Ukulungiswa Hepatitis C "sofosbuvir": ukubuyekezwa, yokusetshenziswa

Izidakamizwa "sofosbuvir" enegama ukuhweba "Sovaldi" ikuvumela ukwelapha ngokuphelele sokusha kwesibindi kohlobo C, umphumela omuhle is atholakala ngokushesha ngokwanele, okuyinto kuqinisekiswa izifundo zokwelapha.

Izidakamizwa "sofosbuvir" aphathe kwesibindi kohlobo C ukuma. yokwelapha Kuhlanganiswe ne ukusetshenziswa kwalesi izidakamizwa nezinye izidakamizwa iqondiswa iziguli omdala. Okwelapha Nokuhlinza abelapha abantu abane-HIV ama-co-ukutheleleka.

Uphiko asebenzayo izibhebhe - sofosbuvir. Basuke camera futhi aqukethe mg 400 ketshezi eziyisisekelo. Iphakheji liqukethe amaphilisi 28.

Izakhiwo ukuthi izidakamizwa kuphangwa "sofosbuvir"

Umuthi ezicindezelayo nomthelela RNA-polymerase NS5B. Ngenxa yalokho, umphumela wawo umzimba OAmaKristu igciwane ukufanisana inqubo, okuyinto agent causative sokusha kwesibindi sohlobo C.

Lapho ukuthenga "sofosbuvir" ngesikhathi intengo imali

Ulwazi oluwusizo kakhulu sendlela uthole ngokuphepha "Yiqiniso ekululameni" wakho, posted on niche sites. Isisetshenziswa kunawo futhi iningi ebalulekile emphakathini kuyinto HCV.RU - abakhuluma isiRashiya-hepatitis iforamu "Misa", okuyinto yasungulwa ngo-2000. Njengomthetho, Intanethi ezinkulu, lonke ulwazi iyenziwa ngokucophelela kusengaphambili futhi ukuhlolwa umphakathi.

Uma ungenalo acabangele izinkundla, omunye iziphakamiso ezithakazelisayo kakhulu, esayifica kwi-inthanethi, ngokuthi HCV24 UKUFINYELELA UHLELO. Ukuze uthole olunye ulwazi mayelana nezinsiza HCV24 ivuliwe website olusemthethweni hlelo.

Izinkomba ukusetshenziswa zomuthi

"Sofosbuvir" imithi enqunyiwe iziguli sokusha kwesibindi kohlobo C, sifo uma idluliselwe ifomu ezingamahlalakhona. Ukuze sibe abafundisi abaphumelelayo, ukwelashwa kusebenza indlela elihlangene. Mhlawumbe ukusetshenziswa kwezidakamizwa ezimweni lapho isiguli unesandulela ngculaza ngaphezu Hepatitis.

Izimo ethola "sofosbuvir" izidakamizwa

Imithi ungayisebenzisi uma hypersensitivity kuya izinto zikhona ngezithako zawo. Naphezu kweqiniso lokuthi izidakamizwa akunamthelela okuzala, it is kuyaqabukela elibekelwe nabesifazane asebeneminyaka efanele yobudala zokuzala. Ukusetshenziswa kwezidakamizwa ngenkathi bekhulelwe nangenkathi bencelisa is hhayi Kunconywa, njengoba kungaba oniwa ingane.

Lapho sokukhulelwa kwenzeka, inhlanganisela "sofosbuvir" nge izindlela ezifana "interferon-alpha" futhi "ribavirin" angase abe nomthelela ongemuhle busebenze. Ngenxa yalesi sizathu, ngesikhathi ukwelashwa yokuzala kuyinto engathandeki. Ukuhlolwa lapho izidakamizwa "sofosbuvir" Kuye evivinywa izilwane, baye babonisa ukuthi leli thuluzi kunomphumela kancane omubi enzalweni. Ngaphambi kokuqala ukuthatha inkambo okufanele ufundisisa imiyalelo izidakamizwa futhi uthintane onguchwepheshe.

Isikali "sofosbuvir" izidakamizwa

Ukwelashwa "sofosbuvir" Hepatitis C ifomu esingapheli singenza kwenziwe kuphela labo ochwepheshe abanesipiliyoni esifanele. Monotherapy akuyona kwenziwe, umuthi njalo kuhlangene nezinye ejenti. Abadala ngokuvamile batusa engayitholi nsuku zonke 400 mg (1 tablet) izimali. I-Tablet isiphuzo ngezikhathi zokudla.

