Izimpawu kanye nokwelashwa kwesifo sokusha kwesibindi sohlobo C igciwane genotypes sokusha kwesibindi sohlobo C. HCV Imithi

Kuze kube muva nje-hepatitis C virus ayebhekwa kuphela uhlobo igciwane Hepacivirus. Kodwa kwathi amahhashi, izinja, amagundane namalulwame nazo ukungenwa yilesi sifo. Zama ukuqonda ukuthi kuyingozi hepatitis C ngoba indoda onjengaye lokuthi bazokwazi ukuhlonza nokwelapha, njengoba uphethwe esifike ngesikhathi lesi sifo lula kakhulu yokwelapha. Ngaphezu kwalokho, isifo ekuthonyweni izingane ezincane, kanye ngaphambili it is itholiwe, aba maningi amathuba umphumela omuhle.

Uyini-hepatitis C virus

Lapho umuntu azibone ilesi sifo ngokushesha uqala ukuhlupha imibuzo eminingi mayelana Hepatitis C: Lokho kuyinto (nesithombe ubufakazi isifo), zisebenza kunoma yikuphi udokotela usizo, nokunye. Jaundice noma ukusha kwesibindi kohlobo virus nezinhlayiya ehlanganisa zofuzo (RNA) e nengaphakathi lizungezwe icosahedral amaprotheni igobolondo futhi uyavikela limbozwe a lipid (noma amafutha) imvilophi cell-etholakala.

Hepatitis C ingenye amagciwane eziningana ezibangela ezinzima ukuvuvukala isibindi ehlasela umzimba. Kufika-85% abantu abaneminyaka ifomu acute lesi sifo, kukhona lesi sifo kanye ukuphila kwakhe konke. Ukutheleleka ikakhulukazi kwenzeka nge igazi (umjovo emthanjeni izinaliti non-oyinyumba, imihuzuko, isilonda). Ingozi yokutheleleka ngokuhlangana ngokocansi nezitho lokhu igciwane kubhekwa ongaphakeme, kodwa usenayo indawo.

Izimbangela Ukusha Kwesibindi Kohlobo B e Abadala

Hepatitis C - yisifo esibangwa igciwane ithelela isibindi. Imisebenzi kokusebenza kwesibindi zihlanganisa ukususwa eziyingozi ikhemikhali emzimbeni, kugayeke, impatho amavithamini nezakhi ukudla, kanye izinqubo amahlule ngesikhathi ukusikeka kanye amanxeba. Hepatitis C kwabesifazane kuyingozi kakhulu izinsana ngoba umntwana angaba kusuka kumama ogulayo bokubeletha. Yingakho kubalulekile ubuke isimo sempilo yakhe uma uhlela ukukhulelwa.

jaundice igciwane omdala ingasatshalaliswa kulezi zimo ezilandelayo:

1. Lapho usebenzisa i-non-oyinyumba umjovo emthanjeni noma izifo esicutshini (kuhlanganise nezidakamizwa).
2. Ukudweba imifanekiso emzimbeni, umzimba, ukutshopa ubambe non-oyinyumba izinaliti nezinqubo.
3. Phakathi ocansini olungavikelekile nomuntu onegciwane, uma kungukuthi ngalesi sikhathi kukhona contact ngegazi (izilonda, ukusikeka, izilonda umthondo noma esesikhathini). Le ndlela iphathelene nemizila elingavamile ukuchayeka.
4. Lapho inqubo igazi.
5. Phakathi ukwelashwa emitholampilo kwamazinyo.

Sneezing, ukukhwehlela, ukwabelana ukudla, exchange Cutlery noma ezinye okungahleliwe ethintekayo contact ukusha kwesibindi kohlobo ayihambi.

