Hepatitis C wata cuta ce mai cutar da hanta, wadda cutar ta hepatitis C (HCV) ta kawo shi kuma yana daya daga cikin manyan dalilai na asibiti da mutuwa tsakanin mutanen dake dauke da kwayar cutar HIV.
Ƙungiyar {ungiyar {asashen Amirka ta Nazarin Harkokin Cutar {anjamau (AASLD) ta bayar da rahoton cewa cutar ta hepatitis mai ciwon daji wadda ta ha] a da hepatitis A, B , da C-ita ce babbar hanyar mutuwa a dukan duniya, tare da asarar rayuka fiye da cutar kanjamau , tarin fuka, da malaria .
Babu maganin alurar rigakafi a halin yanzu.
Cutar HIV / HCV
Rahotanni da aka ruwaito na kamuwa da cutar HIV / HCV ya nuna bambancin da binciken, amma bincike ya nuna cewa yawancin kamuwa da cutar HCV tsakanin mutanen da ke dauke da kwayar cutar HIV ya kai kashi 30 cikin 100 a Amurka da Turai. A dukan duniya, yawan kwayar cutar HIV / HCV yana kusa da mutane miliyan 4-5, ko tsakanin kashi 10-15 na yawan mutanen HIV.
Masu amfani da miyagun ƙwayoyi masu guba (IDUs) suna da haɗari mafi girma ga kamuwa da cutar HIV / HCV, tare da jimillar daga kashi 82 zuwa 93 bisa dari. Ya bambanta, tsaftace ta hanyar hanyar jima'i yana kusa da kashi 9.
Yayinda maza da suka yi jima'i da maza (MSM) ba su da haɗari ga ƙwayar cutar HCV, haɗarin zai iya karuwa har zuwa kashi 23 cikin MSM tare da halayen haɗari-irin su mahaɗi masu jima'i, jima'i na jima'i, ko ko da magungunan magungunan da aka ƙwace su ko nassi.
Mutanen da aka haifa suna da nauyin HCV mafi girma fiye da takwarorinsu guda ɗaya, wanda ya haifar da ci gaban ci gaba zuwa fibrosis , cirrhosis , da kuma carcinoma hepatocellular (yawancin ciwon hanta).
Bugu da ƙari, mutanen da ke fama da cutar suna da haɗari mafi girma na uku da ke tattare da maganin cutar kanjamau (haɗarin hanta) fiye da wadanda ke dauke da HIV kadai.
Wadannan bayanan sun nuna bukatar da yafi ganewa na HCV tsakanin mutanen da ke dauke da cutar HIV, da magunguna mafi mahimmanci don kawar da kamuwa da HCV ko kuma, a kalla, jinkirin ci gaba da ciwo.
Lokacin da za a Fara Jiyya
Lokacin da za a fara HCV zai iya zama matsala mai rikitarwa. Kullum magana, HCV magani yana nuna a cikin mutane da tabbatar da halayen hanta HCV hade. Ma'aikatar Kiwon Lafiya ta Amurka da Ayyukan Dan Adam (DHHS) a halin yanzu suna bada shawarar cewa an fara farautar HCV a cikin mutanen da ba su da kwarewa wadanda suke da fibrosis da yawa kuma suna da haɗari ga ci gaban cirrhosis.
Saboda babbar mahimmanci ga sakamako na kwayoyi-tare da cewa babu magani a kan HCV - hukuncin da za a bi da shi ya fi dacewa a kan shiri na haƙuri, da kuma ƙididdigar alamun alamun tabbatar da nasara (misali, HCV genotype , HCV kayan kyamarar hoto ).
Duk da haka, yana da muhimmanci a lura cewa cigaba da inganta HCV kwayoyi suna rage shinge don maganin jiyya, tare da amfani da farfadowa da ya fi iyakar sakamakon da zai iya haifar.
DHHS ya cigaba da bada shawarar yin amfani da hadewar maganin antiretroviral (ART) a cikin dukan mutanen da ba su da tsabta ba tare da la'akari da yawan CD4 ba , wanda aka nuna ya rage jinkirin ciwon cutar HCV. Bugu da ƙari:
- Ga mutanen da ƙananan CD4 suna ƙidayar (a karkashin kwayoyin 200 / ML), ya kamata a jinkirta kulawar HCV har sai lokacin da CD4 ya ƙaru. Zabin da ake yi na maganin maganin rigakafin kwayar cutar yana da alaƙa kan hulɗa da miyagun ƙwayoyi masu magungunan ƙwayoyi, da magungunan ƙwayoyin cuta. (Babban damuwa shi ne cewa wasu daga cikin kwayoyi da aka yi amfani da su a cikin HCV magani sun hadu ne a cikin hanyoyi kamar wasu antiriovirals, rage tasirin maganin magungunan mawuyacin hali yayin da haɗarin haɗarin haɗari ya faru.)
