Kurapa Viral Hepatitis Infections
Viral hepatitis inotsanangurwa sechiropa chokuputika kunokonzerwa nehutachiona hwehutachiona. Zvinonyanya kukosha ndezvipi zvishanu zvisingabatanidzi mavhairusi anonyatsoshandura masero echiropa, anonzi hepatocytes. Aya mavhirusi ehepatotropic haasi kusiyana nemaitiro avanobva kuvanhu nemunhu, asi pane nzira dzavanogona kudzivirirwa kana kubata.
Mune zvimwe zviitiko, chirwere chehepatitis chinogona kugara kwenguva pfupi-kugadzirisa pachako pachako uye vashoma, kana pane, zviratidzo kana mhinduro.
Pane dzimwe nguva, inogona kufambira mberi zvinyararire pamusoro pemakore emakore kana makumi emakore, zvichikonzera kupora zvishoma nezvishoma kwechigunwe chechiviri (fibrosis) chinogona kutungamirira kuchiropa chinokanganisa ( cirrhosis ) kana kenza yeropa ( hepatocellular carcinoma ).
> Ona hutano hwakanaka nehuruvara rwechivara muropa.
Asi, hazvishamisi kuti kurapwa kwehutachiona hwehutachiona hwehutachiona hwakasiyana nemavarasi pachavo. Kubva pane hepatitis A kusvika hepatitis E, mazano ekurapa iyezvino anogadzirisa kupararira nekupararira kwezvirwere, izvo nhasi zvinorayira vanhu vanopfuura mamiriyoni 1.5 vakafa gore negore.
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Mavyret Anokwanisa Kurapa Hepatitis C muShoma Mavhiki masere
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Unofanira Kuwana Hepatitis C Yako Mishonga Inobva kuIndia?
Hepatitis A
Hepatitis A inokonzerwa nehutachiona hweH hepatitis A (HAV) uye inowanzoparadzirwa kuburikidza nezvokudya kana mvura yakasvibiswa nehutachiona hweHIV. Inowanzopa sehutachiona hwehutachiona (kuzvidzora), uye zviratidzo zvichionekwa chero kupi zvako kubva mavhiki maviri kusvika matanhatu uchitevera kutanga kwekutsvaga. Muzviitiko zvakawanda, zvinogona kunge zvisingatauriki, uye zvishomanana, kana zviripo, zviratidzo zvekuti utachiona hwave hwaitika.
Kana zviratidzo zvakakomba zvikaonekwa, zvinogona kuratidza ne jaundice (kuchena kweganda nemaziso), choluria (rima remuti), denga-mavara, uye manzwiro ekunyengedzera kwakanyanya kana malaise.
Hapana mazano anonyatsorapwa kurapwa kwehepatitis A kunze kwekuderedza kusagadzikana kwomunhu uye kuve nechokwadi chekuchengetedza kwakakwana uye kushandiswa kwezvokudya mumamiriro ezvinhu ekurutsa kana kubuda. Zviratidzo zvinowanzogadzirisa zvizere mukati memwedzi miviri, kunyange zvazvo zvinogona kupedzisira kusvika kune zvitanhatu.Vhidhiyo inowanika kuchengetedza HAV chirwere, ichiendeswa nejojo pane zvidzidzo zvitatu.
Hepatitis B
Hepatitis B inokonzerwa nehutachiona hweH hepatitis B (HBV) uye inowanzopararira kuburikidza neropa reutachiona kana muviri wemvura. Kushandiswa kwezvinodhaka kwezvinodhaka uye zvepabonde inzira dzakajairika dzehutachiona sekuparidzirwa kubva kuna amai kuenda kumwana panguva yekuzvitakura.
Sezvo ne hepatitis A, hepatitis B inogona kupa zviratidzo zvakakomba, kazhinji mumazuva makumi matatu kusvika makumi masere ekubuda. Kana zviratidzo izvi zvigadziriswa, utachiona hunogona kuramba hwakanyarara kwemakore munguva yekusingaperi (yakagara kwenguva refu) yechitachiona. Izvi ndezvenguva ino kuti kuputika kwemazuva ose kunogona kukanganisa chiropa.Asi huzhinji hwevanhu vane hepatitis B dzichanyatsojekesa hutachiona mushure mekunge utapukirwa, avo vane chirwere chisingagoneki vanogona kurapwa kuti vaderedze njodzi yekrrhosis uye kenza yeropa.
