Ukuqonda Lokhu Lesi-Hepatitis C "Isifo"
Impendulo ye- virologic esebenzayo (SVR ) yabantu abane- infection ye- hepatitis C isho ukuthi akukho bufakazi begciwane lesandulela ngculaza (HCV) egazini labo ngemuva kokuthola ukwelashwa kwe-hepatitis C. I-SVR iyinhloso yokugcina yokwelashwa kwe-HCV futhi, ezimweni eziningi, ingachazwa ngokomzimba ngokuthi "ukwelapha" uma umthamo wegciwane lesandulela ngculaza uhlala ungabonakali emavikini angu-24 ngemuva kokuphela kokwelashwa.
Cishe zonke izimo, abantu abane-SVR yamaviki angama-24 abengeke babone ukubuyiswa kwegciwane (ie, ukubuya kwegciwane). Ucwaningo oluningi lubonisa ukuthi amanani okubuyiswa aphansi njengamaphesenti angu-1 kuya kumaphesenti amabili ezimweni ezinjalo.
Ukuchaza i-SVR nezinye izimpendulo ze-Virologic
Ngemva kokuqaliswa kwe-hepatitis C yokwelapha, igazi lihlolwe ukukala umsebenzi wegciwane. Umgomo oyinhloko ukufeza umthamo wegciwane elingenakulinganiswa. "Ukungatholakali," kulokhu, akusho ukuthi u-zero noma ukungabikho okuphelele komsebenzi wegciwane emzimbeni; Kunalokho, kuchazwa ngokuthi awunaso igciwane elibonakalayo egazini besebenzisa ubuchwepheshe bokuhlola bokusebenza.
Isigaba ngasinye sempendulo sinikezwa ngezigaba, ngezigaba ezithile ezihambisana nomphumela omkhulu noma omncane wokuphumelela ukwelashwa. Bheka leli shidi, ngezansi.
| Ithemu | Okushoyo | Incazelo | Isibikezelo |
| RVR | Ukusabela okusheshayo kwegciwane | Umthamo wegciwane elingenakulinganiswa emva kwamasonto amane okwelashwa | Ngokuvamile amathuba okufinyelela i-SVR |
| I-eRVR | Ukuphendula okusheshayo kwe-viral | Umthamo wegciwane elingenakulinganiswa ngeviki 12, emva kwe-RVR yokuqala | Ngokuvamile amathuba okufinyelela i-SVR |
| EVR | Impendulo yokuqala yegciwane | Umthamo wegciwane elingenakulinganiswa noma ukunciphisa amaphesenti angu-99 ekutheni umthamo wesandulela ngculazi ngesonto 12 | Ukuhluleka ukuthola ama-correlates e-EVR angaphansi kwama-4 amaphesenti amathuba okufinyelela i-SVR |
| I-ETR | Ukuphela kokuphendula kokwelashwa | Umthamo wegciwane elingenakutholakali otholakala ekupheleni kwesonto 12 | Akusizi ekubikezeni imiphumela yokwelapha |
| Umphenduli oyingxenye | Iyakwazi ukufeza i-EVR kodwa ayikwazi ukugcina umthamo wegciwane elingenakutholakali ngemva kwamasonto angu-24 ngemuva kokuphelelwa ukwelashwa | Kucatshangwa ukwehluleka kokwelashwa | |
| Umphenduli ongenayo | Ayikwazi ukufeza i-EVR ngesonto 12 | Ukwelashwa kuvamise ukuphela uma i-EVR ingatholakali ngesonto 12 | |
| I-SVR | Impendulo yegciwane lesondlo | Iyakwazi ukusekela umthamo wegciwane elingenakulinganiswa amasonto angu-12 (i-SVR-12) namaviki angu-24 (i-SVR-24) ngemva kokuphelelwa ukwelashwa | I-SVR-24 ibhekwa ngokuthi "ukwelashwa," futhi iziguli ezine-SVR-12 zivame ukufeza i-SVR-24 |
Ukwandisa amathuba akho okufeza i-SVR
Esinye sezici eziyinhloko zokuphumelela kwe-SVR yisikhathi, kanti iziguli ezitholayo ngaphambilini zizuzisa ukwelashwa okulibalekile. Ngokuphatha ukutheleleka kwakho ngaphambi kokulimala kwesibindi (noma, ngokuqinisekile, noma yimuphi umonakalo), ngokuvamile unethuba elingcono lokuthola ukwelashwa kwemitholampilo ye-HCV.
Ukwengeza, ama-antiviral (ama-DAA) amasha asebenza ngokushesha (ama-DAA) amasha ayenomthelela ojulile kumazinga okuphulukisa kubantu abanokutheleleka kwe-HCV okungapheli. Ngisho nabantu abanesifo se- cirrhosis , ababekade benenzuzo ye-50/50 yokwelapha impumelelo, amazinga e-SVR aye kancane kancane enyukela ngamaphesenti angu-95 nangaphezulu kulezi ziningi.