Izimbangela isifo sokusha kwesibindi ngo izingane

Izimpawu kanye nokwelashwa kwesifo sokusha kwesibindi sohlobo C ezinganeni athé ukwehluka izimpawu isifo kwabadala. Ingane-hepatitis ubabonisa ngezindlela ezimbili: kusuka kumama kuya enganeni (indlela mpo ukutheleleka) futhi axhumane ngokuqondile igazi lomuntu onegciwane sika (umzila parenteral ukutheleleka). I Lingadluliselwa umama onegciwane ukuze ewusana olusanda kuzalwa ngesikhathi sokubeletha, ukuvama ezinjalo mayelana 4-5%. Uma kuphakama isimo esinjalo, lona wesifazane ahlinzekwa ukwenza Ukubeletha, okuyinto kancane kunciphisa ingozi yokudlulisela ukusha kwesibindi kohlobo B igciwane owayesanda kuzalwa. Ukutheleleka izingane indlela yesibili ngokuvamile kwenzeka ukungenelela ezihlukahlukene zezokwelapha, ukwelashwa kwamazinyo, ukuphatha izidakamizwa nge amathuluzi oyinyumba, hemodialysis, ukumpontshelwa igazi nezinye izinqubo zokwelapha.

Ngo intsha, njengoba abadala, ke kwandisa amathuba okuthola ukusetshenziswa ukusha kwesibindi kohlobo izidakamizwa. Ngaphezu kwalokho, ingozi yokutheleleka ezinganeni ingane anda ephula imithetho kwenhlanzeko we ukubhalwa kwesikhumba, ukubhoboza umzimba kanye nezinye izinto. Lapho ukushefa imikhiqizo kwenhlanzeko jikelele ngokusebenzisa ukusikeka kanye imihuzuko esikhumbeni emzimbeni futhi ingadlulela ngalé amagciwane.

Izimpawu ze-hepatitis B e abadala

Ngokuvamile abantu abaningi nge-hepatitis C azinazo izimpawu ezisheshe zibonakale isici isifo. Izimpawu ze-sifo singalapheki ingekho kuze nezibazi kuze isibindi ayakhekanga (isifo sokusha). Kulesi isifo ngokuvamile uhambisana ubuthakathaka jikelele, ukukhathala ngokweqile futhi inezimpawu nonspecific ngisho nalapho engekho ngokoma kwesibindi.

Izimpawu ngokuvamile kubonakala khona ukutheleleka kakhulu kamuva njengesifo sokusha kwesibindi kohlobo bayashintshana ekufukameleni inkathi isuka kuzinsuku 15 kuya 150. abantu elinegciwane ngaphandle izimpawu zesifo kunosongo kwabanye, njengoba uba othwala igciwane futhi ungadlulisela igciwane kwabanye ngaphezu izindlela. Izimpawu oyinhloko sifo zihlanganisa lokhu okulandelayo:

- ukungakuthandi ukudla;

- umkhuhlane, ngenxa yobuthakathaka;

- isicanucanu, ukuhlanza,

- sohudo;

- okungazelelwe isisindo okukhulu ukulahlekelwa okukhulu ngaphandle kwesizathu;

- yellowing kwesikhumba, izinhlamvu zamehlo sclera (kangaka okuthiwa ama isifo jaundice edume);

- ushintsho umbala umchamo (kuya konsundu) kanye sezinyawo (indle olumhlophe).

Izimpawu ze-isifo sokusha kwesibindi ngo izingane

Isilinganiso bayashintshana ekufukameleni inkathi ukusha kwesibindi kohlobo ingane ingathatha izinsuku ezingu-15 kuya ku-6 izinyanga. Izimpawu ze-jaundice ezinganeni zenzeka esikhathini esingaphansi kuka-50% amacala futhi wazwakalisa ngokuyinhloko yellowing kwesikhumba nabamhlophe samehlo. isikhathi Icteric kuvame ukuthatha amasonto angu-3. Ngoba i-hepatitis libhekene ukuvuvukala kwesibindi, ingane ukudakwa Imininingwane kwenzeka, okuyinto kuhambisana isicanucanu, ukuhlanza, ukukhishwa isisu. Ifomu acute lesi sifo iqala kancane, izimpawu ukwandisa kancane kancane, kuyilapho kukhona ukuthuthukiswa izifo dyspeptic futhi astenovegetativnogo syndrome. Izimpawu ze-jaundice ezinganeni kungase kuhambisane imfiva, ikhanda. indle ezishintshe umbala, umchamo, kunalokho, iba nombala konsundu.

