Hepatitis C (HCV) mishonga inobatsira chaizvo mukurapa utachiona, uye madzinza matsva emadhaka anogona kuvandudza mamiriro evanhu vane cirrhosis inokonzerwa neHCV, kunyange kana chirwere chakapfuura chakakundikana.
Kazhinji, pakati pe20% ne30% yeHCV zvirwere zvinopedzisira zvisinganzwisisiki pasina mushonga wokurapa. Pamamwe makumi manomwe kubva ku70 kusvika ku80%, chirwere chinogona kufambira mberi kwemakore emakore uye zvishoma nezvishoma kukanganisa chiropa.
Vanenge 30% yevanhu vanotapukirwa neHCV vanoita zvinetso zvakakomba zvakadai se- cirrhosis , kenza yeropa , kana kuti pakupedzisira kwechiropa kusakundikana, uye pakupedzisira inogona kuva nechiropa chokupemha.
Zvinyorwa
Chinangwa chehutachiona hweH hepatitis C ndechekudzivirira hutachiona kusvika pakunenge husingaoneki muropa. Apo utachiona hunoramba husingagoneki neongororo yeropa kwenguva refu, izvi zvinotsanangurwa sechisimbiso che virologic response (SVR) .
Kutsvakurudza kwakaratidza kuti vanhu avo vane hutachiwana hweHCV avo vane SVR kwemavhiki makumi mana anotevera hutachiona hweHCV vane 1% kusvika 2% mukana wekuwana kudzoka kwehutachiona. An SVR-24 inorondedzerwa semushonga. Kunyange vanhu vane HCV vasina SVR-24 vanoona zvirwere zvishoma nezvishoma kufambira mberi uye kuchinja chimwe chekupera kwechiropa chinosangana nehutachiona.
Kurongedza Zvakasimba Maitiro Antivirals (DAAs)
Kutora maitiro ekuvhara mairi (DAAs), iri boka idzva remishonga inobatsira kurapa mazana kusvika 99%, pamwe nekurapwa kwemaawa anenge gumi nemaviri, uye zvishoma nezvishoma uye zvishoma nezvishoma zvinokonzerwa nemigumisiro.
Iyi mishonga inogona kushandiswa kwehutachiona uye husingaperi hutachiona hweHCV, pamwe nehutachiona hwechiropa.
DAAs dzinogona kubata nhamba inowedzera yeHCV marinthini, uye rimwe nerimwe re DAA rinokurudzirwa chete kune mamwe matambudziko.
Aya maDAA anotevera akabvumirwa neDFA kuitira kurapwa kwechirwere chekushaya chirwere chechipatara C:
- Daklinza (daclatasvir) : inogamuchirwa neHCV genotype 3. Inotorwa sehwendefa rezuva nezuva uye haifaniri kukurudzirwa kana une chirwere chemwoyo.
- Harvoni, Epclusa (sofusbuvir + ledipasvir ) : inogamuchirwa neHCV genotype 1. Inotorwa sehwendefa rezuva nezuva, rinowanzobatanidzwa ne ribavirin.
- Sovaldi (sofusbuvir ) : inogamuchirwa neHCV genotype 1, 2, 3 ne4. Tora sehwendefa rezuva rimwe nerimwe rbavirin kana ne ribavirin uye peginterferon.
- Technivie (ombitasvir + paritaprevir + ritonavir) : inogamuchirwa neHCV genotype 4. Mahwendefa maviri anotorwa zuva nezuva, uye anopindira mishonga yakawanda yemishonga.
- Viekira Pak (ombitasvir + paritaprevir + ritonavir yakapetwa ne dasabuvir) : inogamuchirwa neHCV genotype 1. Inotorwa sehwendefa rezuva rimwe nerimwe uye inogona kutorwa ne ribavirin.
- Olysio (simeprevir) : inogamuchirwa neHCV genotype 1. Inotorwa sehwendefa kamwe chete zuva nezuva uye inogona kusanganiswa nemishonga yekutapukirwa kweHIV.
- Zepatier (grazoprevir + elbasvir) : inogamuchirwa neHCV genotype 1, 4 ne6, Inotorwa sehwendefa rezuva rimwe nerimwe kana kuti pasina ribavirin.
Mishonga yakawanda yakwegura, yakadai seIncivek naVaVictrelis, vakazvipira kusiya basa nevanokugadzira, nokuti vakanga vasisipo pakudzingwa apo maDAA matsva akagamuchirwa.
Peginterferon uye Ribavirin
Peginterferon , uye ribavirin , vave vachionekwa kwenguva yakareba kurapwa kwechirwere cheHCV chisati chavapo kusati kwavapo kuAAAs.
