Bhuku idzva reAntiviral Zvinodhaka Zvirwere Zvinopfuura 90% Cure Rates
Kana iwe uchifunga kuti utachiona hweH hepatitis C (HCV) hwakatanga kuonekwa muna 1989 uye kuti hukuru hwacho hwaifungidzirwa husingagoni kurapwa kusvika kumagumo ekupedzisira ezana remakore rechi20, kufambira mberi mukurapa kwave kusina kushamisa.
Yakanga iri munaDisemba 2013, chaizvoizvo, kuti mutambo wacho wakashandurwa zvachose nekusunungurwa kweSovaldi , kurwisa zvakananga kuvhara (DAA) iyo yakapa madhara mashoma, nguva shomanana yekurapa, uye chirwere chepuresi yepamusoro se 99 muzana mune imwe populations.
Saka zvinodhaka zvinoshandiswa kuti mishonga nhasi yakaparidzirwa kune vanhu vose vane chirwere cheHCV chisingagumi uye chisingaperi, pamwe chete nevaya vane chirwere chakakomba cheropa.
Nekunzwisisa zviri nani zvinangwa zve hepatitis C therapy-kusanganisira kuti mishonga inosarudzwa sei uye inoshandiswa-unogona kuita sarudzo yakanyatsoziva sekuita kwechiito chakakodzera iwe.
Zvinangwa zveHepatitis C Therapy
Sekutonga kwechigunwe, kunyanya kurapwa kwehepatitis C kunobatanidza nemigumisiro iri nani, kwete chete mukusunungura hutachiwana asi mukudzivirira chero upi zvenguva refu kuora kwechiropa uye nhengo dzakabatana.
Zvinangwa zve hepatitis C therapy, naizvozvo, iviri:
- Kubudirira kwehutachiona hwehutachiwana hweSVR , hunotsanangurwa sekuti kusaramba kuripo kwehutachiwana muropa remunhu kwemavhiki makumi maviri nemasere ekurapa
- Kuchengetedza kufambira mberi kwechiropa chechiropa, kusanganisira kukura kwechirrisis uye kenza yeropa
Munguva yekodzero yekurapa, maongororo ebazi anoitwa nguva dzose kuti aongorore huwandu hwehutachiwana muropa remunhu.
Iyo inozivikanwawo seHCV yehutachiona hutachiona , izvi zvinogona kubatsira vanachiremba kuti vatarise zvingazoitika mugumisiro (kana kufanirwa) kwemishonga.
Chimwe chetachiona chetachiona chinotaridzirwa shanduro yakanakisisa, uye mavhiki makumi maviri nemaviri eSVR anonyatsoonekwa se "mushonga."
Pathologists vanowanzofananidza mhinduro yekurapa sezvinotevera:
| Nguva | Meaning | Tsanangudzo | Prognosis |
| RVR | Rapid viral response | Imwe musingaoneki wehutachiona mushure mavhiki mana ekurapa | Kazhinji kazhinji inogona kuwana SVR |
| RVR | Yakawedzerwa nekukurumidza kwehutachiona mhinduro | Iko kusingaoneki kwehutachiona hwemavhesi pavhiki 12, inotevera yekutanga RVR | Kazhinji kazhinji inogona kuwana SVR |
| EVR | Kutanga kwehutachiona hwekutanga | Iko kusingaoneki kwehutachiona hwehutachiwana kana kuti 99 kubva muzana kuderedzwa kwehutachiona hwemaawa nevhiki 12 | Kukundikana kusvika kuEVR nevhiki 12 correlates kusvika pasi pe4 muzana mukana wekuwana SVR |
| ETR | Mugumo wemhinduro yekurapa | Iko kusingaoneki kwehutachiona hwehutachiwana hunopera pakupera kwesvondo 12 | Hazvibatsiri pakufanotaura mberi kwemigumisiro yehutano |
| Partial responder | Inokwanisa kuzadzikisa EVR asi haikwanise kuchengeta musingaoneki wehutachiona hwemaawa masere makumi maviri pashure pekurapa kupera | Inofungidzirwa kurapa kukanganisa | |
| Null mhinduro | Haikwanisi kuwana EVR nevhiki 12 | Mishonga inowanzoguma kana EVR isingagoneki nevhiki 12 | |
| SVR | Mhinduro yehutachiona yakasimudzirwa | Inokwanisa kuchengetedza usingaoneki utachiona hwemavhiki gumi nemaviri (SVR-12) uye masvondo makumi maviri nemaviri (SVR-24) mushure mokupera kwerapi | SVR-24 inogona kuonekwa se "mushonga," apo varwere vane SVR-12 vanowanzokwanisa kuwana SVR-24 |
Nhasi, vanopfuura 99 muzana yevaya vanopedza SVR-24 vachagara vasina hutachiwana kwemakore mashanu. Pakati pavo, inenge hafu ichava nekugadziriswa kwechirrisis mukati megore, nepo vazhinji vachaona kuchinja kwakanyanya mukupera kwechiropa ( fibrosis ).
