-HIV nabo banesandulela nge-HCV.
Ngakho-ke, kubalulekile ukuqonda izimpawu nezimpawu ze-hepatitis yegciwane, kanye nezinhlobo zama-virus okwamanje ezikhonjisiwe.
Izigaba ze-Viral Hepatitis Infection
I-hepatitis e-viral ingafakwa ngokubanzi ngesigaba sokutheleleka.
Ukutheleleka okuvame kakhulu kwenzeka esikhathini noma lapho kutholakala khona igciwane. Ukuqala kwezimpawu kungaba ngokungazelelwe noma kancane kancane kodwa ngokuvamile kuphila isikhathi eside, ngokuvamile kuxazululwa ngaphakathi kwesikhashana kwezinyanga ezimbili. Phakathi nalesi sigaba, ukulimala kwesibindi kuvame ukubonisa ubumnene obuboniswa ukukhwabanisa (fibrosis) esibindi ngokwayo. Umsebenzi wesibindi ngokuvamile awunqatshelwe futhi izimpawu, uma zikhona, azivamile ukubulala. Kwezinye izimo, ukutheleleka okunzima kungase kuvele ngokucacile, kungashiyi ubufakazi bokuthi igciwane noma umonakalo.
Ukutheleleka okungapheli yilokhu okuqhubekayo isikhathi eside.
Izimpawu ezingxenyeni zokuqala zesigaba esingapheli zingase zingabizo ngqo ekungabikho khona naphezu kokuthi i-fibrosis ingase iqhubekele esibindi. Ngesikhathi sesiteji, ukutheleleka kungachazwa njengokuphikelela okungapheli (ngezimpawu ezikhula kancane futhi ngobumnene) futhi ezinzima kakhulu (uma ukubonakaliswa kwesifo kuyingozi futhi kubonakala).
Kulabo abanesifo esingenalutho esingaphelele, kukhona ingozi eyengeziwe yokwelapha, lapho ukubhuka kwesibindi kukhulu kakhulu ukuphazamisa ukusebenza kwesibindi (ukuvimbela i-cirrhosis) noma ukuyiyeka ngokuphelele (i-cirrhosis ephoqelekile), okuholela ekuhlulekeni kwesibindi.
Ezinye izibonakaliso zokutheleleka okungavamile okungapheli zibandakanya i-hepatocellular carcinoma, uhlobo olusongela impilo yesifo somdlavuza wesibindi kunokwelapha kuphela ukufakelwa kwesibindi.
Izimpawu Ezivamile Nezibonakaliso Ze-Viral Hepatitis
Izimpawu zesifo sofuba singashintsha, kuye ngokuthi uhlobo lwegciwane oluhilelekile, kepha lungabandakanya lokhu okulandelayo ngesikhathi sokutheleleka kwesifo sofuba esibangele :
- I-jaundice (ukuphuzika kwamehlo nesikhumba)
- I-choluria (ukumnyama komchamo)
- Fever
- Ukukhathala
- I-nausea
- Ukuvota
- Ubuhlungu besisu
- Ubuhlungu obuhlangene (i-arthralgia)
- Ubuhlungu besisu ( myalgia )
Phakathi nesigaba esingapheli sokutheleleka, izimpawu zingabonakala ngokwengeziwe, nakuba zingavamile ukukhubazeka. Ezimweni eziningi, kunzima ukunikeza ukukhubazeka kwesibindi kuphela. Ngaphezu kwalokhu okungenhla, izimpawu ezijwayelekile kakhulu zokutheleleka kwesifo sofuba esingapheli yizi:
- Ukulinganisa okungavamile noma izinzwa ezivuthayo (i-paresthesia)
- Ukungazweli "izikhonkwane-nezinaliti" inzwa (i-peripheral neuropathy)
- Isikhumba esinamahloni (pruritus)
- Izindawo ezikhuphukile zokuvuthwa (i-urticaria)
- Amehlo anomile ahambisana nomlomo owomile (i-Sicca syndrome)
Kuyinto kuphela uma isibindi sisigxile futhi umsebenzi wakhe uphelelwe amandla ukuthi izimpawu zibonisa kakhulu izifo zesibindi. Izimpawu nezimpawu ze- cirrhosis ezikhokhelwa zihlanganisa:
- Izinambuzane ze-spider (spider nevi), ngokuyinhloko esihlahleni nasobusweni
- Isikhumba esinamahloni (pruritus)
- Ukubomvu ezintendeni zezandla (i-erythema yesundu)
- Ukulimala kalula noma ukuphuma okungavamile (variceal bleeding)
- Ukwakha-up of fluid emaqenjini nasezinyaweni (i-edema)
- Ukuhlushwa okuncane nokukhumbula
- Ukulahlekelwa kwesifiso (i-anorexia)
- Ukulahlekelwa kwesisindo
- Amathemikhali ahlazayo (atrophy testicular)
- Ukuhlukumeza kwe-Erectile noma ukulahlekelwa kwe-libido
- Ukungahambisani nokuphuza utshwala
I-cirrhosis ehlukumezekile ne-hepatocelllular carcinoma zombili zibhekwa njengesifo sokuphela kwesibindi.