Ukwelashwa kusho "sofosbuvir" Hepatitis C kungathatha izinyanga eziyisithupha. Isikhathi esining impela nesidingo esingaka kuphakama lapho kukhona ezinye izici ezimbi. Umthamo kuyakhethwa esekelwe isisindo lesiguli.

ukwelashwa ukusha kwesibindi kohlobo C:

• Genotypes 3-6 - emuthini main yengezwe "Interferon-alpha" futhi "Ribavirin" (ukuphathwa kuthatha izinyanga ezingaphezu kwezintathu);
• genotypes 1, 4-6 - ngaphezu kwalokho besebenzisa "interferon-alpha" futhi "ribavirin" izinyanga ezintathu noma nje "ribavirin" izinyanga eziyisithupha (samuntu yesibili lwenteke kuphela lapho ukungakwazi ukusebenzisa indlela yokuqala);
• 2 genotype - izidakamizwa is kuhlangene "Ribavirin", yokutakula ngokuvamile kwenzeka kungakapheli izinyanga ezintathu ukusetshenziswa imithi.

Uma kudingekile, isibindi womuntu ukufakelwa, isifo sokusha kwesibindi kohlobo C ogulayo, ngaphambi reception yayo ebekiwe "sofosbuvir" kanye "Ribavirin". Phakathi ukwelashwa kusho "sofosbuvir" impatho lwemithi kweziguli Yiqiniso ahlangene HIV kanye ne-hepatitis ingasetshenziswa uyefana.

Lapho side effects zenzeka ngenxa ekuphathweni angumfelandawonye izidakamizwa nge "Interferon-alpha" ephelezelwa eziwukwephulwa okukhulu "Interferon" noma senqabe ukukhiqiza nokwehlisa umthamo ngaphambilini osungulwe. Uma ukuthuthukiswa sina side effects unesandla, "Ribavirin", umthamo futhi kuncishiswe noma ukwenza ukuqedwa zomuthi. Izinqumo ezinjalo zenziwa udokotela ukuba khona. Kamuva, lapho isiguli wabuyela esimweni esivamile, ungazama uqhube ukuphuza imithi.

Ukusebenzisa "sofosbuvir" izidakamizwa

Lapho ekwelapheni ejenti "sofosbuvir" isicelo kwemithi Kwenziwa kanye ukudla. iphilisi Umunyu, ngeke ukuchoboza ikhefu, une ukugwinya lonke.

Uma, kungakapheli amahora amabili ngemuva kokuthatha ukuhlanza iphilisi kwenzeka, kutuswa ukuba baphuze enye. Ezimweni lapho ukuhlanza kwenzeka kamuva okudlula amahora amabili, lesi senzo akudingekile ukukwenza.

Lapho ukweqa Isikali lapho sekudlule amahora kungekho kuka 18, kubalulekile ukuthatha umthamo uphuthelwe uma ngabe kube isikhathi esiningi, udinga baphuze umthamo ngesikhathi evamile.

Ukuqedwa yokwelapha

Uma esikhathini Inkambo yokwelashwa kuhlanganiswe isibe adingekayo ukwesulwa omunye izidakamizwa, futhi uqede imithi "sofosbuvir". Manual ubonisa ukuthi idatha ku ekwelapheni izingane nentsha, eqinisekisa ukuphumelela kwalesi indlela, akukho. Uma ziphethwe iziguli isifo sokusha kwesibindi kohlobo abaphethwe ukungakhuli kwezinso (ifomu okuncane noma okusesilinganisweni), asikho isidingo yokukhethwa ngazinye Ukweqiwa. In iziguli nesifo esinzima ebekiwe umthamo ezithile izimali ezidingekayo ngemizimba yabo.

Imiphumela emibi "sofosbuvir" izidakamizwa

Lapho ekwelapheni "sofosbuvir", "interferon" futhi "Ribavirin" avele okufanayo side effects njengoba esikhathini ukwelashwa "interferon" kuphela "Ribavirin". Kulokhu, ukubukeka kwabo hhayi iyakhula.

Esikhathini kuhlanganiswe ukwelashwa izidakamizwa "sofosbuvir" izimpendulo abonisa ukuthi inhlanganisela yakhe nge "Ribavirin" ngokuvamile kuholela ukuthuthukiswa lezi zithi:

• ukucasuka, ukukhathala;
• ikhanda;
• anda bilirubin ezingeni noma ukwehla elithwala umoya-mpilo;
• isicanucanu;
• inkinga yokungalali kahle.

