Hepatitis C

ʻO ka Hepatitis C kahi maʻi maʻi e alakaʻi i ka pehu (mumū) o ke ake.

ʻO nā ʻano ʻē aʻe o ka hepatitis viral e laʻa me:

• Hepatitis A.
• Hepatitis B
• Hepatitis D.
• Hepatitis E.

Hoʻokumu ʻia ka maʻi Hepatitis C e ka maʻi hepatitis C (HCV).

Hiki iā ʻoe ke hopu i ka maʻi hepitis C inā komo ke koko o kekahi i loaʻa iā HCV i kou kino. Hōʻike ʻia paha ka hōʻike:

• Ma hope o kahi lāʻau kuʻi a ʻino paha
• Inā pili ke koko mai kekahi mea i loaʻa i ka HCV i kahi ʻoki o kou ʻili a hoʻopili paha i kou mau maka a waha paha

ʻO ka poʻe e makaʻu nei no ka HCV ka poʻe nāna:

• Hoʻokomo i nā lāʻau āpau a kaʻana aku i kahi nila me kekahi mea loaʻa iā HCV
• Ua noho ma ka lōʻihi lōʻihi lōʻihi dialysis
• E launa mau me ke koko ma ka hana (e like me ka limahana mālama ola)
• E launa moe kolohe ʻole me kahi kanaka i loaʻa iā HCV
• Hānau ʻia i kahi makuahine i loaʻa iā HCV
• Loaʻa i kahi peʻa a i ʻole akupunktur me nā nila ʻaʻole i disinfected pono ma hope o ka hoʻohana ʻia ʻana i kahi kanaka ʻē aʻe (haʻahaʻa loa ka makaʻu me nā poʻe loea i loaʻa kahi laikini peʻa a i ʻole kahi laikini acupuncture)
• Loaʻa i kahi transplant organ mai kahi mea hāʻawi i loaʻa ka HCV
• E kaʻana like i nā mea pilikino, e like me nā palaki niho a me nā pahi kaua, me kekahi mea i loaʻa iā HCV (ʻoi aku ka liʻiliʻi)
• Loaʻa i kahi kōpili koko (kakaʻikahi i ka United States mai ka loaʻa ʻana o ke kānana koko i 1992)

ʻO ka hapa nui o ka poʻe i laha ʻia me ka HCV i loaʻa ʻole nā ​​ʻōuli. Loaʻa i kekahi poʻe ke melemele o ka ʻili (jaundice). ʻAʻohe kumu o ka maʻi maʻi mau. Akā hiki ke luhi, kaumaha a me nā pilikia ʻē aʻe.

ʻO nā kānaka i loaʻa i ka maʻi wā lōʻihi (mau) ʻole i loaʻa ʻole nā ​​hōʻailona a hiki i ka hōʻeha ʻana o ko lākou ate (cirrhosis). ʻO ka hapanui o ka poʻe me kēia ʻano he maʻi lākou a nui nā pilikia o ke olakino.

Hiki ke hana ʻia nā ʻōuli me ka maʻi HCV:

• ʻEha ma ka ʻōpū luna pono
• Pahu ʻōpū ma muli o ka wai (ascites)
• Nā noho pālolo pālolo a i ʻole ʻulaʻula
• Mimi ʻeleʻele
• Ka luhi
• Fiva
• Kāwili
• ʻO Jaundice
• Loaʻa ka ʻai ʻole
• ʻO Nusea a me ka luaʻi

Hana ʻia nā hoʻokolohua koko e nānā iā HCV:

• Enzyme immunoassay (EIA) e ʻike ai i ka maʻi pale HCV
• ʻO ka hopena Polymerase chain (PCR) e ʻike ai i ka maʻi ponoʻī ponoʻī, e ana i nā pae o ka maʻi (viral viral), a e ʻike ai i ke ʻano o ka maʻi hepatitis C

Pono nā mākua āpau i nā makahiki 18 a 79 i kahi hōʻoia hoʻokahi manawa no ka HCV. Nānā kēia hōʻike hōʻike loiloi no nā mea ʻino e kūʻē iā HCV (anti-HCV). Inā maikaʻi ka hōʻoia antibody, hoʻohana ʻia kahi hōʻike PCR e hōʻoia i ka maʻi HCV.