Havasi ivo vanorapwa zvakakwana, asi vachiri kuonekwa seikosha kune vanhu vane zvirwere zvakanyanya, kusanganisira chirwere cheshushu, kana sevamwe nzira kana maDAA asingashandisi. Nenzira yakawanda, iyo inoshanda ye peginterferon, uye ribavirin inenge 90%, iyo isiri yakakwirira seyeyiyo maDAA matsva, Dzimwe DAA dzinorayirwa kutorwa ne ribavirin imwechete kana kuti peginterferon.
Pakati pezvakaipa zve peginterferon uye ribavirin ndiyo migumisiro yemigumisiro yemishonga. Zvimwe zvikanganiso zvinosanganisira:
- Anemia
- Headache
- Kunyangadza, kushushikana, kuora mwoyo uye kuzviuraya
- Kuora bvudzi
- Kunhuwa uye ganda rinoputika
- Kunyunyuta uye kuneta
- Kubatana uye kusuruvara kurwadziwa
- Nausea uye kurutsa
- Fever, chills
Mhinduro kune DAA kana mamwe maitiro antiviral anorondedzerwa nezvinotevera:
- Rapid viral response (RVR) - Imwe musingaoneki wehutachiona mushure mavhiki mana ekurapa
- Yakawedzerwa nekukurumidza kwehutachiona hwehutachiona (eRVR) - Imwe musingaoneki wehutachiona hwemasvondo masvondo gumi nemaviri. kutevera kutanga RVR
- Kutanga kwehutachiona hwepakutanga (EVR) - Chimwe chinhu chisingaoneki chetachiona kana 99 muzana kuderedza muwandu hwehutachiona nemavhiki gumi nemaviri
- Mugumo wemhinduro yekurapa (ETR) - Chimwe chetachiona chetachiona chinowanikwa mumavhiki gumi nemaviri
- Partial responder- Inobudirira EVR, asi haikwanise kuchengeta musingaoneki utachiona hwemaawa masere makumi maviri pashure pokurapa kupera
- Null responder- Haikwanisi kuwana EVR nemavhiki 12
- SVR-Sustainable response (SVR) - Inokwanisa kuchengetedza zvisingaoneki zvehutachiona hwemavhiki gumi nemaviri (SVR-12) uye masvondo makumi maviri nemaviri (SVR-24) mushure mokupera kwerapi
Surgery
HCV inogona kukonzera chirwere chakakomba chechiropa, uye inogona kufambira mberi kusvika pakuguma kwechiropa chirwere chechiropa. Iyi ihupenyu hunotyisa hunoguma kana chiropa ichikuvadza zvokuti hachikwanise kushanda sezvinofanira. Zvirwere zvokuvhiya zvekumagumo kwechiropa chirwere chinosanganisira zviratidzo zvekuita uye zvichida chiropa chekuisa.
- Chiropa Kupindira: Chiropa chokupemha chinonzi chirwere chokurapa kwekupedzisira kwechiropa chechiropa chirwere. Zvisinei, HCV inogona kudzoka kunyange mushure mokunge tashandurwa nokuti utachiona hunogona kurarama muropa. Muzhinji, chiropa chekushandiswa chinoshandiswa uchishandisa chiropa kubva kune wakafa. Chirwere chekuwedzerwa chinogona kuitwa nekushandiswa kwechiropa chisina chikamu kubva kune munhu anorarama. Kana iwe ukagamuchira chiropa kubva kune munhu anorarama, chiropa chako chitsva chisina kukodzera chinotarisirwa kuti chidzoke zvakare nokukurumidza. Chiropa chisina kukwana chinoramba chiri mumuviri wevapenyu vanorarama chinotarisirwa kuti chidzokezve nokukurumidza. Nepo kuvhiyiwa inzira yakakosha kune vose vanopa uye vanogamuchira, mumwe nomumwe anotarisirwa kupona uye kuva nechiropa chakakwana chebasa.
- Esophageal Banding: Kubudirira kwemasimba esophageal, chinetso chekupedzisira kwechiropa chirwere chepfungwa, ndiko kuputika kwemitsipa yeropa yepopu inokonzerwa nezvinetso neropa riri muropa rinorwara. Iyo varices inogona kupedzisira ichibuda ropa. Imwe nzira inonzi banding inogona kumira kubuda kweeophageal varices nekuisa mabhanhire emabheji pamidziyo.
Kuzvitarisira Nega / Maitiro Ekugara
Kana uine HCV, pane zvimwe zvinokosha zvaunofunga kuti uchengetedze mupfungwa sezvaunodzorera. Kuita kuti iwe udzivise chero chinhu chinogona kukuvadza chiropa chako chinhu chinokosha.