Lapho ethola oluyisisekelo izidakamizwa is kuhlangene nokusetshenziswa "ribavirin" futhi "Interferon", ngokuvamile kungenziwa waphawula:

• myalgia, ubuhlungu emalungeni;
• nokungalali;
• ukukhwehlela, iphika;
• amazinga aphezulu bilirubin;
• neutropenia, ukuntuleka kwegazi emzimbeni, ukungabi platelet count, lymphocyte;
• imfiva, Ukugodola;
• ukucasuka;
• ukutubeka;
• isikhumba silume, ukuqubuka;
• izimpawu engakhi pheshana emathunjini;
• ikhanda, isiyezi;
• imnyama.

Lapho kwalokho, "Ribavirin" kodwa "sofosbuvir" ukulungiselela Umhlahlandlela libonisa amathuba kancane ekuthuthukiseni le miphumela emibi:

• anaemia;
• ukushayisana ipheshana wokugaya ukudla;
• nokucindezeleka;
• ukukhathala umkhuhlane;
• Ukudlikizela;
• nobunzima sokugxila;
• myalgia;
• ubuhlungu emuva nezihlanganiso;
• nasopharyngitis;
• buthakathaka izimpande izinwele;
• ukulunywa, ukoma ngokweqile;
• ukukhwehlela;
• ukubukeka dyspnea ngaphansi komthwalo.

Lapho kuhlangene okwelashwa, "Ribavirin" futhi "interferon", kungenzeka ukusabela elandelayo enqabayo kubonakala kwezinye izimo:

• umbono izinkinga kanye okuhlushwa;
• ukulahlekelwa isikhumba umswakama;
• Reflux;
• ukukhathala kanye nokuhlukumezeka esifubeni, emuva;
• ababuthakathaka izinwele izimpande;
• nokucindezeleka;
• migraine;
• Ukudlikizela;
• ukungahlaliseki, futhi ukubonakaliswa kokwesaba;
• ukuqunjelwa;
• inkumbulo abampofu;
• iphele ulwelwesi ezazigudla ngalo ingaphakathi ngomlomo;
• kwesisindo;
• iphika njengoba ukusabela komzimba akusingatha ngayo ukucindezeleka.

ukusabela ezingezinhle zivame kakhulu otholakala kwesikhathi yokwelashwa "Izibuyekezo sofosbuvir 'zihlanganisa:

• anda ukucasuka;
• ukutubeka;
• nokwehlisa lokuhlushwa elithwala umoya-mpilo egazini;
• isicanucanu;
• ikhanda;
• nokungalali;
• amazinga aphezulu bilirubin.

imiphumela Common enqabayo zimi kanje:

• ukushayisana ipheshana wokugaya ukudla;
• imisipha amajaqamba nobuhlungu kuzo;
• anaemia;
• nezinwele;
• ukwephulwa inqubo zokuphefumula;
• nokucindezeleka;
• ukungakwazi ukugxilisa disorder;
• ukukhwehlela;
• iphika, okuyinto ukusabela komzimba ukuze ukucindezeleka ngokomzimba;
• umkhuhlane;
• rhinitis;
• yokuntuleka amandla;
• sishintshe isimo ngesikhashana;
• Abuzwa emhlane nezihlanganiso.

Lonke isikhathi reception "sofosbuvir" ukulungiselela kumelwe nakanjani zenzeke ngaphansi kokuqondisa kukadokotela. Akunakusetshenziswa abakwazi ngokuzimela liqoke ukulungiselela inikezwe.

izidakamizwa ekuhlanganyeleni

ukwelashwa Inxanxathela usebenzisa "sofosbuvir" kusho izilinganiso ivumele ukusetshenziswa kungenzeka okweqa izingozi ezikhona. Ochwepheshe ukweluleka ukwelashwa nale izidakamizwa ngesikhathi esifanayo futhi "Boceprevir 'noma' telaprevir." Kuyefana nasendleleni inhlanganisela izidakamizwa kanye nemithi ezibhekwa eqinile isinyathelo glycoprotein inducers. Ukuze izidakamizwa kanye izakhiwo ephethwe "Phenytoin", "Karbamatsepin". Kulezi amafa bungabonakala futhi wort iSt John sika "Rifamycin". Ikhono ukuhlanganisa imithi ethile setha udokotela.

