Mune mishonga yakanaka yeHCV mishonga
Mishonga yakagamuchirwa neDAA ye hepatitis C yakadzoka kumavambo kwema1990 apo interferon-alfa yakawanikwa sejozi katatu vhiki nevhiki yeHCV. Pamakore makumi maviri anotevera, interferon kana yakagadziriswa yakagadziriswa, peginterferon kana kuti pasina muromo we ribavirin, yaiva yepamusoro yekuchengetedza chirwere chehepatitis C. Interferon yakashanda zvakajeka pahutachiona nekuwedzera maitiro ehutachiona ehutachiona hwemunhu anotapukirwa.
Iyi kurapa yakanga yakaoma kushivirira, inobatanidza majekiseni akawanda kusvikira kune rimwe gore, uye yakave nehupfumi hwema 6% chete -54%. Zviri pachena, kurapwa kwakanaka kwaidiwa.
Muna 2011, FDA yakagamuchira mishonga yekutanga iyo yakashanda zvakananga pamagetsi ekudzoka kwehutachiona. Idzi dzaiva HCV protease inhibitors: boceprevir uye telaprevir. Vaive vanobudirira mukugadzirisa kudzokorora kwehutachiona, asi nekuda kwekubuda kwehutachiona hwemishonga kumishonga, vaifanira kuendeswa pamwe ne peginterferon uye ribavirin. Saka pasinei nekuti kubudirira kwezvikwereti kwakakwira kusvika 69% -74%, migumisiro yemutatu inosanganiswa nemishonga yakave isina kuvhiringidzwa nevarwere vakawanda. Iyi mishonga haisisiri kushandiswa muUnited States nhasi.
Kubudirira kukuru kwekutanga kwakasvika muna 2013 nekugamuchirwa kwe sofosbuvir uye simeprevir. Kunyange zvazvo imwe neimwe yakatanga kugamuchirwa kuti ishandiswe ne peginterferon ye genotype 1, kunze kwekushandisa kwemaira maviri aya pamwe chete pasina peginterferon , munguva pfupi yakave yakashandiswa zvikuru.
Success rates yakasvika 90% kana kupfuura; uye kudzivisa interferon kwaireva kuti kurapa kwaive kwakanyatsorambidzwa kwemavhiki 12-24 ekurapwa kwenguva. Zvisinei, aya majeri aive anodhura zvikuru uye mamwe mashoma asinganzwisisiki uye mamiriro ezvinhu ehepatitis C achiri kudikanwa peginterferon (KUZIVA MHURI).
Izvo zvakasara hutano hweHCV kurapwa kusvika munaOctober 2014 pamwe nekutenderwa kwebumbiro rimwe chete rebhetheni yekubatanidzwa kwe sofosbuvir uye ledipasvir (HARVONI). Iyi piritsi yakabatana yakabudirira kwazvo mu genotypes 1 uye 4 pasina kudiwa peginterferon kana ribavirin. Inoramba iine chirongwa chakanyanya kurairwa chehepatitis C muUnited States. Pane, zvisinei, zvimwe zviyeuchidzo zvinokosha. Sezvo sofosbuvir isingafaniri kugadziriswa kune varwere vane chirwere chakaipa chekushaya simba (creatinine chibvumirano chisingasviki 30 mL / min), iyi kuumbwa kwebheteri imwechete inogadziriswa. Uyezve, mishonga haifaniri kutarisirwa kune avo vanotorawo Amiodarone, chirwere chepfungwa chemwoyo. Proton pump inhibitors (Prevacid, Neium, etc.) inogona kuderedza kushanda kwemishonga iyi uye inofanira kubatanidzwa.
Mamwe mashoma gare gare muna 2014, AbbVie akazivisa FDA kuvimbiswa kwemishonga yavo mitatu inonzi Viekira Pak (VIEKIRA PAK). Iko kusanganiswa kunosanganisira mbiri, kamwe chete zuva rimwe nerimwe, mishonga yakagadzirirwa: Ombitasvir uye Paritaprevir uye kaviri mishonga zuva nezuva Dasabuvir. IParitaprevir inobatanidza pamwe ne-booster mishonga, ritonavir, kuwedzera simba reParitaprevir.
Pakupedzisira, kune genotype 1a zvirwere, kusanganiswa uku kunopiwa kaviri ribavirin zuva nezuva. Iko kusanganiswa kunonyanya kuwanda mujenotype 1 zvirwere uye kana pasina cirrhosis. Uku kusanganiswa kwakachengeteka uye kunoshanda kune varwere vane chirwere chepirhosis chakanaka, asi vangave vasina kuchengeteka kune avo vane uchapupu hwekubhadharisa ( Manyevero ) ( Chii chinouraya varwere vane cirrhosis? ). Zvinokonzera kukanganisa kwekurapa uku ndeimwe kushungurudza kwezvinodhaka-zvinodhaka nekuda kwe ritonavir uye nhamba yemapiritsi inoda kutorwa zuva rega rega.
Sekuguma kwegore ra2015, mushonga mutsva wakagamuchirwa neCDA ndiDaclatasvir (DACLATASVIR).
Iyi imishonga ine HCV yakakura ye genotype reactivity yakafanana neyefosbuvir asi yeboka rakasiyana remishonga, saka kupa mishonga iyi pamwe chete inogona kubvumira kuti zvose zveHCV genotypes zviite pasina kushandisa peginterferon kana ribavirin, asi inokurudzirwa kuti genotype 3 zvakananga . Kune, zvisinei, kushandiswa kwezvinodhaka-zvinodhaka neDaclatasvir, saka kubvunzurudza nachiremba kana wemishonga inokurudzirwa.
Mamwe mapiritsi maviri matsva anopa hepatitis C anotarisirwa kutanga kwegore ra2016. Izvi zvichava nyaya yenyaya inouya. Unogona kuwanawo ruzivo pamusoro pehupatitis C kubva kuAmerican Liver Foundation (ALF)