Parizvino muUnited States, kune zvinomwe zvinodhaka zvinorambidzwa zvinoshandiswa kuti zvishandiswe mukurapwa kwehutachiona hwehupembenene hweH hepatitis B. Kunyange zvazvo mishonga iyi isingagoni kujekesa hutachiwana, inogona kudzivisa kudzokorora kwehutachiona, nokudaro nekuderedza kuputika uye pangozi yechiropa chirwere.Mishonga inowanzoshandiswa zvikuru, inoshandiswa se nucleoside reverse transcriptase inhibitors (NRTIs) ndeyikuti:
- Epivir (lamivudine)
- Hespera (adefovir)
- Viread (tenofovir)
- Tyzeka (telbivudine)
- Baraclude (entecavir)
Mishonga inowanzoonekwa kana iwe uine hutachiona hwekuita huwandu (sezvakaenzana neHBV test DNA) uye yakakwirira ye-enzyme yevindi (kanowanikwa kaviri inowanikwa). Vanhu vanoonekwa kuti vane cirrhosis vanopiwa zvakanyanya kupfuura. Kurapa kweAntiviral kunogona kunge kusina kubudirira kune avo vane chirwere chakakomba kana chigumo chechiropa.
Mushonga weIntron A (interferon alpha-2B) inoshandiswawo dzimwe nguva, kunyanya kune vanhu vaduku kana kune avo vanotarisira kubata. Ichi chigadzirwa che interferon (chirwere chinorwisa zvirwere) chinoshandiswa nejojo rinopfuura masvondo 24 kusvika ku48.
Kunyange zvazvo chirwere ichi chiri chiduku pane zvimwe zvinoshandiswa nemishonga, migumisiro inogona kuve yakajeka Kunewo chirwere chinogona kudzivirira hutachiona hweHBV, uyewo mushonga unobatanidza unogona kudzivirira zvose hepatitis A uye hepatitis B.
Hepatitis C
Hepatitis C inokonzerwa nehutachiona hweH hepatitis C (HCV) uye inopararira zvikurukuru kuburikidza nekushandisa injongedzo yemishonga. Kuita zvepabonde nekuendesa kubva kune amai kusvika kumwana panguva yekuzvitakura hazviwanzoitiki. Zviratidzo zvakajeka, kana zviripo, zvinogona kuonekwa kupi zvako kubva kune vhiki mbiri kusvika kumwedzi mishanu pashure pokutanga kuonekwa. Kunyange zvazvo vazhinji vevanhu vane hutachiona hwehutachiona vachanyatsojekesa hutachiona nemwedzi mitanhatu yehutachiona, vazhinji vanenge 30 muzana yeavo vane chirwere chisingagumi vacharamba vachienda ku-cirrhosis.
Kurapa kwechirwere chepachirwere chepachirwere chetachiona chakaonekwa sechimwe chinhu chekubudirira nyaya nevechizvarwa chitsva chinoratidzira maitiro antivirals (DAAs) anokwanisa kuwana zvirwere zvehutano zvinopfuura 95 muzana mune vamwe vanhu. "Kurapa" kunotsanangurwa sekukwanisa kuchengetedza kusingaoneki mazinga eHCV muropa rako (inozivikanwawo sehutachiona hwehutachiwana husingaperi kana SVR ) kwemavhiki makumi maviri nemashure mushure mekupera kwerapi.
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Nzira Yokusarudza Chero Kana Entecavir Ndiyo Mishonga Yakakodzera Kwauri
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HCV Mishonga: Zvinhu Zvose Zvaunoda Kuziva
Kutsvakurudza kwekliniki kwakaratidza kuti 92 muzana yevanhu vanogona kuwana mhinduro iyi icharamba isina utachiona kwekanguva kwemakore mashanu.