Izixwayiso

Inkambo yokwelashwa kumele yabelwe uchwepheshe abanolwazi. Kukhona ingozi komzimba, isifuba somoya kubonakala, amehlo abomvu, ukulunywa zabo nokuvuvukala, ukulunywa, nolwelwesi lwamafinyila, rhinitis, ukuqubuka. Ezinye iziguli kungenzeka ukuthi ulahlekelwe ukwazi, mhlawumbe ukushaqeka anaphylactic. Uma kukhona izimpawu ukusabela iguliswa udinga usizo udokotela uma kunesidingo - ukulungiswa we lwemithi yokwelashwa, noma ukuqedwa lesi sidakamizwa "sofosbuvir" ngokuvamile.

"Sofosbuvir" analogue zomuthi alisetshenziswa ekwelapheni iziguli ezingaphansi kweminyaka engu-iminyaka eyishumi nesishiyagalombili, njengoba ukuphepha lokhu yokwelapha alikaqinisekiswa ngocwaningo.

Kuye kwaphawulwa ukuthi izigameko ohlangothini ukusabela siphezulu kakhulu ezigulini ezineminyaka engaphezu kwengu-35. NgoLwesine kutholakale isidumbu sendoda intsha zisamukele kakhudlwana imithi.

amalungiselelo Kudingekile akhethiwe udokotela ecabangela izici eziningi, kuhlanganise nesifo genotype. Phakathi ukwelashwa kwesifo sokusha kwesibindi sohlobo genotype lokuqala kuvunyelwe inhlanganisela yemithi "Ledipasvir" futhi "sofosbuvir". Esikhathini genotypes lesibili nelesithathu kungenzeka ukusebenzisa "ribavirin" genotypes ekuqaleni noma lesine - "ribavirin" nge "Interferon".

Ucwaningo luye lwabonisa ukuthi "sofosbuvir" aphathe kakhulu ngempumelelo genotypes isifo 1-4. Ezimweni eziningi, liye kuqinisekiswa umthelela yokwelapha nale izidakamizwa ebukhoneni umuntu hhayi kuphela ukusha kwesibindi kohlobo kodwa futhi human immunodeficiency virus.

Phakathi ukwelashwa, isiguli kufanele ukwethula ezinye imikhawulo ezimpilweni zabo. Awukwazi ukwenza imisebenzi ephathelene ne-ngesidingo sokubonisa ukunakekela okungeziwe futhi athathe isinyathelo ngokushesha ukuze okwenzekayo.

Kwabesifazane abakhulelwe umzimba inhlanganisela engathandeki "sofosbuvir" + "ribavirin" + "Interferon".

Izindleko zomuthi, ukubuyekezwa, analogs "sofosbuvir"

Kungcono ukwazi ukuthi uma usebenzisa "sofosbuvir" intengo ukwelashwa okunjalo kuyoba eliphezulu kakhulu. Umuthi kuyabiza, ke zingathengwa for ecishe ibe yizinkulungwane 16-25. Euro. Nakuba izidakamizwa kubhekwa ngempumelelo ekulweni ne-hepatitis asebenzisa C, kungenzeka ukuthi kungasizi kuzo zonke izimo, ngoba umzimba nhlobo ezahlukene futhi usabela ngendlela ehlukile ku izindlela ezahlukene. Ukwelashwa kudinga ukunakekelwa okukhethekile, kukhethwa umthamo edingekayo kumele kwenziwe udokotela, okuningi kuncike ukutholakala isipiliyoni onguchwepheshe ekwelapheni isifo sokusha kwesibindi kohlobo "sofosbuvir".

Ngezinye izikhathi kudingeka 'sofosbuvir "esikhundleni izidakamizwa. Izibuyekezo zibonisa ukuthi, ukuze kwelashwe isifo sokusha kwesibindi kohlobo C, okuyinto engakaze iqedwe kuleli esigabeni oyingozi, indlela udokotela kungase kushintshwe, nomphumela ofanayo. Phakathi analogue kungenzeka - "TSikloferon", "Ledipasvir", ". PegIntron" Udokotela angase anikeze isiguli "Neovir" noma "Algeron". Ngoba impatho ingasetshenziswa "Ferrovir", "Daklatasvir". Kukhona esikhundleni ezifana "Rebetol", "Ingaron". Ukwelashwa kungaba "EU reaferona", "Asunaprevirom" noma "peginterferon". Ngokuvamile, odokotela abaphendukela "ribamidil", "Layfferona", "Altevira". A nomphumela ofanayo kufinyelelwa ngenxa yokwamukela "Sovriada", "Pegasisa" "Meduna ribavirin." Ayikho ngempumelelo ngaphansi "Roferon A". Zikhona nezinye izidakamizwa okufanayo - "Intron A," "ALFARON". Mhlawumbe ukuphumelela ukwelashwa kwesifo sokusha kwesibindi sohlobo B, ngokusekelwe ukusetshenziswa "Realdiron" noma "Moliksana".

