{"id":11499,"date":"2024-07-19T13:39:28","date_gmt":"2024-07-19T06:09:28","guid":{"rendered":"https:\/\/abtvn.com\/?p=11499"},"modified":"2025-08-06T12:15:42","modified_gmt":"2025-08-06T04:45:42","slug":"viem-gan-c-xet-nghiem-va-dieu-tri","status":"publish","type":"post","link":"https:\/\/abtvn.com\/en\/viem-gan-c-xet-nghiem-va-dieu-tri\/","title":{"rendered":"Vi\u00eam gan C – X\u00e9t nghi\u1ec7m v\u00e0 \u0111i\u1ec1u tr\u1ecb<\/strong>"},"content":{"rendered":"

Vi\u00eam gan C l\u00e0 m\u1ed9t trong nh\u1eefng nguy\u00ean nh\u00e2n g\u00e2y n\u00ean vi\u00eam gan m\u00e3n t\u00ednh d\u1eabn \u0111\u1ebfn x\u01a1 gan v\u00e0 ung th\u01b0 gan. B\u00e0i vi\u1ebft cung c\u1ea5p c\u00e1c th\u00f4ng tin li\u00ean quan \u0111\u1ebfn vi\u00eam gan C, c\u00e1c x\u00e9t nghi\u1ec7m v\u00e0 th\u00f4ng tin li\u00ean quan nh\u01b0: s\u1ef1 kh\u00e1c nhau c\u1ee7a vi\u00eam gan B v\u00e0 C, \u0111i\u1ec1u tr\u1ecb b\u1ec7nh v\u00e0 li\u1ec7u c\u00f3 kh\u1ea3 n\u0103ng t\u00e1i l\u1ea1i sau khi \u0111i\u1ec1u tr\u1ecb kh\u1ecfi hay kh\u00f4ng? <\/p>\n\n\n\n

1. Vi\u00eam gan C <\/strong><\/h2>\n\n\n\n

1.1 T\u1ed5ng quan vi\u00eam gan C<\/strong><\/h3>\n\n\n\n

Virus Vi\u00eam gan C, ban \u0111\u1ea7u \u0111\u01b0\u1ee3c bi\u1ebft \u0111\u1ebfn nh\u01b0 m\u1ed9t lo\u1ea1i “vi-r\u00fat g\u00e2y t\u1ed5n th\u01b0\u01a1ng gan” (kh\u00f4ng ph\u1ea3i Vi\u00eam gan A hay B), \u0111\u01b0\u1ee3c x\u00e1c \u0111\u1ecbnh ch\u00ednh x\u00e1c v\u00e0o n\u0103m 1989 v\u1edbi t\u00ean g\u1ecdi Hepatitis C (HCV). Theo T\u1ed5 ch\u1ee9c Y t\u1ebf Th\u1ebf gi\u1edbi (WHO), n\u0103m 2021, c\u00f3 kho\u1ea3ng 58 tri\u1ec7u ca nhi\u1ec5m HCV m\u00e3n t\u00ednh to\u00e0n c\u1ea7u, v\u1edbi 1,5 tri\u1ec7u ca nhi\u1ec5m m\u1edbi m\u1ed7i n\u0103m v\u00e0 399.000 ca t\u1eed vong.<\/p>\n\n\n\n

Vi\u00eam gan C l\u00e0 m\u1ed9t b\u1ec7nh truy\u1ec1n nhi\u1ec5m g\u00e2y t\u1ed5n th\u01b0\u01a1ng gan do virus HCV g\u00e2y ra. HCV c\u00f3 k\u00edch th\u01b0\u1edbc nh\u1ecf (55-65nm), thu\u1ed9c chi Hepacivirus, h\u1ecd Flaviviridae, v\u00e0 c\u00f3 v\u1eadt ch\u1ea5t di truy\u1ec1n l\u00e0 RNA s\u1ee3i \u0111\u01a1n d\u01b0\u01a1ng t\u00ednh. Virus n\u00e0y c\u00f3 c\u1ea5u tr\u00fac \u0111a di\u1ec7n \u0111\u1ec1u, v\u1edbi l\u1edbp v\u1ecf lipid ngo\u00e0i c\u00f9ng ch\u1ee9a glycoprotein E1 v\u00e0 E2. RNA c\u1ee7a virus d\u00e0i 9600 nucleotide, m\u00e3 h\u00f3a m\u1ed9t chu\u1ed7i protein \u0111\u01a1n kho\u1ea3ng 3300 acid amin v\u00e0 c\u00e1c protein nh\u1ecf kh\u00e1c.<\/p>\n\n\n\n