Izivivinyo zesigaba se-III sezilinganiselwe izibalo ezilandelayo zokuphulukiswa kweziguli ezisanda kuphathwa (naïve) kanye neziguli ezilashwa ngaphambili (ezitholakele) ezine-HCV:
- I-Daklinza (daclatasvir) esetshenziselwa uSovaldi: amaphesenti angu-98 angama-naive namaphesenti angu-58 abhekene ne-cirrhosis
- I-Harvoni (i-sofusbuvir + ledipasvir) : amaphesenti angu-99 a-naïve namaphesenti angu-94 ahlangene
- I-Sovaldi ( sofosbuvir ) esetshenziselwa i- ribavirin + peginterferon noma i-ribavirin yedwa: amaphesenti angu-82 kuya kwangu-92 jikelele
- I-Technivie (i-ombitasvir + paritaprevir + ritonavir) : amaphesenti angu-99 angenayo futhi anolwazi
- I-Viekira Pak (i-ombitasvir + paritaprevir + ritonavir ehlanganiswe ne-dasabuvir) : amaphesenti angu-95 angama-navive
- I-Olysio (simeprevir) esetshenziselwa i-ribavirin + peginterferon: ama- 80 kuya kuma-85 amaphesenti ayi-naïve
- I-Zepatier (grazoprevir + elbasvir) esetshenziselwa noma ngaphandle i-ribavirin: amaphesenti angu-95 angenayo futhi anolwazi
Okungafinyeleleki SVR Kusho
Nakuba umgomo we-HCV ukwelapha ukuqeda igciwane ngokuphumelelayo futhi ukuvumela umuntu ukuba aphile impilo enempilo, engenayo isibindi, isiguli akufanele siphelelwe ithemba uma engakwazi ukufeza lezi zinhloso.
Ngisho noma unempendulo eyingxenye kuphela, izifundo zibonise ukuthi izinzuzo zesibindi zingaba yinkimbinkimbi-hhayi nje ukunciphisa inkambo yesifo kodwa kwezinye izimo ziguqula i-fibrosis, ngisho nalabo abanokulimala kwesibindi.
Uma uhluleka ukwelashwa kwakho kokuqala noma kwesibili, thatha isikhathi ukuqapha imiphumela yakho yegazi nodokotela wakho. Uma unomuzwa wokuthi usulungele ukuzama futhi, udokotela wakho angenza izivivinyo eziningi ukuthola ukuthi iziphi izidakamizwa ezingakunika ithuba elihle lokufeza impumelelo ye-SVR.
Ukubhekana ne-Hepatitis C
Ungavumeli ukutheleleka kwe-hepatitis C kukukwenza uzizwe ukhululekile. Kukhona usizo olutholakalayo.
Ngaphandle kokucela abangani bakho namalungu omndeni ukuba akusize phakathi nohambo lwakho, ungathola induduzo ekujoyineni umphakathi osebenzayo we-hepatitis C noma iqembu elixhasayo le-hepatitis. Futhi, ukufunda kabanzi mayelana nokudla kwesifo sofuba esingapheli kungenza uzizwe ungcono futhi kungase kuthuthukise impendulo yakho yokwelashwa.
> Imithombo:
> Chopra, S., noD. D. Muir. Izindlela zokwelapha ze-Chronic Hepatitis C Virus Genotype 1. UpToDate . Kubuyekezwe 09/14/16.
> Kattakuzhy, S., Wilson, E., Sidharthan, S. et al. Izindleko zokuziphendulela ezilinganiselwe ezilinganiselwe ezinama-6-I-Weekly Combination Acting Anti-Hepatitis C I-Virus Therapy ezigulini ezinezifo eziphakeme ezibangelwa yi-Liver. Izifo ezithathelwanayo emitholampilo . 2016. 62 (4): 440-7.
> Kattakuzhy, S., Wilson, E., Sidarthan, S. et al. Ukuziphendukela Kwemibono Yokuphikisana Okuxhunyanisiwe Ngesikhathi Sokuqala Ukwelashwa, Ukuhluleka Kwegciwane, Nokubuyiswa Kwe-Treatment Ngokusebenza Ngokuqondile Ukwelashwa Kwe-Antiviral Therapy (Trial NIH SYNERGY). Umhlangano we-AASLD wesibindi; 2015; abstract 220.
> Smith-Palmer, J., Cerri, K., noW. Valentine. Ukufeza impendulo eqinisekisiwe ye-Virologic ku-Hepatitis C: Ukubuyekezwa okuhlelekile kwe-Clinical, Economic and Quality of Life Benefits. I-BMC Isifo Esithathelwanayo . 2015. 15:19.