"Sofosbuvir" (Egypt - ezweni lendabuko kusho) - umuthi ezibizayo, ngakho kufanele uqaphele ikakhulukazi lapho uthenga. Kubalulekile banake kobufakazi zabantu asebethole wathenga izidakamizwa. kube Ngakho bakwazi ukwazi ukuthi side effects zenzeka njalo kakhulu futhi ukuthi izidakamizwa ubhekana kahle umsebenzi. Egypt Akukhona nje ukhiqiza "sofosbuvir". India uveza lokhu izidakamizwa.

Umuthi isidlulile zokwelapha eziningana. Ngenxa yalokho kwezinqubo eziyisithupha enjalo ukuvunyelwa izidakamizwa senziwa okusekelwe imiphumela emihle. Ezifundweni zabantu 1947 iqhaza amakhulu, iziguli ezinemishini sokusha kwesibindi sohlobo C. isifundo abakhethwa abantu ababemise ongakayisebenzisi welashelwa isifo sabo, futhi kulezo ziguli isidumbu akasabeli yokwelapha kwenziwe ngaphambili.

izidakamizwa ngempumelelo ukuthi kungase kutholakale ku ekwelapheni isifo genotypes ngowokuqala lesine. Imiphumela emihle kuye kwakhishwa ngenxa ekwelapheni iziguli ezine-hepatitis B no-HIV. Cishe 50-90% of abantu abathintekayo ucwaningo, nokuhlupheka ukusha kwesibindi kohlobo B C, okuqhubekayo virologic impendulo livele. Iningi leziguli ezine-ifomu ezingamahlalakhona sokusha kwesibindi negciwane lengculaza ukutheleleka ngenxa ukusetshenziswa kwezidakamizwa etholwe umphumela ofanayo. Virological impendulo okuqhubekayo sifundzile 76-92% wabantu abane coinfection.

Abantu abaningi abaphethwe ifomu njalo ukusha kwesibindi kohlobo B C, ushiya impendulo, phawula ukuthi ngemva kokuba ukudlula inkambo ebekiwe yokwelashwa isimo sabo siphinde sibe nokuphila okuvamile. Kungakapheli izinyanga ezintathu ukwelapha ngenhlanganisela izinkomba enzyme isibindi kungenzeka evamile, ngemva cishe izinyanga eziyisithupha lesi sifo kungenzeka ukukhohlwa igazi igciwane ayikwazi ukutholwa. Mayelana neminye imiphumela emibi okukhulunywa neze, ngokuvamile ezincane: ukukhathala, ukukhathala. Ngisho ikhambi, kumelwe siqaphele ukuthi isifo asibuyanga.

Abanye abantu abanalesi sifo lesibili genotype sidakamizwa sisiza inyanga eyodwa nje, imiphumela ukuhlaziywa zinhle, agent causative of-hepatitis C egazini ayikwazi ukutholwa emva ukwelashwa izidakamizwa "sofosbuvir". Inani izidakamizwa kunalokho enkulu, kodwa, befuna ukuze belaphe futhi bagomele ukhohlwe ngalesi sifo ekhathazayo, isifo sokusha kwesibindi kohlobo C, abantu basengozini. ukungaphathwa kahle imithi kuba ngokuvamile okuncane noma okusesilinganisweni noma lumane. Noma kunjalo, izidakamizwa is best kwenziwa ngaphansi kokuqondisa udokotela wakho. Ayikho impendulo engeyinhle, okusho ukuthi uma udokotela wakho ezinqunyiwe imithi efanele futhi azinake zonke izici zomzimba lesiguli, impilo yakhe, ukukhipha khona Izimo, umphumela ukwelashwa kufanele kube omuhle. Kubalulekile ukuqonda ukuthi onguchwepheshe oqeqeshiwe ekwelapheni isifo sokusha kwesibindi kohlobo C iyasebenza kubaluleke kakhulu ukuze uthole imiphumela emihle futhi babuyele ngokugcwele. ngokugadwa Permanent likadokotela, ukuhambisana nazo zonke izincomo kanye nokugcina yokuphila enempilo ngokuqinisekile kuholela empilweni engcono. Ngisho noma lesi sifo hhayi belashwa zaphumelela, kuyothuthuka ukuhlaziywa izinkomba, okuzokwenza ngempela nethonya elihle empilweni.