HCV c\u00f3 7 ki\u1ec3u gen ch\u00ednh (1 \u0111\u1ebfn 7) v\u00e0 67 ki\u1ec3u ph\u1ee5, trong \u0111\u00f3 c\u00e1c ki\u1ec3u gen 1, 2, 3 v\u00e0 6 ph\u1ed5 bi\u1ebfn v\u00e0 g\u00e2y b\u1ec7nh ch\u00ednh t\u1ea1i Vi\u1ec7t Nam. RNA virus c\u00f3 c\u00e1c \u0111\u1ea7u 5\u2019URT v\u00e0 3\u2019URT tham gia v\u00e0o qu\u00e1 tr\u00ecnh d\u1ecbch m\u00e3 v\u00e0 sao ch\u00e9p. RNA m\u00e3 h\u00f3a cho 11 protein kh\u00e1c nhau chia th\u00e0nh hai nh\u00f3m:<\/p>\n\n\n\n

    \n
  1. Nh\u00f3m protein c\u1ea5u tr\u00fac g\u1ed3m protein l\u00f5i C, protein v\u1ecf E1 v\u00e0 E2. E1 h\u1ed7 tr\u1ee3 dung h\u1ee3p v\u00e0o t\u1ebf b\u00e0o ch\u1ee7, c\u00f2n E2 ho\u1ea1t \u0111\u1ed9ng nh\u01b0 th\u1ee5 th\u1ec3 ti\u1ebfp nh\u1eadn.<\/li>\n\n\n\n
  2. Nh\u00f3m protein phi c\u1ea5u tr\u00fac g\u1ed3m P7, NS2, NS3, NS4A, NS4B, NS5A v\u00e0 NS5, tham gia v\u00e0o c\u00e1c qu\u00e1 tr\u00ecnh x\u00e2m nh\u1eadp, nh\u00e2n l\u00ean v\u00e0 ho\u00e0n thi\u1ec7n virus.<\/li>\n<\/ol>\n\n\n\n
    \"c\u1ea5u
    H\u00ecnh 1: c\u1ea5u tr\u00fac virus vi\u00eam gan C<\/figcaption><\/figure>\n\n\n\n

    HCV x\u00e2m nh\u1eadp v\u00e0o t\u1ebf b\u00e0o gan qua th\u1ee5 th\u1ec3 \u0111\u1eb7c hi\u1ec7u tr\u00ean b\u1ec1 m\u1eb7t t\u1ebf b\u00e0o, ti\u1ebfn h\u00e0nh nh\u1eadp b\u00e0o (endocytosis), v\u00e0 gi\u1ea3i ph\u00f3ng RNA. RNA \u0111\u01b0\u1ee3c d\u1ecbch m\u00e3, c\u1eaft th\u00e0nh c\u00e1c \u0111o\u1ea1n m\u00e3 h\u00f3a v\u00e0 kh\u00f4ng m\u00e3 h\u00f3a protein, nh\u00e2n \u0111\u00f4i v\u00e0 t\u1ed5ng h\u1ee3p HCV-RNA m\u1edbi. Virus ho\u00e0n ch\u1ec9nh sau \u0111\u00f3 \u0111\u01b0\u1ee3c t\u1ea1o th\u00e0nh qua b\u1ed9 m\u00e1y Golgi, ph\u00e1 v\u1ee1 t\u1ebf b\u00e0o gan, v\u00e0 ti\u1ebfp t\u1ee5c x\u00e2m nhi\u1ec5m c\u00e1c t\u1ebf b\u00e0o kh\u00e1c.<\/p>\n\n\n\n

    1.2 Nguy\u00ean nh\u00e2n nhi\u1ec5m Vi\u00eam gan C <\/strong><\/h3>\n\n\n\n

    Virus vi\u00eam gan C (HCV) l\u00e2y truy\u1ec1n qua ba con \u0111\u01b0\u1eddng: <\/p>\n\n\n\n

      \n
    1. \u0110\u01b0\u1eddng m\u00e1u<\/li>\n\n\n\n
    2. \u0110\u01b0\u1eddng t\u00ecnh d\u1ee5c<\/li>\n\n\n\n
    3. T\u1eeb m\u1eb9 sang con khi sinh. <\/li>\n<\/ol>\n\n\n\n

      L\u00e2y truy\u1ec1n qua \u0111\u01b0\u1eddng m\u00e1u c\u00f3 t\u1ef7 l\u1ec7 cao nh\u1ea5t, do ti\u1ebfp x\u00fac v\u1edbi m\u00e1u ho\u1eb7c c\u00e1c v\u1eadt d\u1ee5ng c\u00e1 nh\u00e2n c\u00f3 th\u1ec3 g\u00e2y tr\u1ea7y x\u01b0\u1edbc. Quan h\u1ec7 t\u00ecnh d\u1ee5c kh\u00f4ng an to\u00e0n v\u1edbi ng\u01b0\u1eddi nhi\u1ec5m b\u1ec7nh c\u0169ng c\u00f3 th\u1ec3 l\u00e2y truy\u1ec1n HCV. M\u1eb7c d\u00f9 HCV l\u00e2y truy\u1ec1n t\u1eeb m\u1eb9 sang con c\u00f3 t\u1ef7 l\u1ec7 th\u1ea5p (kho\u1ea3ng 5%), vi\u1ec7c sinh th\u01b0\u1eddng hay sinh m\u1ed5 \u0111\u1ec1u c\u00f3 nguy c\u01a1. <\/p>\n\n\n\n

