Kusho ukuthini i-SVR kubantu abane-Hepatitis C?

-Delile

• Ezinye izimpendulo ze-virologic
• Ungayifeza kanjani i-SVR
• Ngabe ama-genotypes ahlobana kanjani ne-SVR?
• Imishanguzo yesimanje ye-HCV
• Kuthiwani uma ungazuzi i-SVR?
• Umbono
• Yakha inethiwekhi yokusekela

Yini i-SVR?

Umgomo wokwelashwa kwe-hepatitis C ukusula igazi lakho egazini le-hepatitis C (HCV). Ngesikhathi sokwelashwa, udokotela wakho uzoqapha izinga legciwane egazini lakho (inani legciwane egazini). Lapho igciwane lingasatholakali, libizwa ngokuthi yi-virologic response, okusho ukuthi ukwelashwa kwakho kuyasebenza.

Uzoqhubeka nokuhlolwa njalo kwegazi ukubheka noma iyiphi i-RNA etholakalayo, imvelaphi yezakhi zofuzo yegciwane le-hepatitis C. Impendulo eqhubekayo ye-virologic (SVR) yenzeka lapho ukuhlolwa kwegazi kwakho kuqhubeka kungabonisi i-RNA etholakalayo emavikini ayi-12 noma ngaphezulu ngemuva kokwelashwa.

Kungani i-SVR ifiseleka? Ngoba abantu abangamaphesenti angama-99 abazuza i-SVR bahlala bengenalo igciwane impilo yabo yonke futhi kungabhekwa ukuthi bayelapheka.

Lapho usuzuze i-SVR, awusenalo igciwane kusistimu yakho, ngakho-ke akudingeki ukhathazeke ngokudlulisela igciwane kunoma ubani omunye. Ngemuva kwe-SVR, isibindi sakho asisahlaselwa. Kodwa uma usuvele uthole ukulimala kwesibindi, ungadinga ukwelashwa okwengeziwe.

Igazi lakho lizohlala liqukethe ama-antibodies e-hepatitis C. Lokho akusho ukuthi awukwazi ukuphinde utheleleke. Kusafanele uthathe izinyathelo zokuzivikela ukugwema ukuvezwa yizinhlobo eziningi ze-HCV.

Ezinye izimpendulo ze-virologic

Ukuhlolwa kwegazi ngezikhathi ezithile kuzohlola ukusebenza kokwelapha. Amagama asetshenziselwe ukuchaza izimpendulo ze-virologic angadida kancane.

Nalu uhlu lwamagama ajwayelekile nezincazelo zawo:

• I-SVR12. Lokhu kulapho ukuhlolwa kwegazi kwakho kukhombisa impendulo eqhubekayo ye-virologic (SVR), noma kungabi bikho mali etholakalayo ye-HCV, ngemuva kwamasonto ayi-12 ekwelashwa. Kuleli qophelo, uthathwa njengolaphiwe isifo sokusha kwesibindi kohlobo C. Umaka wokwelashwa wayejwayele ukuba yi-SVR24, noma kungabi khona inani elitholakalayo le-HCV egazini lakho ngemuva kwamasonto angama-24 okwelashwa. Kepha ngemithi yesimanje, i-SVR12 manje isibhekwa njengophawu lokwelapha.
• I-SVR24. Lokhu kulapho ukuhlolwa kwakho kukhombisa impendulo eqhubekayo ye-virologic (SVR), noma kungabi bikho mali etholakalayo ye-HCV egazini lakho, ngemuva kwamasonto angama-24 okwelashwa. Lokhu bekuyindlela ejwayelekile yokwelashwa, kepha ngemithi emisha yanamuhla, i-SVR12 manje isithathwa njengophawu lokwelapha.
• Impendulo engaphelele. Amazinga akho e-HCV ehle ngesikhathi sokwelashwa, kepha igciwane lisabonakala egazini lakho.
• Ukungaphenduli noma ukuphendula okuyize. Kunoshintsho oluncane noma alukho nhlobo kumthamo wegciwane le-HCV ngenxa yokwelashwa.
• Ukubuyela emuva. Leli gciwane belingabonakali egazini lakho okwesikhashana, kodwa liphinde latholakala futhi. Ukubuya kwayo kungenzeka phakathi nokwelashwa noma ngemuva kokwelashwa. Udokotela wakho uzokusiza unqume ngezindlela zokwelashwa ezengeziwe.