Nguva Yokutanga Kutapwa
Uchapupu hunotsigira zvakasimba kurapwa kwevanhu vose vane hepatitis C, vane makore 18 kana kupfuura. Izvo chete zvisiri izvo ndevaya vane tarisiro yehupenyu kwemwedzi inopfuura 12 nekuda kwechikonzero chisingaiti chiropa.
Zvisinei, sezvo kurapwa kungave kusingawaniki kune vese varwere (zvichida zvichida mari kana kuti kupera kwehushuwarisi), chinonyanya kupiwa kune avo vane zvinodiwa zvakanyanya kukurumidza. Izvi zvinosanganisira vanhu vane advanced fibrosis, vanobhadhara chirwere chetrhosis, chiropa chechiropa, kana zvinetso zvisina simba zvehupombwe zveHCV.
Kufunga kunowanzopiwa kune vanhu vari pangozi yakawanda yehutano hwehutachiona hwaH hepatitis C, kusanganisira avo vane mwero wakawanda we fibrosis, hutachiwana hwehutachiwana hwehutachiona hweHIV , hutachiona hwehutachiona hwepabonde, chirwere chechirwere cheshuga, uye zvimwe zvirwere zvinokonzerwa nechiropa.
Zvakakosha kuziva, zvakadaro, kuti vanhu vane ruzivo rwokutanga kurapwa vanogona kubatsirwa zvikuru, kwete chete nekuderedza kuora kwechiropa asi nekuwedzera kwenguva yeSVR.
Kutsvakurudza kwakaratidza kuti vanhu vanobatwa muzvikamu zvekutanga zve fibrosis (sekuenzaniswa nemakadhi eMETAVIR ) vane 92 muzana yekana yekusara mavairwere pasina makore gumi nemashanu.
Usati watanga chero nzira ipi yekurapa, zvinokosha kuti iwe uongorore zvose kuda kwako uye kukwanisa kutevedzera kurapa. Kana iwe uchitarisa matambudziko chero ose-kusanganisira basa kana nezvehupenyu hwako, kushandisa doro / zvinodhaka, kana kutya pamusoro pemishonga pachako-iva nechokwadi chekukurukurirana izvi nachiremba wako usati watanga kurapwa. Sangano rinobatsira rinogona kuwanika kune rubatsiro rwekubatsira kukunda nyaya idzi.
Approved Hepatitis C Mishonga
Hepatitis C therapy inosanganisira imwe kana kupfuura mamwe madhiragi ezvinodhaka, izvo zvinowanzonyorwa mumatambo gumi nemaviri.
Mune zvimwe zviitiko, nguva yekurapa inogona kuwedzera kusvika kumasvondo makumi mana nemashanu kana makumi mana, kazhinji pane vanhu vane cirrhosis kana avo vakambokundikana chirwere.
Mukuwedzera kune DAA yakatarwa, mamwe mimwe mishonga inogona kushandiswa sechikamu chekubatanidza kurapa:
- peginterferon , shanduro yakaitwa nevanhu ye interferon, iyo inoita nokuisa chiratidzo mumuviri kune hutano hunokonzera zvirwere seHCV
- ribavirin , mishonga yemuromo inozivikanwa kuti inopesana nekudzoka kwehutachiona
Peginterferon, yakakonzerwa nejojo, inowanzopiwa ne ribavirin. Ribavirin, zvakasiyana, inowanzoshandiswa iga yoga ichibatanidzwa neDA primary drug.