- Ga wanda ya riga ya kasance a kan ART, dole ne a yi la'akari da sake duba magungunan don rage rashin tasiri, tare da amfani da canza sake damuwa game da yiwuwar ci gaban maganin cutar HIV .
- Don mutanen da ba tare da izini ba tare da CD4 sun fi sama da 500 Kwayoyin / ML, likitoci na iya zaɓi jinkirta ART har sai an kammala HCV.
Bayani na HCV Medication Zabuka
Kashi na kashin cutar HCV ya dade yana haɗuwa da haɗin alphafeed alpha (ko PEG-IFN) da ribavirin . PEG-IFN haɗuwa ne da abubuwa uku wadanda ke haifar da kwayoyin halitta don samar da adadi mai yawa na enzymes wanda zai iya kashe duka kwayar cuta kuma ya kamu da kwayar cutar.
Ribavirin, wani wakili mai maganin jini, yana magance matsalar ta RNA da ake bukata don yin amfani da maganin hoto.
Sabbin magungunan sababbin magunguna (DAAs) suna karuwa sosai da kwayoyin cutar Hizzanci ba tare da amfani da PEG-INF ba, kuma, a yawancin lokuta, ribavirin. Ta hanyar yin haka, illa da ke tattare da farfado da HCV yana ragu sosai, kamar yadda tsawon lokaci yake.
Daga cikin DAA da aka yarda da su a halin yanzu da aka yi amfani dashi wajen magance rashin lafiyar hepatitis C na yau da kullum (ta hanyar izinin FDA):
| Drug | An amince don | An tsara shi | Bayyanawa | Duration |
| Ƙasar (sofosbuvir + velpatasvir) | Dabbobi 1, 2, 3, 4, 5, da 6 tare da mu ba tare da cirrhosis ba | ribavirin a lokuta na cirrhosis da raguwa kuma ba tare da ribavirin ba a duk wasu lokuta | daya kwamfutar hannu yau da kullum ko kuma ba tare da abinci ba | Makonni 12-16 |
| Zepatier (elbasvir + grazoprevir) | genotypes 1 da 4 tare da ko ba tare da cirrhosis ba | ribavirin ko ba tare da ribavirin ba, dangane da tsarin genotype da magani | daya kwamfutar hannu yau da kullum ko kuma ba tare da abinci ba | Makonni 12-16 |
| Daklinza (daclatasvir) | genotypes 3 ba tare da cirrhosis ba | Sovaldi (Sofosbuvir) | daya kwamfutar hannu yau da kullum tare da abinci | Makonni 12 |
| Technivie (ombitasvir + paritaprevir + ritonavir) | genotypes 4 ba tare da cirrhosis ba | ribavirin | biyu Allunan yau da kullum tare da abinci | Makonni 12 |
| Viekira Pak (ombitasvir + paritaprevir + ritonavir, co-kunshe da dasabuvir) | genotypes 1 tare da ko ba tare da cirrhosis ba | ribavirin ko dauka a kansa, inda aka nuna | biyu Allunan na ombitasvir + paritaprevir + ritonavir dauka sau ɗaya yau da kullum tare da abinci, da daya kwamfutar hannu na dasabuvir riƙi sau biyu a kullum tare da abinci | Makonni 12-24 |
| Harvoni (Sofosbuvir + ledipasvir) | genotype 1 tare da ko ba tare da cirrhosis ba | dauka kan kansa | daya kwamfutar hannu yau da kullum ko kuma ba tare da abinci ba | Makonni 12-24 |
| Sovaldi (Sofosbuvir) | Dabbobi 1, 2, 3 da 4 tare da cirrhosis, ciki har da wadanda ke da cirrhosis ko kuma hepatocellular carcinoma (HCC) | dabbar ribavirin, ribavirin kadai, ko Olysio (simeprevir) tare da ko ba tare da ribavirin ba, inda aka nuna | daya kwamfutar hannu yau da kullum ko kuma ba tare da abinci ba | Makonni 12-24 |
| Olysio (simeprevir) | genotype 1 tare da ko ba tare da cirrhosis ba | dabbar dabbar ribavirin, ko Sovaldi (sofosbuvir), inda aka nuna | Ɗaya daga cikin hatsin yau da kullum tare da abinci | 24-48 makonni |
Hanyoyin Kasuwanci
Ɗaya daga cikin manyan damuwa game da magance cutar HIV / HCV shine ƙwarewar tasiri mai yiwuwa wanda zai iya faruwa a sakamakon farfadowa. Yayinda gabatarwar sababbin kwayoyin tsara kwayar cutar ta canza magungunan kamuwa da HCV, babu wani abu da ke fuskantar matsalolin da wasu marasa lafiya suka fuskanta.
