Harvoni chirongwa chakasanganiswa chinoshandiswa nemishonga inoshandiswa mukurapa chirwere chisingaperi chechipatara C (HCV) . Mishonga mbiri iyo inosanganisira Harvoni (ledipasvir, sofosbuvir) inoshanda nekuvhara zvose mapuroteni (NS5A) uye enzyme (RNA polymerase) inokosha pakudzokorora kwehutachiona.
Harvoni yakabvumirwa munaOctober 10, 2014, neU.S. Food and Drug Administration (FDA) iyo inoshandiswa kune vanhu vakuru makore gumi nemana kana kupfuura neHCV genotypes 1 utachiona, kusanganisira avo vane cirrhosis .
Harvoni inogamuchirwa kuti ishandiswe mune zvekare isati yashandurwa ("chirwere-naïve") varwere, pamwe chete nevaya vasina rutivi kana kusina mhinduro kune HCV yakatanga kurapwa ("kurapa-ruzivo").
Harvoni ndiro dhiyabhorosi yekutanga yeAVA inogamuchirwa neHCV iyo haifaniri kutorwa pamwe ne pegylated interferon (peg-interferon) kana ribavirin (mishonga miviri inoshandiswa pakushandiswa kweHCV pamwe chete, iyo yose yaiva nehuwandu hwehuwandu hwehuwandu hwemashoko).
Harvoni inonzi inoporesa mazana ari pakati pe 94% uye 99%, nepo Phase II miedzo yakarondedzera chirwere chema 100% muvarwere vanokonzerwa neHIV neHCV.
Dosage
Rimwe piritsi (90mg / 400mg) inotorwa zuva nezuva kana kuti isina zvokudya. Mahwendefa eHaroni ane mhando yakadhaimani, ginger-mavara, uye mafirimu-akavharwa, ane "GSI" yakaiswa kune rumwe rutivi uye "7985" pane imwe.
Kunyora Zvikurudzira
Harvoni inorayirwa pamusoro pemisangano ye12 kusvika ku24, maererano nezvinodiwa zvinotevera:
- Kurapa-naïve kana kuti pasina cirrhosis: mavhiki 12
- Mishonga-inozivikanwa pasina cirrhosis: masvondo gumi nemaviri
- Mishonga-inozivikanwa ne-cirrhosis: masvondo makumi maviri nemaviri
Uyezve, kosi yevhiki masere inogona kuongororwa kune vanorapwa-naïve varwere vasina cirrhosis vane HCV yehutachiona hwemamiriyoni emamiriyoni matanhatu / mL.
Nharaunda Dzakabatana
Maitiro akawandisa anowanzobatanidzwa nekushandiswa kweHarvoni (inowanikwa mu10% kana pasi pevarwere) ndeiyi:
- Kuneta
- Headache
Zvimwe zvinokonzerwa nemigumisiro (pasi pe10%) zvinosanganisira kuora mwoyo, chirwere, uye kusuruvara.
Kubatana Kwemishonga
Izvi zvinotevera zvinofanirawo kudziviswa kana uchishandisa Harvoni:
- Rifampin-based anti-tuberculosis mishonga: Mycobutin, Rifater, Rifamate, Rimactane, Rifadin, Priftin
- Anticonvulsants: Tegretol, Dilantin, Trileptal, phenobarbital
- Aptivus (tipranavir / ritonavir) inoshandiswa muHIV antiretroviral therapy
- St. John's Wort
Contraindications nekufungisisa
Izvo hazvina kupesana kwekushandiswa kweHarvoni kune varwere vane HCV genotype 1.
Zvisinei, kune varwere vane HIV vanoshandisa mutachiona tenofovir (kusanganisira Viread, Truvada , Atripla, Complera, Stribild ), kuwedzera kwekufanirwa kunofanira kupiwa mukuongororwa kwemamwe matambudziko anokonzerwa neTenofovir, kunyanya kuora (kidzo) kuora mwoyo.
Antacids inofanira kutorwa pamwe chete maawa mana mushure mekunge kana mushure meHarvoni dose, apo maitiro eproton pump inhibitors uye H2 receptor inhibitors (aka H2 blockers) angadikanwa kuderedzwa kuitira kudzivirira kuderedza ledipasvir kukohwa.
Kunyange zvazvo pasina kubvumirana kwekushandiswa kweHarvoni pakuberekwa, data duku yekliniki inowanika. Zvisinei, zvidzidzo zvemhuka kune kushandiswa kwemadipasvir uye sofosbuvir hazvina kuratidza kuti hazvina maturo pakukura kwekurera.
Kubvunzurudza kunyanzvi kunokurudzirwa panguva yekuzvitakura kuongorora kukurumidza kweHaronionira, kunyanya kana kutanga pakarepo kana kumirira kusvikira mushure mokuberekwa.
Zvinokurudzirwa kuti vakadzi vose vane makore anobereka vana vanofanira kuongororwa mwedzi wega wega nekuda kwepamuviri panguva yekurapa. Inokurudzirwawo kuti murwere nemurume wake mukomana vagoverwa maitiro maviri asingaiti mahomoni ekudzivirira kubata pamuviri uye kuti anoshandiswa panguva yekurapa uye kwemwedzi mitanhatu gare gare.
Kunobva:
US Food and Drug Administration (FDA). "FDA inobvumira kutanga kusanganiswa kwemishonga kuti irape hepatitis C." Silver Spring, Maryland; nyaya yekubudiswa yakabudiswa musi waOctober 10, 2014.