Kusarudzwa kwezvinodhaka kwakavakirwa paine genetic (genotype) yehutachiona munhu anenge atapukirwa, uyewo kuongororwa kwehutano hwehutano hwehutano uye nhoroondo yekare yehutano.
Ikozvino mairi masere eDAA anogamuchirwa neU.S. Food and Drug Administration:
| Zvinodhaka | Approved for | Yakanyorwa | Kusarudza | Nguva |
| Epclusa (sofosbuvir + valpatasvir) | mazita e-genotype 1, 2, 3, 4, 5, uye 6 ane kana asina cirrhosis | pamwe nesu pasina ribavirin, zvichienderana nejenotype uye nenyaya yekurapa | Rimwe bheti rimwe nerimwe zuva risina zvokudya | 12-16 vhiki |
| Zepatier (elbasvir + grazoprevir) | genotypes 1 uye 4 ane kana pasina cirrhosis | pamwe nesu pasina ribavirin, zvichienderana nejenotype uye nenyaya yekurapa | Rimwe bheti rimwe nerimwe zuva risina zvokudya | 12-16 vhiki |
| Daklinza (daclatasvir) | genotypes 3 pasina cirrhosis | naSovaldi | Rimwe piritsi zuva rimwe nerimwe nechingwa | Vhiki 12 |
| Technivie (ombitasvir + paritaprevir + ritonavir) | genotypes 4 pasina cirrhosis | na ribavirin | mapiritsi maviri zuva nezuva nechingwa | Vhiki 12 |
| Viekira Pak (ombitasvir + paritaprevir + ritonavir, yakabatanidzwa ne dasabuvir) | genotypes 1 kana kana pasina cirrhosis | ane kana asina ribavirin, sezvakaratidzwa | mahwendefa maviri ehumbitasavir + paritaprevir + ritonavir inotorwa kamwe chete zuva nezuva nezvokudya, pamwe chete nehwendefa rimwe reDasavuvir rinotorwa kaviri zuva nezuva nezvokudya | 12-24 mavhiki |
| Harvoni (sofosbuvir + ledispasvir) | genotype 1 ine kana pasina cirrhosis | pacharo | imwe piritsi zuva rimwe nerimwe kana kuti isina zvokudya | 12-24 mavhiki |
| Sovaldi (sofosbuvir) | genotypes 1, 2, 3, uye 4 ane kana asina cirrhosis | pamwe chete ne ribavirin, Olysio, peginterferon + ribavirin, kana Olysio + ribavirin, sezvakaratidzwa | imwe piritsi zuva rimwe nerimwe kana kuti isina zvokudya | 12-24 mavhiki |
| Olysio (simeprevir) | genotype 1 ine kana pasina cirrhosis | pamwe chete neSovaldi kana peginterferon + ribavirin, sezvakaratidzwa | rimwe capsule zuva nezuva rine zvokudya | 24-48 vhiki |
Kukurukurirana kunyanzvi kunofanira kutsvaga kune vanhu vari kutorwazve nokuda kwehupatitis C mushure mokunge kusapera kwekare kusapera. Kudzokorora kusarudzwa kunofanirwa kuenzaniswa nekuongororwa kwemhando uye kusanganiswa kwemishonga inoshandiswa kare, pamwe nekuongorora kwechiropa chomunhu.
Mune zvimwe zviitiko, kuongorora maitiro ekudzivirira, izvo zvinogona kutarisa kukura kweHCV kusagadzikana kwezvinodhaka, zvinogona kubatsira mukusarudzwa kwezvinodhaka, kunyanya kune vanhu vane genotype 1 utachiona avo vakamboratidzwa neAADA.
> Kwakabva:
> American Association for the Study of Liver Diseases (AASLD) uye Infectious Diseases Society of America (IDSA). "HCV Nhungamiro: Zvirongwa zvekuedza, Kutarisira, nekurapa Hepatitis C." Yakaperedzwa July 6, 2016.