Utachiona hunotsanangurwa nehutachiona (genotype) yehutachiona munhu ane hutachiwana-hunotsanangurwa sejenotype 1, 2, 3, 4, 5 kana 6-pamwe nesero rechiropa. Kunyange zvazvo kurapwa kunogona kurongerwa munguva yehutachiona hwehutachiona, inonyanya kuratidzwa kune vanhu vasina hutachiwana hwehutachiona, kunyanya avo vane cirrhosis.
- Daklinza (daclatasvir): inogamuchirwa kune genotype 3
- Epclusa (sofosbuvir + velpatasvir): inogamuchirwa nejenotype 1, 2, 3, 4, 5 uye 6
- Harvoni (sofusbuvir + ledipasvir): inotenderwa ku genotype 1
- Sovaldi (sofusbuvir): inogamuchirwa nejenotypes 1, 2, 3 uye 4
- Technivie (ombitasvir + paritaprevir + ritonavir): inogamuchirwa ku genotype 4
- Viekira Pak (ombitasvir + paritaprevir + ritonavir yakapeteredzwa ne dasabuvir): inogamuchirwa nejenotype 1
- Olysio (simeprevir): inotenderwa ku genotype 1
- Zepatier (grazoprevir + elbasvir): inogamuchirwa kuti iite geneotypes 1, 4 uye 6
Aya maAAA anowanzoshandiswa pamwe chete nemishonga peginterferon uye / kana ribavirin , kazhinji mune avo vakakundikana chirwere chekare kana kuti vakaonekwa kuti vane cirrhosis yakakurumbira. Ikozvino hapana mishonga yekudzivirira hutachiona hweH hepatitis C.
Hepatitis D
Hepatitis D inokonzerwa nehutachiona hweH hepatitis D (HDV) uye inongogona kuitika kana munhu aine hutachiwana hwehutachiona hweH hepatitis B Iyo inonyanya kupararira kuburikidza nekushandisa injongedzo yemishonga uye inoonekwa zvikuru muAfrica yeSouth Africa, Middle East, uye kuchamhembe kweSouth America.
Mishonga yekurapa haigone. Zvirwere zvakanyanya zvinotarisirwa nehutano hwekudya uye / kana intravenous hydration kana zvichidiwa. Utachiona hweHIVV husingaperi hunova hwakaoma kubata. Nepo pane ikozvino hakuna maDA-approved acharwa maitiro, mushonga weIndron A (interferon alpha-2B) wakaratidzwa kuti uwane hutachiona husingagadziriswi mu20 kusvika ku25 muzana yevanhu vasingazivikanwi vane utachiona. Sezvo HDV inogona kupararira muhupo hweHBV, chirwere che hepatitis B chinonzi chinobudirira mukudzivirira chirwere cheHpatitis D.
Hepatitis E
Hepatitis E inokonzerwa nehutachiona hweH hepatitis E (HEV) uye inopararira zvikurukuru kuburikidza nemvura yakasvibiswa munzvimbo dzisina kucheneswa. Kunyange zvazvo zvirwere zvakawanda zvakanyanya zviringa kuzviraramira pachavo kana zvisingabatsiri mune zvekurapa, vanhu vane maitiro ezvirwere zvekuzvidzivirira (kusanganisira avo vane chiropa chinoputika kana kuti vane hutachiona hweHIV ) vane mikana yekufambira mberi kuhutachiona husingaperi.
Sezvo ne hepatitis E, zvirongwa zvekurapa zve hepatitis D zvishoma. Iko kune, asi zvakadaro, zvakave zvichibudirira pakuzadzikisa kwehutachiona nekushandiswa kwemishonga ye ribavirin.Haichina chirwere chinowanikwa kuchengetedza hepatitis E.
> Sources:
> American Association for the Study of Chiver Disease (AASLD). "Kuongororwa Kwepasi rose uye Munharaunda Kutakura Kwechiropa Zvirwere." Washington, DC Press release yakabudiswa musi waNovember 3, 2013.
> Centers for Disease Control and Prevention (CDC). "Viral Hepatitis." Atlanta, Georgia; yakasvika musi waJuly 19, 2016.