izimpawu Ukhombe kanye nokwelashwa kwesifo sokusha kwesibindi sohlobo C kuhlobene eduze, kusukela uphethwe ngasekupheleni noma ukungabi khona ukwelashwa okufanelekile e 10-20% azo zonke amacala acute ifomu jaundice isifo kuba amahlala khona. jaundice Okungalapheki ngokuvamile asymptomatic futhi ngokuvamile itholwe ngenkathi kokuhlola okungahleliwe wengane uma isikhathi lulahlekile kanye nesifo namanje naye impilo yakho yonke. Lezi zingane une-ukukhathala yanda, asthenia, izimpawu extrahepatic (telangiectasia, kapillyarity).

ukuhlola

Ngenxa yokuthi i-acute HCV ukutheleleka ngokuvamile asymptomatic, ekuhlonzweni kubaluleke kakhulu lesi sifo. Lapho edlulisa amathuba ezingamahlalakhona ukutheleleka ukuthola encishisiwe isifo ahlale asixilongwa futhi angagcina yokuthola izifo ezifana no sibe sesomile noma nomdlavuza wesibindi.

Ukuthola igciwane emzimbeni kwenzeka nangokunquma amazinga masosha omzimba egazini, bese siqinisekiswe yimiphumela yokuhlolwa eyengeziwe ukunquma RNA ezibangelwa amagciwane. Inani i-RNA egazini (viral load inkomba) is hhayi kuhlobene nezinga isifo kanzima kodwa ingasetshenziswa ukuqapha ukusabela umzimba belashwa. Isibindi biopsy isetshenziswa ukuhlola sezingeni isifo ukunqotshwa yayo (umonakalo isitho kanye nezibazi amaseli), ukubaluleka okuyinto ebaluleke for ukuhlela ukwelashwa.

Sifo wenziwa 2 izigaba:

- Ukuhlola amasotsha omzimba igciwane jaundice kungacacisa ukuthi noma ngabe umuntu igciwane;

- novivinyo omuhle amasotsha omzimba Kwenziwa ngumuntu nucleic acid Assay ngoba HCV RNA, ukucacisa uhlobo lesi sifo (acute noma zezifo ezingelapheki).

Khona-ke, novivinyo omuhle, udokotela udinga ukuhlola izinga lomonakalo kwesibindi (cystic noma isifo sokusha). Lokhu kungenziwa ngokukhumula biopsy noma ehlukahlukene test non-koda. Ngaphezu kwalokho, isiguli angakhulula ukuhlolwa laboratory ukucacisa genotype uhlobo sokusha kwesibindi sohlobo C. I degree of ukulimala kwesibindi kanye genotype asetshenziselwa nokwenza izinqumo ekwelashweni kanye nokuphathwa isifo.

I genotypes ka-hepatitis C

Ukuze ukwelapha lesi sifo ukuze sibe abafundisi abaphumelelayo, kubalulekile ukuchaza amazwi okungokwakho genotype igciwane. Genotypes HCV ihlukaniswe zinhlobo ezihlukahlukene eziyisithupha. Njengomthetho, iziguli ezinegciwane lesandulela nge genotype eyodwa kuphela, kodwa empeleni ngamunye wabo inhlanganisela amagciwane ehlobene eduze ngokuthi athi zilwane. Sinenkosi ukuthambekela liguquke futhi emqaleni ukwelashwa zamanje. Yilokhu uchaza ubunzima ekwelapheni jaundice ezingamahlalakhona.

Ngezansi uhlu genotypes ezahlukene kwesibindi kohlobo C:

1. Genotype 1a.
2. Genotype 1b.
3. Genotype 2a, 2b, 2c, 2d.
4. Genotype 3a, 3b, 3C, 3d, 3E, 3F.
5. Genotype 4a, 4b, 4c, 4D, 4e, 4F, 4g, 4H, 4, 4j.
6. Genotype 5a.
7. Genotype 6a.