Hana ʻia kahi hoʻāʻo genetika hou e nānā no ke ʻano o ka HCV (genotype). Aia he ʻeono ʻano o ka maʻi (genotypes 1 a hiki i ka 6). Hiki i nā hopena hōʻoia ke kōkua i kāu kauka e koho i ka lapaʻau ʻoi aku ka maikaʻi iā ʻoe.

Hana ʻia nā mea e hōʻike aʻe nei e ʻike a nānā i ka hōʻino o ke ake mai ka HCV.

• Pae Albumin
• Nā hoʻāʻo hana ate
• Prothrombin manawa
• ʻO ka biopsy ate

Pono ʻoe e kamaʻilio me kāu kauka olakino e pili ana i kāu koho maʻi a i ka wā e hoʻomaka ai ka lāʻau.

• ʻO ka pahuhopu o ka mālama ʻana e hoʻopau i ke kino o ka maʻi. Hiki i kēia ke pale aku i nā hōʻino o ke ake e hiki ai i ke kī ʻole o ke ake a i ʻole ke kanesa maʻi ate.
• He mea nui ka mālama ʻana no ka poʻe e hōʻike ana i nā hōʻailona o ka fibrosis o ke ake a i ʻole ka scarring.

Hoʻohana ʻia nā lāʻau Antiviral e mālama iā HCV. Kōkua kēia mau lāʻau i ke kaua HCV. Nā lāʻau antiviral hou:

• Hāʻawi i kahi helu hōʻola i hoʻomaikaʻi maikaʻi ʻia
• Loaʻa nā hopena ʻē aʻe a ʻoi aku ka maʻalahi o ka lawe ʻana
• Lawe ʻia e ka waha no 8 a 24 mau pule

ʻO ke koho ʻana o nā lāʻau i pili i ka genotype o HCV āu.

Kākoʻo ʻia kahi hoʻoliʻiliʻi ate no ka poʻe e hoʻomohala i ka cirrhosis a me / a i ʻole ke kanesa maʻi ate. Hiki i kāu mea hoʻolako ke haʻi hou aku iā ʻoe e pili ana i ka lawe ʻana i ke ake.

Inā loaʻa iā HCV:

• Mai ʻai i nā lāʻau i loaʻa mai i ka lāʻau i loaʻa mai ʻole ma mua me ka noi ʻole ʻana i kāu mea hāʻawi. E nīnau hoʻi e pili ana i nā wikamina a me nā mea hoʻohui ʻē aʻe.
• Mai hoʻohana i ka wai ʻona a i ʻole nā ​​lāʻau lāʻau. Hiki i ka wai ʻona ke hoʻokuʻi i ka hōʻino o kou ake. Hiki iā ia ke hōʻemi i ka maikaʻi o ka hana ʻana o nā lāʻau.
• Inā hōʻike nā hōʻike ʻana i ke koko ʻaʻohe ou antibodies i ka hepatitis A a me ka B, pono ʻoe i nā lāʻau hepatitis A a me ka maʻi hepitis B. Inā ʻaʻole i loaʻa iā ʻoe kahi lāʻau lapaʻau no ka maʻi hepatitis A a ʻo B a i ʻole loaʻa kēia mau ʻano hepatitis iā ʻoe, pono paha ʻoe i ka lāʻau lapaʻau no lākou.

ʻO ka hui ʻana i kahi hui kākoʻo hiki ke kōkua i ka maʻalahi o ka loaʻa ʻana o ka HCV. E nīnau i kāu mea hāʻawi e pili ana i nā kumuwaiwai maʻi ate a me nā hui kākoʻo i kou wahi.

ʻO ka hapa nui o ka poʻe (75% a 85%) nā mea i loaʻa i ka maʻi maʻi e hoʻomōhala i ka HCV mau. Kūpono kēia ʻano no ka cirrhosis, ka maʻi ʻaʻai ate, a i ʻole ʻelua paha. Aia ke kuanaʻike no ka HCV ma ka ʻāpana o ka genotype.

Kūpono kahi pane maikaʻi i ka mālama ʻana inā ʻaʻole hiki ke ʻike hou ʻia ka maʻi ma ke koko he 12 mau pule a ʻoi paha ma hope o ka lapaʻau ʻana. Kapa ʻia kēia "pane virologic hoʻomau" (SVR). Aia i 90% o nā mea i mālama ʻia no kekahi mau genotypes i kēia ʻano pane.

