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Ingabe kufanele uthole umuthi wokugoma i-hepatitis B?

Imfundo Yezempilo

I-Hepatitis B yisifo esingenza umonakalo omkhulu esibindini, kufaka phakathi isibazi saphakade (i-cirrhosis), umdlavuza wesibindi , ukwehluleka kwesibindi, isifo esingalapheki sesibindi, ngisho nokufa. Kubangelwa igciwane le-hepatitis B (HBV), elingatholakala egazini, isidoda, nolunye uketshezi lomzimba.

Ngokusho kwe- Izikhungo Zokulawulwa Nokuvikelwa Kwezifo (CDC) , cishe abantu abangama-22,000 kulelizwe baphila nokutheleleka okunamandla kwe-HBV (ukugula kwesikhashana), kuyilapho abacishe babe isigidi esisodwa benesifo sokusha kwesibindi kohlobo B. Okutheleleka — okungaveza izimpawu ezingacacile njengokukhathala, umkhuhlane nesisu - kungaba uvinjelwe ngomuthi wokugoma, kodwa akuwona wonke umuntu ogonywayo. Umuthi wokugomela i-hepatitis B uvame ukunconyelwa izingane / izingane kanye nabantu abadala emaqenjini athile asengozini enkulu. Kodwa njengoba i-hepatitis B ingukutheleleka lokho i-asymptomatic kuze kufike kokuthathu kwamacala futhi usabalale ngoketshezi okungaba nzima ukukugwema ngokuphelele, ungazibuza ukuthi ngabe wonke umuntu kufanele agonywe yini. Lapha, okudingeka ukwazi.

Ngubani odinga umuthi wokugoma i-hepatitis B?

Ngokusho kwe- Isisekelo se-Hepatitis B , Abantu baseMelika abangama-80,000 baba nesifo sokusha kwesibindi kohlobo B unyaka ngamunye. Emhlabeni jikelele, abantu ababili babulawa ukutheleleka njalo ngeminithi.

Kusukela 1991 , Kunconyiwe ukuthi zonke izingane ezisanda kuzalwa ezinempilo zithole umuthi wokugoma i-hepatitis B oqala ngemuva nje kokuzalwa. I-American Academy of Pediatrics (AAP) ithi izingane ezisanda kuzalwa ezinempilo kufanele zithole umthamo wazo wokuqala wokugoma kungakapheli amahora angama-24 ezelwe, kuthi umthamo wesibili ube nezinyanga ezi-1 kuya kwezi-2 ubudala, bese kuthi owesithathu nowokugcina ube phakathi kwezinyanga eziyisithupha kuya kwezi-18. Uma umama ozala umama ehlola ukuthi unesifo sokusha kwesibindi kohlobo B ngesikhathi sokukhulelwa (futhi abesifazane abakhulelwe bavame ukuhlolwa), lawo masethingi wezikhathi anganyuselwa phezulu, njengoba i-hepatitis B ingadluliselwa ngesikhathi sokubeletha.

Kungani izingane zidinga umuthi wokugoma i-hep B, ikakhulukazi uma zihlala phakathi kwabantu abadala abangekho eqenjini elisengozini enkulu? Ngoba abantu abaningi abanesifo segciwane le-hepatitis B abanasifo, futhi ukutheleleka kungasakazeka ngento engenacala njengesixubho samazinyo noma insingo yokushefa yomuntu onegciwane. Ngokusho kweSibhedlela Sezingane sasePhiladelphia (CHOP), i-hepatitis B itheleleka ngokuphindwe kayikhulu kune-HIV . Amaphesenti angama-95 ezingane ezithola yonke imithamo emithathu yomuthi wokugoma i-hep B zizovikeleka ezinkingeni ezibangelwa ukutheleleka, kusho i-AAP.

Esinye isizathu sokugoma abancane? I-AAP ibuye iphawule ukuthi abantu abangaphezu kwengxenye yabantu abadala ababulawa yisifo sokusha kwesibindi kohlobo B kuleli lizwe minyaka yonke bathola ukutheleleka besengabantwana. Uma ungumuntu omdala ongaqiniseki ukuthi wake wagonyelwa noma cha, ungathola ukuhlolwa kwegazi okuzohlola ukuzivikela komzimba - kodwa akulungile kuwo wonke umuntu; kufanele uhlole nomhlinzeki wakho ukuthola ukuthi ukuhlolwa kufanelekile yini.

Uma usuvele uvikelekile emzimbeni, ungakugwema ukuthola isibhamu esengeziwe nokwenza ukuvakashelwa emitholampilo okungadingeki, ikakhulukazi kule nkathi ye-COVID, amanothi Amon Asgharpour , MD, uprofesa osizayo kuDivision of Liver Diseases at Icahn School of Medicine eNtabeni iSinayi eNew York City. Kodwa-ke, ukufaka imithamo eyengeziwe yokugoma i-single-antigen hepatitis B akuyona ingozi.