I genotypes ka HCV ibalulekile ngoba odokotela lapho elikhiphe izincomo zokwelapha. Ngokwesibonelo, genotype 1 inzima kakhulu ukuthi aphathe, futhi iziguli ezine HCV genotype 2 no-3, kusabela okungcono ekwelashweni nge inhlanganisela-alpha-interferon nge ribavirin. Ngaphezu kwalokho, uma usebenzisa ukwelashwa, isikhathi Kunconywa ukwelashwa incike genotype.

Ukwelashwa nokuvikelwa Hepatitis C

Izimpawu kanye nokwelashwa kwesifo sokusha kwesibindi sohlobo C kuhlobene eduze, ngoba yokwelapha kusekelwe okufaka izimpawu zesifo. Ngaphambi ukwelashwa kumele iqhutshwe ukuxilongwa okujuli- ukuze kutholakale indlela enhle kakhulu yokuba isiguli futhi isifo sakhe. Ngaphezu kwalokho, ngesisekelo ulwazi zokuxilonga udokotela ukuthola lokho Hepatitis C ephumelela kunazo ngayinye icala ngabanye. Modern yokwelapha esezingeni ye-jaundice luyinhlanganisela yokwelapha namagciwane nge "interferon" futhi "Ribavirin", okuyizinto ngempumelelo yokulwa zonke genotypes. Ngeshwa, "Interferon" is kabanzi kwezokwelapha, okuyinto has nethonya elibi isimo iningi iziguli, futhi empeleni inhlanganisela ribavirin nale umuthi, mhlawumbe, umuthi best ukusha kwesibindi kohlobo C kuze kube manje.

kwentuthuko yesayensi ziye zaholela kwemithi emisha elwa namagciwane kusukela jaundice, okuyizinto ephumelela kakhudlwana, ephephile futhi ngcono kunalena ekhona. It antivirals oyibamba oqondile (PDP), ekwazi hhayi kuphela lula ukwelapha lesi sifo, kodwa futhi sokukhulisa iphesenti iziguli vyzdoravlivaemosti. Nokho, izidakamizwa elwa namagciwane unemiphumela emibi futhi ngokuvamile kubangela lezi zifo in iziguli:

- ubuhlungu bekhanda;

- izimpawu zomkhuhlane;

- ukucanuzelelwa inhliziyo;

- ukukhathala;

- umzimba ukuqaqamba;

- nokucindezeleka;

- ukuqubuka, nokungezwani komzimba nezinto.

Uma ingane ukuthi nginesifo sokusha kwesibindi kohlobo C, ukwelashwa kufanele kuvinjelwe ukwedlulela ifomu acute lesi sifo ibe ezingamahlalakhona. Ukwelashwa futhi ngokuyisisekelo liyinkimbinkimbi futhi kuhlanganisa inhlanganisela ezifana interferon unamasu isakhi sokuzakhela, reaferon e parenteral ifomu viferona futhi suppositories rectal. Ukwelashwa zemithi akhethiwe ngamunye ngengane ngayinye.

Izingane ezivela eminyakeni 7 kuya enkathini yokuthomba bangakwazi ukunikeza inhlanganisela yemithi, "interferon" futhi "Ribavirin". Zimise inductors ( "TSikloferon") futhi immunomodulators ( "Taktivin"). Isikhathi ekwelapheni jaundice ezinganeni kuxhomeke ezicini eziningi, ezisukela 24 amasonto angu-48. Uma kutholakale ukuthi une-hepatitis C, ukwelashwa kufanele kuhambisane Ukudla, ukugcina ukudla okunempilo nendlela yokuphila, ukubhema lokuphela kanye notshwala. Kubalulekile ukugcina lonke embhedeni futhi ugweme ukuphuza imithi engadingekile.

Kukhona izindlela zesintu ukwelapha i-jaundice, kodwa asebenzise kubo, qiniseka bonana nodokotela wakho kuqala, ukuze ukulimaza umzimba hhayi babhebhethekise isifo.

