Ukwelapha Izifo Zesifo Se-Hepatitis Viral
I-hepatitis evindiwe ichazwa njengokuvuvuka kwesibindi okubangelwa ukutheleleka ngegciwane. Izimbangela ezivame ukwedlula zonke amagciwane ayisihlanu angathinteki aqondisa ngqo amaseli esibindi, okuthiwa i-hepatocytes. Lezi virusi ze-hepatotropic azifani ngokuthi zithathwe kanjani umuntu komunye umuntu, kodwa kunendlela ezingavinjelwa noma zokuphathwa ngazo.
Kwezinye izimo, ukutheleleka kwe-hepatitis kungase kube nokuxazululwa okwesikhashana okuwukuphela kwezinkomba noma imiphumela.
Ngezinye izikhathi, lingathuthuka ngokuthula phakathi neminyaka noma ngisho neminyaka emashumi, okwenza ukuthi ukubola kancane kancane kwe-organ fibusis (fibrosis) kungabangela ukulimala kwesibindi (i- cirrhosis ) noma umdlavuza wesibindi (i- hepatocellular carcinoma ).
> Bheka iziphimbo ezinobuthi ezinempilo esibindile.
Kodwa, akumangalisi ukuthi ukwelashwa kwegciwane lesifo sofuba nesifo sofuba nesifo se-virus nesifo se-virus nesifo sofuba. Kusuka ku-hepatitis A kuya ku-hepatitis E, izincomo zokwelashwa zanamuhla zihlose ukuguqula ukusabalala nokuqina kwezifo, okwenzeka namuhla kubantu abangaphezu kwezigidi ezingu-1.5 ngonyaka.
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I-Mavyret Iyakwazi Ukwelapha I-Hepatitis C esikhathini esingangamaSonto ayisithupha
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Ingabe Kufanele Uthole Imishanguzo Yakho Ye-Hepatitis C Evela India?
I-hepatitis A
I-Hepatitis A ibangelwa igciwane le-hepatitis A (HAV) futhi livame ukusabalala ngokudla noma amanzi aphikisiwe ngamanqamu aphethwe yi-HAV. Ngokuvamile iveza njengokutheleleka okunamandla (okuzimele), nezimpawu zivela noma yikuphi amasonto amabili kuya kwamasonto emva kokuchayeka kokuqala. Ezimweni eziningi, kungaba okungenakuqhathaniswa ngokuphelele, okumbalwa, uma kunjalo, izimpawu zokuthi isifo sithathekile.
Uma izimpawu ezinzima zivela, zingabonakalisa nge-jaundice (ukuphuziza kwesikhumba namehlo), i-choluria (ukukhanya komchamo), izitshalo zobumba, nemizwa yokuphefumula ngokweqile noma i-malaise.
Azikho izincomo zokwelashwa eziqondile zokutheleleka kwesifo sohlobo lwe-hepatitis A ngaphandle kokunciphisa ukukhathazeka komuntu nokuqinisekisa ukuthi amanzi afanelekile nokusekelwa okunomsoco uma kwenzeka ukuhlanza noma uhudo. Izimpawu zivame ukuxazulula ngokugcwele ezinyangeni ezimbili, nakuba zingadlulela kuze kube yizinyanga eziyisithupha. Umuthi wokugoma utholakala ukuvimbela ukutheleleka kwe-HAV, okulethwa umjovo ngaphezu kwezifundo ezintathu.
I-hepatitis B
I-Hepatitis B ibangelwa yi-virus ye-hepatitis B (HBV) futhi ivame ukusabalala ngegazi eligciwane noma uketshezi lomzimba. Ukusetshenziswa kwezidakamizwa ezingenalutho kanye nokulala ngokobulili yizinto ezivamile zokutheleleka njengoba ukudluliselwa kusuka kumama kuya kwengane ngesikhathi sokukhulelwa.
Njenge-hepatitis A, i-hepatitis B ingabonisa ngezimpawu ezinzima, ngokuvamile ezinsukwini ezingu-30 kuya kwezingu-80 zokudalwa. Uma lezi zimpawu zixazululwa, igciwane lingaphikelela ngokuthula ngokuyiminyaka ngesikhathi sesiguli (esingapheliyo) isigaba sokutheleleka. Ngalesisikhathi ukuvuvukala okuqhubekayo kungabangela ukulimala esibindi. Nakuba iningi labantu abane-hepatitis B lizokhipha ngokuzenzakalelayo igciwane ngokushesha ngemuva kokutheleleka, labo abanesandulela ngculaza bangaphathwa ukuze banciphise ingozi ye-cirrhosis nesifo somdlavuza wesibindi.