Ungayifeza kanjani i-SVR

Kunezindlela eziningi zokusondela ekwelashweni. Kungenzeka ukuthi ibandakanye inhlanganisela yemithi, eminingi yayo manje ehlanganiswe yaba amaphilisi owodwa. Ngakho-ke kungadingeka uphuze iphilisi elilodwa kuphela ngosuku.

Udokotela wakho uzoncoma uhlobo lwemithi olususelwa ku:

• ubudala nempilo yonke
• uhlobo oluthile lwe-hepatitis genotype
• ukulimala kwesibindi, uma kukhona
• ikhono lokulandela imihlahlandlela yokwelashwa
• imiphumela emibi engaba khona

Ukwethulwa kwemithi elwa namagciwane e-direct-acting (DAAs) ngo-2011 kwashintsha ngokuphelele ukwelashwa kwesifo sofuba esingamahlalakhona uC.

Ngaphambi kwalokho, ukwelashwa kwakuqukethe imijovo yemithi ebizwa nge-interferon ne-ribavirin, kanye neminye imithi esefomini lephilisi. Ukwelashwa kwakuvame ukungasebenzi, futhi imiphumela emibi, efaka ukudangala, isicanucanu, nokushoda kwegazi, kwakukubi kakhulu.

Ngo-2014, kwethulwa igagasi lesibili lama-DAA asebenza kangcono. Le mithi emisha elwa namagciwane isiphenduke insika yokwelashwa kwesimanje kwesifo sokusha kwesibindi kohlobo C e-United States. Bahlasela igciwane ngqo futhi baphumelela kakhulu kunemithi yokuqala.

Ama-DAA amasha angathathwa ngomlomo, imvamisa ngephilisi elilodwa nsuku zonke. Banemiphumela emibi embalwa, bakhuphuka amazinga okwelashwa, futhi banciphisa isikhathi sokwelashwa ngaphezulu kwemithi ethile yezidakamizwa eminyakeni emihlanu edlule.

Ama-DAA e-wave yesibili nawo ayakwazi ukwelapha uhla olubanzi lwezinhlobo eziyisikhombisa ezaziwa nge-hepatitis C genotypes, noma izinhlobo zofuzo. Amanye ama-DAA amasha angakwazi ukwelapha wonke ama-genotypes ngokuhlanganisa imishanguzo ehlukene emaphilisi ukukhomba ama-genotypes ahlukene.

Amanye ama-DAA egagasi lokuqala asasetshenziswa ngokuhlanganiswa ne-interferon ne-roburin, kepha ama-DAA amaningi wesigungu sesibili asetshenziswa wona uqobo.

Izinga lokwelashwa elijwayelekile, noma i-SVR, lamarejimeni e-DAA anamuhla manje selingamaphesenti angama-95 jikelele. Leli zinga livame ukuba likhulu kubantu abangenayo i-cirrhosis, noma isibazi, sesibindi futhi abangakaze bathole ukwelashwa kwesibindi hepatitis C kwangaphambilini.

Kusukela kwengezwa ama-DAA asebenza kangcono kusukela ngonyaka we-2014, amanye ama-DAA egagasi lokuqala aphelelwa yisikhathi, futhi abenzi bawo bawakhipha emakethe.

Lokhu kufaka phakathi i-Olysio (simeprevir), eyekwe ngoMeyi 2018, kanye nezidakamizwa i-Technivie (ombitasvir / paritaprevir / ritonavir) neViekira Pak (ombitasvir / paritaprevir / ritonavir kanye ne-dasabuvir), eyekiswe ngoJanuwari 1, 2019.