Emisebenzi kanye nemiphumela

Uma iziguli ukubona isifo sokusha kwesibindi kohlobo C, ukuthi ungaphila kanjani nalo, cishe omunye yemibuzo ebaluleke kunayo yonke lapho ibuzwe kudokotela. Ngokushesha kufanele kuphawulwe ukuthi izibikezelo kuzoncika ukuthola esifike isifo kanye nasekuphumeleleni therapy ebekiwe. Isikhathi ezikhonjwe izimpawu kanye nokwelashwa kwesifo sokusha kwesibindi sohlobo C, thola ilungelo - isihluthulelo sempumelelo. Ukwelashwa kuhle isimo jikelele isiguli, kumlethela mkhuba omuhle futhi kwandisa amathuba okuthi umphumela omuhle. Ngokwezibalo, mayelana 20% eziguli abaye izinkontileka kwesibindi, ilulame ngokuphelele, nakuba lokhu akusho ukuthi bavikelekile ukutheleleka esizayo. Labo abasele abanga-80% eziguli ukuthuthukisa lesi sifo singalapheki (ukubukeka izimpawu isici noma asymptomatic). Laba bantu ukuhlala ezithathelwanayo kwabanye ukuphila, njengoba abathwali igciwane.

Lapho udokotela ikhomba nesineke Hepatitis C (izimpawu), ukwelashwa kanye nemiphumela zesifo - ulwazi kufanele kukhulunywe ngayo isiguli ngokushesha ngangokunokwenzeka futhi ifomu kufinyeleleke. Uma umuntu ophila ne-hepatitis C for eminingana, ngokuvamile uye ukuthuthukisa nezinkinga ezilandelayo:

- i-hepatitis ezingamahlalakhona;

- isifo sokusha;

- nomdlavuza wesibindi.

ekuvimbeleni izifo

Ngeshwa, okwamanje awukho umuthi wokugoma ngokumelene jaundice. Iziguli kwadingeka sokusha kwesibindi kohlobo C, shiya amazwana ngalokho kungcono ukuvimbela isifo esingayenza ngaphandle kokuthi siphathe ke. Ngakho, ukugwema ukusabalala kwezifo kanye nezinye izifo igazi yizinambuzane, abantu kufanele nigcine nalezi zidingo ezilandelayo:

1. Gwema ekwabelaneni siqu ukugqoka futhi asebenzise izinto kungenzeka ingcoliswe igazi (isib, izinsingo zokushefa ezilahlwayo, izixubho, njll).
2. Gwema indlebe ukubhoboza, ukubhoboza umzimba, ukutshopa ukwelashwa, okudweba ezindaweni nge inzalo engabazekayo kanye nokuntuleka kwenhlanzeko.
3. Abantu nge-hepatitis C virus, lapho ehambele umhlangano yamazinyo, noma yimuphi omunye izikhungo kwezempilo aphoqelelwe ukuba wazise udokotela bona bafeza igciwane. Ukuhluleka ukwenza njalo angafiki izivakashi eziningi endaweni yamazinyo.
4. Noma yimuphi ukusikeka noma imihuzuko kufanele kube ngokucophelela ukusingatha magciwane izixazululo uzinameke phezu ngebhandeshi amanzi.
5. Abantu kokuba alale nabantu abaningi, ukusebenzisa izindlela okuvimbelayo inzalo, ezifana amakhondomu, ukuze kukhawulwe ingozi yokutheleleka nge-hepatitis C virus nezinye izifo ngocansi ngokuhlangana ngokocansi.
6. Kubalulekile ukuba afeze izinyathelo zokuvimbela okuhloswe ngazo izindlela eziphephile zokusebenzisa amathuluzi for umjovo, imijovo, okudweba nezinye izinto.

Kuyaqondakala ukuthi igciwane hepatitis C ayihambi ngokuthintana okuvamile. Handshake, angiqabule futhi basanga ziphephile, kuleso simo asikho isidingo ukusebenzisa izinqubo ezikhethekile ngabodwa lapho esebenza Iziguli onegciwane. Oxhumana nabo, ezikhulisa ingozi yokudlulisela, ngaso sonke isikhathi sihambisana ukukhululwa kwegazi.