Don mutanen da suka fara farawa a karon farko, yawancin illa na HCV (faruwa a akalla 5% na lokuta) sune:
- Harafi: gajiya, ciwon kai
- Zepatier : gajiya, ciwon kai, tashin zuciya
- Daklinza : gajiya, ciwon kai, tashin zuciya, zawo
- Technivie : rauni na jiki, gajiya, tashin hankali, rashin barci
- Viekira Pak : gajiya, tashin zuciya, itchy fata, fata dauki, rashin barci, rauni, gajiya
- Harvoni : gajiya, ciwon kai
- Sovaldi + PEG / INF + ribavirin: gajiya, rashin barci, tashin zuciya, ciwon kai, anemia
- Sovaldi + ribavirin: gajiya, ciwon kai
- Olysio + PEG / INF + ribavirin: rash, itchy fata, tashin zuciya, tsoka zafi, shortness na numfashi
Yayinda yawancin abubuwan da ke cikin tasiri sun kasance masu tsayayyarwa, yin sulhu a cikin mako daya ko biyu na farawa, wasu alamun cututtuka na iya tsawo da kuma furta (musamman a hanyoyin kiwon lafiya na PEG / INF). Yi magana da likitanka nan da nan idan bayyanar cututtuka sun kasance game da / ko kuma m.
Kafin fara HCV Far
Kasancewa da kuma tsammanin yiwuwar illa mai lalacewa shine mahimmanci ga farfadowa da tsararraki da kuma cimma burin magance mafi kyau. Nauyin kwaya, gyaran jigilar kayan shafa, da canje-canjen abincin (watau, ƙara yawan mai mai amfani ga masu cin abinci maras mai) ne kawai wasu batutuwa da ake buƙatar magance su don tabbatar da shirye-shiryen haƙuri.
Kuma yayin da zabin miyagun ƙwayoyi za a iya la'akari da mahimmanci ga nasara na maganin, haka kuma, shi ne maganin miyagun ƙwayoyi . Ya danganta ba kawai ga mafi kyawun sakamakon ba amma a lokuta da yawa yakan rage rashin tasiri da kuma rashin tasiri. Biyan kuɗi na gaba ɗaya shi ne, a gaskiya, a matsayin maɗaukaki ga yiwuwar rashin nasarar rashin lafiya kamar yadda abubuwan da suka faru.
Hanyoyin Tsaro
Cirrhosis saboda rashin lafiya na HCV na yau da kullum shine mai nuna alama ga halayyar hanta a Amurka, Turai, da kuma Japan, ko da yake an gano cutar ta kusan kashi 70 cikin 100 na masu karɓa a cikin shekaru uku. Bugu da ƙari, kamuwa da kamuwa da gwargwadon kanta zai iya haifar da tsakanin kashi 10 zuwa 30 na marasa lafiya masu tasowa a cikin shekaru biyar.
A cikin mutanen da ke buƙatar hawan hanta, farawa na HCV sau uku zai iya rage hasara na asarar kusan 30%.
Duk da halayen haɗakarwa, yana da muhimmanci a lura cewa yawan lafiyar lafiyar ya kasance daidai da sauran alamomi ga masu hanta na hanta-tare da yawan rayuka na rayuwa tsakanin 68% da 84% a cikin shekaru biyar.
Sabbin magunguna na HCV zasu iya haifar da waɗannan sakamako, yayin da suke tsai da matakan haɗarin magungunan miyagun ƙwayoyi masu dangantaka da magani.
> Sources:
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