Njengamanje e-US, kunezidakamizwa eziyisikhombisa ezivimbela i-antiviral ezivunyelwe ukusetshenziswa ekwelapheni ukutheleleka okungapheli kwesifo se-hepatitis B. Nakuba le mithi ingakwazi ukususa igciwane, ingakwazi ukuvimbela ukuphindaphinda kwamagciwane, ngaleyo ndlela ukunciphisa ukuvuvukala kanye nobungozi bokugula kwesibindi. Izidakamizwa ezisetshenziselwa kakhulu, ezihlukaniswe njenge-nucleoside reverse transcriptase inhibitors (NRTIs) ziyi:
- I-Epivir (lamivudine)
- I-Hespera (adefovir)
- I-Viread (i-tenofovir)
- I-Tyzeka (i-telbivudine)
- I-Baraclude (entecavir)
Ukwelashwa kuboniswe ngokujwayelekile uma unomsebenzi ophezulu wegciwane lesandulela ngculazi (njengoba kulinganiswa nokuhlola kwe-HBV DNA) kanye nama-enzyme ephakeme yesibindi (okungenani kabili izinga elivamile). Abantu abathintekayo abane-cirrhosis banikezwa phambili okuphezulu. Ukwelashwa kwe-antiviral kungase kungasebenzi kangako kulabo abanezifo ezinzima noma zokuphela kwesibindi.
Isidakamizwa i-Intron A (i-interferon alpha-2B) nayo isetshenziswa ngezinye izikhathi, ikakhulukazi kubantu abasha noma kulabo abalindele ukukhulelwa. Lolu hlobo lwama-interferon (i-proteine yokulwa nezifo) lwenziwa umjovo ngaphezu kwamasonto angu-24 kuya kwangu-48.
Ngenkathi inkambo yokwelashwa imfushane kunamanye okukhethwa kwezidakamizwa, imiphumela emibi ingaba yinkimbinkimbi. Futhi kukhona umgomo ongavimbela ukutheleleka kwe-HBV, kanye nomuthi wokugoma ohlangene ongavimbela kokubili isifo sofuba A nesifo se-hepatitis B.
I-Hepatitis C
I-Hepatitis C ibangelwa igciwane le-hepatitis C (i-HCV) futhi lisakazeka ngokuyinhloko ngokusetshenziswa kwezidakamizwa. Ukwedlulisa ngokocansi nokudluliselwa komama kusuka kumama kuya kwengane ngesikhathi sokukhulelwa kuyindlela engavamile. Izimpawu ezizwakalayo, uma zikhona, zingabonakala noma kuphi kusukela emavikini amabili kuya ezinyangeni ezinhlanu emva kokuchayeka kokuqala. Ngenkathi iningi labantu abanesandulela ngculaza lizocacisa ngokuzenzakalelayo igciwane ngezinyanga eziyisithupha zokutheleleka, cishe amaphesenti angama-30 alabo abanesifo esingenasifo esiqhubekayo bazoqhubekela phambili e-cirrhosis.
Ukwelapha ukutheleleka kwesifo sofuba esingapheli kuye kwacatshangwa njengento yenkambiso yokuphumelela ngezizukulwane ezishaya indiva ezisebenza ngokuqondile (DAAs) ezikwazi ukufeza amazinga okuphulukisa amazinga angaphezu kwamaphesenti angama-95 kwezinye izindawo. "Ukwelashwa" kuchazwa ngokuthi ukwazi ukusekela okungabonakali amazinga e-HCV egazini lakho (eyaziwa nangokuthi i- viral response sVR noma i-SVR ) yamaviki angama-24 ngemuva kokuphela kwelashwa.
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Indlela Yokunquma Kungakhathaliseki ukuthi i-Entecavir iyisidakamizwa esifanele kuwe
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Imithi ye-HCV: Konke Okudingeka Ukwazi
Ucwaningo lwezokwelapha luye lwabonisa ukuthi amaphesenti angu-92 abantu abakwazi ukufeza le mpendulo ngeke ahlale engelagciwane isikhathi esingenani iminyaka emihlanu.