Onke ama-DAA ayinhlanganisela yezidakamizwa. Ososayensi bathole ukuthi ukuhlanganisa imishanguzo eqonde ngqo kuleligciwane kungakhulisa amathuba okwelashwa. Abantu abathola ukwelashwa bavame ukuthatha amaphilisi ahlukahlukene, yize izindlela eziningi zokwelapha manje sezibandakanya iphilisi elilodwa elihlanganisa imishanguzo ehlukahlukene. Imvamisa bathatha imishanguzo amasonto ayi-12 kuye kwangama-24, noma ngaphezulu.

Udokotela wakho uzokusiza uthathe isinqumo ngemithi yakho yemithi, kuya ngomlando wakho wezokwelapha nokuthi iyiphi uhlobo lwe-hepatitis C onalo. Awukho umuthi wokugoma otholakalayo wesifo sokusha kwesibindi kohlobo C njengoba kukhona nesifo sokusha kwesibindi kohlobo A no-B.

Ngabe ama-genotypes ahlobana kanjani ne-SVR?

Imithi ye-Hepatitis C ivame ukuhlukaniswa ngohlobo lwegciwane elenzelwe ukwelashwa. I-genotype wuhlobo oluthile lwegciwane olwenziwa njengoba igciwane liguquka.

Kukhona okwamanje ama-genotype we-HCV ayisikhombisa aziwayo, kanye nama-subtypes aziwayo phakathi kwalawo ma-genotypes.

IGenotype 1 yiyona evame kakhulu e-United States, ethinta cishe amaphesenti angama-75 abantu baseMelika abane-HCV. IGenotype 2 ingeyesibili evame kakhulu, ethinta abantu baseMelika abangamaphesenti angama-20 kuye kwangama-25 abaneHCV. Abantu abathola i-genotypes 3 kuya ku-7 imvamisa bangaphandle kwe-United States.

Eminye imishanguzo ilapha yonke noma izinhlobo eziningi ze-HCV genotypes, kepha ezinye izidakamizwa zibhekisa kuhlobo olulodwa kuphela. Ukufanisa ngokucophelela imithi yakho ne-genotype yokutheleleka kwakho kwe-HCV kungakusiza ukuthi uzuze i-SVR.

Udokotela wakho uzokuhlolela ukuthola uhlobo lwakho lokutheleleka nge-HCV, olubizwa nge-genotyping. Izinhlobo zemithi kanye nama-dosing schedule ahlukile kuma-genotypes ahlukahlukene.

Imishanguzo yesimanje ye-HCV

Okulandelayo uhlu lweminye imishanguzo yesimanje yokulwa namagciwane esetshenziswa kakhulu ukwelapha i-hepatitis C, ehlelwe ngokulandelana kwama-alfabhethi. Ungathola imininingwane enemininingwane ngemithi etholakalayo ye-HCV lapha.

Imininingwane esohlwini olungezansi ithathwa emithini evunyiwe yokusha kwesibindi kohlobo C. Igama lomkhiqizo lomuthi ngamunye lilandelwa ngamagama ejwayelekile wezithako zawo.

Abenzi bale mithi bavame ukunikeza imininingwane eningiliziwe nezimangalo zokusebenza ngempumelelo kwama-genotypes angeziwe kumawebhusayithi abo. Udokotela wakho angakusiza ukuthi uhlole lolu lwazi. Okunye kungahle kuvumeleke, kanti okunye kwakho kungenzeka kube nehaba noma kungaphandle komongo kuwe.

Qiniseka ukuthi uxoxa nodokotela wakho ukuthi imiphi imithi ekufanele ukukusiza ufike ku-SVR.

• I-Daklinza (daclatasvir). Imvamisa kuhlanganiswa ne-sofosbuvir (Sovaldi). Kwavunywa ngo-2015 ukwelapha i-genotype 3. Ukwelashwa kuvame ukuba amasonto ayi-12.

• Kuthiwani uma ungazuzi i-SVR?

  Akuwona wonke umuntu ofinyelela ku-SVR. Imiphumela emibi kakhulu ingadala ukuthi uyeke ukwelashwa kusenesikhathi. Kepha abanye abantu bamane bangaphenduli, futhi akucaci njalo ukuthi kungani. Udokotela wakho angancoma ukuthi uzame inhlanganisela ehlukile yezidakamizwa.