Izinhlobo ze-Hepatitis eVira
Njengamanje, kunezigciwane eziyisithupha ezaziwa ezibangelwa i-hepatitis, ezikhethwe yizinhlamvu A ngokusebenzisa iG. Izindlela zokudluliselwa kwazo, ukusabalaliswa kwezwe kanye nesethulo kungahlukahluka, kanye nezinketho ezitholakalayo zokuvimbela noma ukuphatha ukutheleleka.
Ngo-alfabhethi:
- I-Hepatitis A (HAV) , eyaziwa ngokuthi i-hepatitis esithathelwanayo, ihlale ilukhuni futhi ingalokothi ibe yindlala. I-HAV idluliselwa ngokuxhumana namazinyo afakwe igciwane noma ukudla okungcolile okwenziwe yi-fecal noma amanzi. I-HAV ukutheleleka kaningi ngenxa yezenzo ezimbi zokuhlanza izandla phakathi kwabaphethe ukudla. Umuthi wokugoma we-hepatitis A utholakala ukuvimbela ukutheleleka, kuhanjiswe ochungechungeni lwezifo.
- I-Hepatitis B (i-HBV) , eyaziwa nge-serum hepatitis isakazwa ngoxhumana naye ngokocansi, umathe, izinaliti ezingcolile ezabiwe, nokuvezwa kwegazi elithelelekile. I-HBV ivame ukuthuthuka kwesifo sofuba esingapheli ngaphandle kokubonisa izimpawu zokushisa kwesifo sofuba. Ingozi yokuthola i-Hep B ingancishiswa nge-vaccine ye-hepatitis B, kuyilapho umgomo wokugoma we- Twinrix ungahlinzeka ukuvikelwa kokubili i-HAV ne-HBV.
- I-Hepatitis C (i-HCV) idluliselwa ngokuyinhloko ngokusetshenziswa okwabelwanayo kweziringana ezingcolile nezinaliti, kepha kungadluliselwa kusuka kumama kuya kwengane ngesikhathi sokukhulelwa futhi, ngokungajwayelekile, ngokuxhumana kocansi. I-HCV ingakwazi ukusula ngokuzenzakalelayo kusukela kunabantu abangaba ngu-30-40% umuntu onegciwane ngaphandle kwezimpawu zezimpawu. Olunye luzoqhubeka nokutheleleka okungapheli okungenzeka kungabonakali iminyaka. Nakuba kungekho mgomo wokuvimbela ukushisa kwesifo sofuba C, kukhona ama-antiviral enamandla okusebenza ngokuqondile (DAAs) manje angakwazi ukuletha amazinga okuphulukisa afike kuma-99% kwezinye izindawo.
- I-Hepatitis D (i-HDV) yindlela ye-hepatitis ye-viral engaphendulwa ngokunamathisela ku-HBV. Ngenxa yalokho, ingahambisana nokutheleleka kwe-HBV kodwa ingabonakali yedwa.
- I-Hepatitis E (HEV) ifana ne-HAV futhi iyadluliselwa ngendlela efanayo ngokudla nokungcola okungcolile noma okuxhunyaniswe nezidakamizwa ezinegciwane. Uma kucatshangwa ukuthi ayingavamile, ukunyuka kwamazwe ngamazwe kuye kwaholela ochwepheshe abathile ukuba balinganise ukuthi abantu baseMelika abangaba ngu-20% bangenwe igciwane.
- I-Hepatitis F (HFV) igciwane lesayensi abanye abayakholelwa ukuthi bangabangela isibindi. Naphezu kwenani labantu abangaba khona eminyakeni engama-1990, kusadingeka ukuthi kube khona ukuqiniswa kwegciwane.
- I-Hepatitis G (HGV) ivame ukuba khona ngokuhambisana ne-hepatitis A, B noma C.
Imithombo:
I-American Association ye-Study of the Liver Illness (AASLD). "Ukuhlola I-Global and Regional Burden of Liver Disease." Washington, DC Ukukhishwa kwezindaba kukhishwe ngoNovemba 3, 2013.