Abanye okufanele bagonywe, kusho i- i-CDC , faka:

Abesilisa abaya ocansini noma ocansini namanye amadoda.
Abantu abekho ebudlelwaneni bobulili obubodwa bomuntu oyedwa.
Abantu abelashwa noma abahlolelwa izifo ezithathelwana ngocansi (STDs).
Abasebenzisi bezidakamizwa zokujova noma abanye abelana noma abasebenzisa izinaliti.
Abasebenzi bezempilo, abasebenzi bezokuphepha komphakathi, abantu ababoshiwe, nalabo abasebenza noma abahlala ezikhungweni zabantu abakhubazeke ngokwengqondo.
Abantu abangaxhumana nabo emindenini yalabo abahlola ukuthi bane-hepatitis B.
Labo abahamba beya ezindaweni zomhlaba (ngokwesibonelo, izingxenye ezithile ze-Eastern and Central Europe, i-Afrika, kanye neNingizimu neMelika Ephakathi) abanezinga eliphakeme lokusha kwesibindi kohlobo B.
Abantu abanezifo ezithile ezingalapheki, njengesifo sesibindi (kufaka phakathi i-hepatitis C ), isifo sikashukela, isifo sezinso, kanye nokutheleleka nge-HIV.
Iziguli zeHemodialysis (i-hemodialysis inqubo lapho kuhlungwa khona imfucuza yegazi; isetshenziswa ngabantu izinso zabo ezingasebenzi kahle).
Abesifazane abakhulelwe abanabalingani abaningi bezocansi, abasebenzisi bemithi efakwa emithanjeni, noma abahlolelwa i-STD, noma abalingani abathandekayo be-hepatitis B. Ngokwe-CDC, abesifazane abakhulelwe bangawuthola umuthi wokugoma ngokuphepha ngaphandle kokulimala ezinganeni zabo ezingakazalwa.

Kuthiwani uma uphumela ngaphandle kwazo zonke lezi zigaba — ngabe kufanele usagonywe? Ngenkathi ubungozi bangempela bokuthola ukutheleleka buhluka kakhulu kubantu bonke, umuthi wokugoma uphephe kakhulu futhi kulula ukuwuthola ukuthi bonke abantu abadala kufanele bawuthole, kungakhathalekile ubungozi babo, kusho uChristine Traxler, MD, udokotela osethathe umhlalaphansi osebenza njengodokotela, umbhali Nginengane: Yini manje?

Ukuphepha kokugoma nokusebenza ngempumelelo

Ngenxa yokugonywa kwezinsana okwandile kusukela ekuqaleni kweminyaka yama-1990, ukusabalala jikelele kwesifo sokusha kwesibindi kohlobo B kuye kwehla kakhulu kuleli. Kodwa-ke, ukutheleleka nge-HBV kuye kwanda eminyakeni embalwa edlule phakathi kwamaqembu athile, ikakhulukazi lawo aneminyaka engama-30 kuya kwengama-49 ubudala, kubika i Umnyango Wezempilo WaseMelika kanye Nezinsizakalo Zabantu (HHS) . I-ejensi ikhomba ukumbozwa kokugoma okungaphelele (umuthi wokugoma i-hepatitis B uvame ukunikezwa ochungechungeni lwemithi yokugoma) phakathi kwaleli qembu leminyaka kanye nokwanda kokusetshenziswa kwezidakamizwa, ikakhulukazi imishanguzo ye-opioid. Ngo-2015, amazinga okutheleleka ngokusha kwesibindi kohlobo B akhuphukile 20.7% , ukwanda kokuqala cishe kweminyaka eyi-10 kusho i-HHS.

Imishanguzo eminingi ye-hep B inikezwa ohlelweni lokugoma olubandakanya imithamo emithathu, ehlukaniswe izinyanga ezimbalwa ngokuhlukana. Ngo-2017, i-Food and Drug Administration (i-FDA) yavuma umuthi wokugomela imithamo emibili (obizwa nge- UHeplisav-B ) inikezwe izinsuku ezingama-30 zihlukanisiwe ukuze zisetshenziswe kubantu abadala. Uthola ukuphendula okuphezulu kwamasosha omzimba nokuhambisana kangcono nohlelo lwemithamo emibili, amanothi URobert G. Gish , MD, umqondisi wezokwelapha we-Hepatitis B Foundation.

Umuthi wokugoma i-hep B (ngaphezu kwe-Heplisav-B, amanye amagama egama afaka U-Engerix-B futhi I-Recombivax HB ibilokhu ikhona amashumi eminyaka. Yize kungekho owazi ngokuqinisekile ukuthi umuthi wokugoma unikeza amasosha omzimba isikhathi esingakanani, okungenani isifundo esisodwa kusuka ku-2016 kukhombisa ukuthi kungaba okungenani iminyaka engama-30. Ama-booster shots ngokuvamile awanconywa kubantu abaphilile abagonyiwe.