  Noma ungafiki ku-SVR, lezi zindlela zokwelapha zingasiza ukunciphisa igciwane futhi zibe lusizo esibindini sakho.

  Uma ungeke uzame isidakamizwa esihlukile sokulwa namagciwane nganoma yisiphi isizathu, ngeke neze udinge ukuhlolwa okwengeziwe kwegciwane legciwane. Kepha usenokutheleleka okudinga ukunakwa. Lokhu kusho ukuhlolwa kwegazi njalo nokusebenza kwesibindi. Ngokusebenzisana eduze nodokotela wakho, ungashesha ukubhekana nanoma yiziphi izinkinga ezivelayo.

  Uma uzame izindlela zokwelapha eziningana ngaphandle kwempumelelo, ungahle uthande ukucabanga ngokufaka isicelo sokuhlolwa komtholampilo. Lezi zivivinyo kwesinye isikhathi zikuvumela ukuthi uzame imithi emisha esesigabeni sokuhlola. Izilingo zomtholampilo zivame ukuba nezindlela eziqinile, kepha udokotela wakho kufanele akwazi ukunikeza imininingwane ethe xaxa.

  Umbono

  Noma ungenazo izimpawu eziningi njengamanje, isifo sokusha kwesibindi kohlobo C yisifo esingelapheki. Ngakho-ke kubalulekile ukunakekela impilo yakho yonke, unaka kakhulu isibindi sakho. Yenza impilo yakho ize kuqala.

  Kumele:

  • Gcina ubuhlobo obuhle nodokotela wakho. Bika izimpawu ezintsha khona manjalo, kufaka phakathi ukukhathazeka nokudangala. Buza udokotela wakho ngaphambi kokuthatha imithi emisha noma izithasiselo, ngoba ezinye zingaba yingozi esibindini sakho. Udokotela wakho angakwazisa futhi ngentuthuko yakamuva kwezokwelapha.
  • Yidla ukudla okunomsoco. Uma unenkinga ngalokhu, cela udokotela wakho ukuthi ancoma isazi sokudla ukuze sikuqondise endleleni efanele.
  • Vivinya umzimba njalo. Uma ijimu ingeyakho, ngisho nokuhamba nsuku zonke kuyasiza. Kungaba lula uma uthola umngani wokuzivocavoca.
  • Thola ukulala okugcwele ebusuku. Ukushisa ikhandlela emikhawulweni yomibili kuthatha umonakalo omkhulu emzimbeni wakho.
  • Ungaphuzi. Utshwala bulimaza isibindi sakho, ngakho-ke kungcono ukukugwema.
  • Ungabhemi. Gwema imikhiqizo kagwayi ngoba iyingozi empilweni yakho yonke.

  Yakha inethiwekhi yokusekela

  Ukuphila ngesimo esingelapheki kungaba ukuzama ngezinye izikhathi. Ngisho nomndeni nabangane abaseduze bangase bangazi ngezinkinga zakho. Noma kungenzeka abazi ukuthi bazothini. Ngakho-ke kuthathe ngokwakho ukuvula iziteshi zokuxhumana. Cela ukusekelwa ngokomzwelo nosizo olungokoqobo lapho uludinga.

  Futhi khumbula, ukude kakhulu. Abantu abangaphezu kwezigidi ezintathu e-United States baphila ne-hepatitis C. engapheli.

  Cabanga ukujoyina iqembu elisekela ku-inthanethi noma elenziwa ngabantu ukuze ukwazi ukuxhumana nabanye abakuqondayo obhekene nakho. Amaqembu okusekela angakusiza ukuthi uzulazule ngolwazi nezinsizakusebenza ezingenza umehluko ophusile empilweni yakho.

  Futhi kungaholela ebudlelwaneni obuhlala njalo, obuzuzisayo. Ungaqala ngokufuna ukwesekwa futhi ngokushesha uzithole usesimweni sokusiza abanye.