- Dzivisa Doro: Doro rinodhaka rinogona kuita kuti chiropa chisakundikana. Mune mwero, doro harifaniri kukonzera chiropa kukanganisa kwemunhu ane chiropa chakareruka. Asi, kana uchitova nemamiriro ezvinhu anokanganisa chiropa chako, haukwanise kushandisa doro zvisizvo, saka kunyange zvishoma zvingave zvine ngozi.
- Usashandisa Acetaminophen: Mishonga yakawanda inoshandiswa muropa , uye iwe haugone kuitora kana iwe uine kuora kwechiropa kubva kuHCV. Yakawanda yemishonga iyi inoda chiremba, naizvozvo hazviiti kuti chiremba wako kana mishonga anokwanisa kukubvumira kuti uzvitore kana iwe uchiziva HCV. Zvisinei, acetaminophen (Tylenol) iri pamusoro pekambani, mishonga inowanzoshandiswa iwe ungangodaro uri nayo kumba. Iwe haugoni kuitora kana iwe une chirwere chechiropa chechikonzero chipi zvacho, kusanganisira HCV. Kana iwe uine zviratidzo zvekutambudzika kana fever, bvunza chiremba wako kuti aratidze imwe mushonga mishonga kwauri iwe usingatongopindi mimwe mishonga yauri kutora kana kuti inoda chiropa chinoshanda.
- Kugadzirisa Kuwedzerwa Kweropa: Kushaya simba kwechiropa kunogona kukonzera chirwere chinonzi portal hypertension, iyo inowedzera mukudzvinyirira mumidziyo yeropa yechiropa. Kunyange zvazvo izvi zvisingabatanidzi zvakananga nehuwandu hwehupfumi hwehupenyu, kuchengetedza chirwere cheropa chinowanzoita nzira inokosha yekudzivisa kuwedzera kwezvinetso zvehutachiona hwehutachiona.
Mishonga Inobatanidza uye Mimwewo
Mamwe mavitamini akakundikana ave akaonekwa pakati pevanhu vane HCV. Vitamini zvakakundikana hazvigone kukonzera HCV, nokuti inokonzerwa nehutachiona. Chiropa chokukundikana pachako pachako kunokonzera kukwana kwevamwe mavitamini.
- Vitamini D: Vitamin D, kunyanya, yakanzi iine ngozi yehutachiwana hutachiona hweHCV, uye chikonzero chekushamwaridzana uku hachisi pachena. Vitamini D ine vitamini yakasviba yakawanda, zvinoreva kuti inoda kuti mafuta awane zvakanaka. Kana iwe une chiropa kukundikana nemhaka yeHCV, izvi zvinogona kuita kuti zvive zvakaoma iwe kuti uwane vitamini D. Zvinongorayirwa kutora zvigadzirwa kana huwandu hwe vitamini D huri pasi.
- Vitamini A, Vitamin E: Maviri maune mavitamini asingasviki kana asingakwanisi kunyatsogadzikana kana iwe uine chiropa kukundikana. Kuwedzerwa kungave kwakakosha, asi chete kana mazinga ako akaderera.
Pane dzimwe nzira dzakasiyana-siyana dzokurapwa dzakarongedzwa munharaunda yakasiyana-siyana yekurapa uye kutungamirirwa kweHCV, asi hapana zvidzidzo zvinoratidza kuchengetedzwa kwekubudirira. Nokuti mishonga yakawanda uye mavithamini zvinoshandiswa muchiropa, dzimwe nzira dzokurapa dzinogona kubatsira kana uine chiropa chinogona kukuvadza kana chiropa chako chisina kunaka. Zvakakosha kuti iwe uchenjere kunyanya kana uchitoshandisa mavitamini kana michero yemishonga, sezvo iwe usingagoni kukwanisa kuatora zvakare kana une HCV.
Zvimwe zvipembenene zvinowanzoitika zvinowedzera kana uine chiropa kukundikana kubva kuHCV:
- Vitamin K: Vitamini yakasimba iyo inobatsira ropa rako kuti rivhare, rinogona kukonzera kuwedzerwa ropa kunokonzerwa nekusawirirana kweropa kubvisa basa rinokonzerwa nechiropa kusakundikana.
- Ginkgo Biloba: Mishonga inokonzera kuonda kweropa, izvi zvinogona kukonzera kubuda kweropa kana uri nechiropa kusakundikana, nokuti kushaya simba kwechiropa kunowanzokonzera kuvhara ropa kusina kunaka.
- Mixed Herbs: Zvidzidzo zvekare zvinoratidza kuti mishonga yemishonga inogona kukonzera kukuvadzwa kwechiropa. Izvi zvinoreva kuti iwe unofanirwa kuchenjerera kana une HCV. Zvakanakisisa kutarisa nachiremba wako kana mhizimisi usati watora mishonga yekuwedzera, kunyange iwe wakatotora iko kwechinguva.
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