Umuthi wokugoma i-Hep B awusiwo umuthi wokugoma ophilayo, ngakho-ke uphephile ezinganeni ezisanda kuzalwa, izinsana, abesifazane abakhulelwe noma abancelisayo, kanye nabantu abangenakuzivikela.

UHep B imiphumela emibi yokugoma

Umuthi wokugoma awusebenzisi igazi noma imikhiqizo yegazi futhi kukhonjiswe ukuthi uphephile. Umphumela ojwayelekile kakhulu ukudabuka endaweni yokujova.Ngaphandle kwalokho, u-1 kuye ku-3% [walabo abagonywayo] babika ikhanda, ubuhlungu bamalunga, umkhuhlane osezingeni eliphansi, i-myalgia, noma i-malaise, kusho uDkt Asgharpour. Ngengozi ephansi yemiphumela emibi, nakanjani yenza ukugoma kukhange kakhulu kodokotela neziguli.

Ukusabela okweqile komzimba akuvamile, kepha nakanjani thola usizo lwezokwelapha olusheshayo kochwepheshe bezokunakekelwa kwezempilo uma uhlangabezana neminye yale miphumela emibi elandelayo:

Isifuba
Ukuvuvukala kobuso
Izinkinga ukuphefumula
Ukushaya kwenhliziyo okusheshayo
Isiyezi

Zingaba yizimpawu zokuphendula okuyingozi.

Ukutholakala komshuwalense nezindleko

Ngokusho kwe- i-CDC , zonke izinhlelo zemakethe yomshuwalense wezempilo kanye nabaningi bomshuwalense abazimele bazokhokhela izindleko zomuthi wokugoma i-hepatitis B uma usebenzisa umhlinzeki okwinethiwekhi. I-Medicare Part B izomboza umuthi wokugoma i-hepB uma useqenjini eliyingozi kakhulu. Inani lizohluka ngezici eziningi, kufaka phakathi uhlobo lomuthi wokugoma osetshenzisiwe nokuthi ngabe ungowokusetshenziswa kwezingane noma kwabantu abadala, kepha ngokujwayelekile umuthi wokugoma ungaba ngamanani kusuka ngaphansi kuka $ 13 kuye phezulu ku- $ 150 . Ungakwazi thola umuthi wokugoma ehhovisi lomhlinzeki wakho wezokunakekelwa kwempilo noma ngeminye iminyango yezempilo yendawo. Indawo yakho ekhemisi nayo ingakwazi ukuyilawula. Ngokukhulu ukonga ku-hepatitis B neminye imishanguzo etholakala ekhemisi lakho, sebenzisa ikhadi lakho le-SingleCare.

Ungazivikela kanjani ku-hepatitis B

Ngenkathi kunemithi elwa namagciwane engasiza ekunciphiseni nasekunciphiseni ukulimala kwesibindi izimbangela zesifo sokusha kwesibindi kohlobo B, alikho ikhambi. Ukuvimbela kuyisihluthulelo. Ngaphezu kokugonywa, ungasiza ukuzivikela ekuthelelekeni ngalezi zeluleko ezivela ku Isisekelo se-Hepatitis B :

Geza izandla zakho kahle ngensipho namanzi ngemuva kokuhlangana negazi noma olunye uketshezi lomzimba.
Sebenzisa isivikelo semigoqo (amakhondomu) uma uya ocansini.
Ungabelani ngamabhulashi wamazinyo, izinsingo, amacici, noma izigaxa zezinzipho.
Gwema ukusetshenziswa kwezidakamizwa ngemithambo.
Hlanza amaconsi egazi ezindaweni emva kokulimala ngesisombululo sengxenye eyodwa yebhlitshi ezingxenyeni eziyisishiyagalolunye zamanzi.
Qiniseka ukuthi kusetshenziswa izinaliti ezintsha noyinki noma nini lapho uthola ukubhoboza, i-tattoo, noma i-acupuncture futhi uthola lezi zinsizakalo kuphela ezitolo ezinelayisense.
Hlala usesikhathini ngayo yonke imigomo, ikakhulukazi i-hepatitis A.
Uma uzama ukukhulelwa noma ukhulelwe, khuluma nomhlinzeki wakho wezokunakekelwa kwezempilo mayelana nokuhlolwa kanye nokugoma kokuqala kwesifo sokusha kwesibindi.
Uma ungumhlinzeki wezokunakekelwa kwempilo noma osebenza obala, hlala usebenzisa izixwayiso ezinconyiwe zomhlaba wonke.
Uma ucabanga ukuthi une-hepatitis B, usengozini ye-hepatitis B, noma uvezwe, xhumana nomhlinzeki wakho ngokushesha okukhulu.