ʻAʻole pane kekahi poʻe i ka lapaʻau mua. Pono lākou e mālama hou ʻia me kahi papa ʻokoʻa o nā lāʻau.

Eia kekahi, hiki i kekahi poʻe ke lilo i maʻi hou a maʻi paha me ka ʻokoʻa genotype ʻokoʻa.

Kāhea i kāu mea hāʻawi inā:

• Hoʻolālā ʻoe i nā ʻōuli o ka hepatitis
• Manaʻoʻiʻo ʻoe ua hōʻike ʻia ʻoe i ka HCV

Nā ʻanuʻu hiki ke hāpai ʻia e pale aku i ka hoʻolaha ʻana o ka HCV mai kekahi kanaka a i kekahi ʻē aʻe e komo pū.

• Pono nā limahana mālama olakino e mālama i ka mālama i ka mālama ʻana i ke koko.
• Mai kaʻana like i nā nila.
• Mai kiʻi i ka peʻa a i ʻole ke ʻoki kino a loaʻa ʻole ka acupuncture mai kekahi mea ʻaʻohe o lākou palapala ʻae a laikini paha.
• Mai hoʻokaʻawale i nā mea pilikino, e like me nā pahi razor a me nā palaki niho.
• Hoʻomaʻamaʻa i ka moekolohe palekana.

Inā maʻi ʻoe a ʻo kāu hoa paha me ka HCV a aia ʻoe i loko o kahi pilina paʻa a monogamous (ʻaʻohe hoa ʻē aʻe), ʻo ka makaʻu o ka hāʻawi ʻana i ka maʻi i, a i ʻole ke kiʻi ʻia ʻana o ka maʻi, ua haʻahaʻa ka mea ʻē aʻe.

ʻAʻole hiki ke hoʻolaha ʻia ʻo HCV e ka launa maʻamau, e like me ka paʻa ʻana o nā lima, ka honi ʻana, ka ʻū ʻana a i ʻole ka ʻū ʻana, ka hānai ʻana i ka waiū, kaʻana like ʻana i nā mea ʻai a i ʻole nā ​​aniani inu.

I kēia manawa ʻaʻohe lāʻau lapaʻau no HCV.

ʻO ka pane virologic i kākoʻo ʻia - hepatitis C; SVR - hepatitis C

• ʻŌnaehana Digestive
• Hepatitis C

Nā kikowaena no ka pūnaewele Disease Control a me Prevent. Nā nīnau a Hepatitis C no ka lehulehu. www.cdc.gov/hepatitis/hcv/cfaq.htm. Hoʻohou ʻia ʻApelila 20, 2020. Loaʻa iā Malaki 30, 2020.

Ghany MG, Morgan TR; AASLD-IDSA Pūnaewele Alakaʻi Hepatitis C. Hepatitis C Alakaʻi 2019 Hoʻohou: ʻōlelo aʻoaʻo AASLD-IDSA no ka hoʻāʻo ʻana, mālama ʻana, a me ka mālama ʻana i ka maʻi hepela C hepatitis. Hepatology. 2020; 71 (2): 686-721. PMID: 31816111 pubmed.ncbi.nlm.nih.gov/31816111/.

ʻO Jacobson IM, ʻo Lim JK, ʻo Fried MW. American Gastroenterological Association Institute hoʻomaʻamaʻa hoʻomaʻamaʻa hoʻomaikaʻi-loiloi loiloi: mālama o nā mea maʻi i loaʻa i ka hoʻomau virologic pane ma hope o antiviral therapy no ka maʻi hepatitis C maʻi mau. Gastroenterology. 2017; 152 (6): 1578-1587. PMID: 28344022 pubmed.ncbi.nlm.nih.gov/28344022/.

Naggie S, Wyles DL. Hepatitis C. I: Bennett JE, Dolin R, Blaser MJ, hua. ʻO Mandell, Douglas, a me Bennett's Principle a me ka hoʻomaʻamaʻa ʻana i nā maʻi kūpilikiʻi. 9th ed. Piladelapia, PA: Elsevier; 2020: chap 154.