Ukwelapha kubhekiswa uhlobo lwezofuzo (genotype) wegciwane umuntu otheleleke-elihlukaniswe njenge-genotypes 1, 2, 3, 4, 5 noma 6-kanye nesigaba sesifo sesibindi. Ngenkathi ukwelashwa kunqunywe ngesikhathi sokutheleleka okunzima, kubonakala kakhulu kubantu abathintekayo abangenasifo, ikakhulukazi labo abane-cirrhosis. Izinketho zamanje zokwelapha zihlanganisa:
- I-Daklinza (daclatasvir): ivunyelwe i-genotype 3
- I-Epclusa (sofosbuvir + velpatasvir): ivunyelwe ama-genotypes 1, 2, 3, 4, 5 no-6
- Harvoni (sofusbuvir + ledipasvir): ivunyelwe i-genotype 1
- I-Sovaldi (sofusbuvir): ivunyelwe ama-genotypes 1, 2, 3 no-4
- I-Technivie (ombitasvir + paritaprevir + ritonavir): ivunyelwe i-genotype 4
- I-Viekira Pak (i-ombitasvir + paritaprevir + ritonavir ehlanganiswe ne-dasabuvir): ivunyelwe i-genotype 1
- I-Olysio (simeprevir): ivunyelwe i-genotype 1
- I-Zepatier (grazoprevir + elbasvir): ivunyelwe ama-genotypes 1, 4 no-6
Lezi zi-DAA ngezinye izikhathi zisetshenziselwa ukuhlanganiswa nezidakamizwa ze- peginterferon kanye / noma i- ribavirin , kaningi kulabo abaye bahluleka ukwelashwa kwangaphambilini noma bathola ukuthi bane-cirrhosis eziphambili. Okwamanje akukho mgomo wokuvimbela ukutheleleka kwe-hepatitis C.
I-hepatitis D
I-hepatitis D ibangelwa yi-virus ye-hepatitis D (i-HDV) futhi ingenzeka kuphela lapho umuntu esenwe yi-virus ye-hepatitis B. Ngokuyinhloko isakazwa ngokusetshenziswa kwezidakamizwa zokujova futhi ibonakala ikakhulukazi e-Afrika engaphansi kweSahara, eMpumalanga Ephakathi, kanye nesigaba esenyakatho saseNingizimu Melika.
Izinketho zokwelapha zilinganiselwe. Ukutheleleka okunamandla ngokuyinhloko kuphathwa ngokusekelwa okunomsoco kanye / noma i-hydration engaphakathi lapho kudingeka. Ukutheleleka kwe-HDV okungapheli kuvame ukuba nzima kakhulu ukuphatha. Nakuba okwamanje akakho izinketho zokwelashwa ezivunyelwe i-FDA, isidakamizwa se-Intron A (i-interferon alpha-2B) sibonisiwe ukuze sifinyelele ukucindezelwa okuqhubekayo kwegciwane kumaphesenti angama-20 kuya kwangu-25 abantu abangenwa yi-HIV. Njengoba i-HDV ingasakazeka kuphela phambi kwe-HBV, ukugonywa kwe- hepatitis B kubhekwa ngokuphumelelayo ekuvimbeleni ukutheleleka kwesifo se-hepatitis D.
I-hepatitis E
I-Hepatitis E ibangelwa yi-virus ye-hepatitis E (HEV) futhi isakazeka ngokuyinhloko ngamanzi angcolile ezifundeni ezinezinhlanzi ezingcolile. Ngenkathi izifo eziningi ezinzima zizixazulula ngokwazo noma kungenjalo ukungenelela kwezokwelapha, abantu abanamasosha omzimba anqamukile (kuhlanganise nalabo abanesifo sengculazi noma i- HIV esithuthukisiwe ) banamathuba amaningi okuqhubeka nokutheleleka okungapheli.
Njenge-hepatitis E, ukhetho lwezokwelapha lwe-hepatitis D lukhawulelwe. Kodwa-ke, kuye kwaba yimpumelelo ekufinyeleleni imvume yegciwane ngokusebenzisa i- ribavirin yezidakamizwa. Akukho mgomo okhona wokuvimbela ukushisa kwesifo sofuba.
> 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.
> Amasevisi Okulawula Nokuvimbela Izifo (CDC). "I-Hepatitis Viral." E-Atlanta, eGeorgia; kufinyelelwe ngoJulayi 19, 2016.