      Virus HCV kh\u00f4ng l\u00e2y qua s\u1eefa m\u1eb9, nh\u01b0ng c\u1ea7n th\u1eadn tr\u1ecdng khi cho con b\u00fa. M\u1ed9t s\u1ed1 b\u1ec7nh nh\u00e2n kh\u00f4ng bi\u1ebft r\u00f5 nguy\u00ean nh\u00e2n l\u00e2y nhi\u1ec5m. Vi\u00eam gan C l\u00e0 b\u1ec7nh truy\u1ec1n nhi\u1ec5m nguy hi\u1ec3m v\u1edbi t\u1ef7 l\u1ec7 t\u1eed vong cao v\u00e0 c\u00f3 th\u1ec3 g\u00e2y suy gan, x\u01a1 gan, ho\u1eb7c ung th\u01b0 gan. Hi\u1ec7n ch\u01b0a c\u00f3 v\u1eafc-xin ph\u00f2ng ng\u1eeba vi\u00eam gan C.<\/p>\n\n\n\n

      1.3 S\u1ef1 kh\u00e1c nhau c\u1ee7a vi\u00eam gan C v\u00e0 vi\u00eam gan B <\/strong><\/h3>\n\n\n\n

      Vi\u00eam gan B v\u00e0 vi\u00eam gan C \u0111\u1ec1u l\u00e0 b\u1ec7nh vi\u00eam gan do virus v\u1edbi c\u00e1c tri\u1ec7u ch\u1ee9ng t\u01b0\u01a1ng t\u1ef1 nhau. S\u1ef1 kh\u00e1c bi\u1ec7t ch\u00ednh gi\u1eefa hai lo\u1ea1i vi\u00eam gan n\u00e0y l\u00e0 vi\u00eam gan B c\u00f3 th\u1ec3 l\u00e2y truy\u1ec1n qua ti\u1ebfp x\u00fac v\u1edbi c\u00e1c d\u1ecbch c\u01a1 th\u1ec3 c\u1ee7a ng\u01b0\u1eddi nhi\u1ec5m b\u1ec7nh, trong khi vi\u00eam gan C ch\u1ee7 y\u1ebfu l\u00e2y qua \u0111\u01b0\u1eddng m\u00e1u.<\/p>\n\n\n\n

      C\u1ea3 vi\u00eam gan B v\u00e0 C \u0111\u1ec1u kh\u00f4ng l\u00e2y qua \u0111\u01b0\u1eddng h\u00f4 h\u1ea5p, qua s\u1eefa m\u1eb9, khi d\u00f9ng chung th\u1ee9c \u0103n ho\u1eb7c khi \u00f4m ng\u01b0\u1eddi b\u1ecb nhi\u1ec5m b\u1ec7nh.Nhi\u1ec1u ng\u01b0\u1eddi m\u1eafc vi\u00eam gan kh\u00f4ng nh\u1eadn ra m\u00ecnh b\u1ecb b\u1ec7nh cho \u0111\u1ebfn khi b\u1ec7nh \u0111\u00e3 ti\u1ebfn tri\u1ec3n n\u1eb7ng.<\/p>\n\n\n\n

      2. C\u00e1c x\u00e9t nghi\u1ec7m vi\u00eam gan C hi\u1ec7n t\u1ea1i <\/strong><\/h2>\n\n\n\n

      2.1 X\u00e9t nghi\u1ec7m men gan<\/strong><\/h3>\n\n\n\n

      Hi\u1ec7n nay, hai lo\u1ea1i x\u00e9t nghi\u1ec7m ch\u1ee9c n\u0103ng gan ph\u1ed5 bi\u1ebfn l\u00e0 ALT v\u00e0 AST. Khi gan ho\u1ea1t \u0111\u1ed9ng b\u00ecnh th\u01b0\u1eddng, c\u1ea3 hai ch\u1ec9 s\u1ed1 n\u00e0y \u0111\u1ec1u d\u01b0\u1edbi 40UI. N\u1ebfu c\u00f3 b\u1ec7nh l\u00fd v\u1ec1 gan, c\u00e1c ch\u1ec9 s\u1ed1 n\u00e0y c\u00f3 th\u1ec3 t\u0103ng g\u1ea5p 2 \u0111\u1ebfn 3 l\u1ea7n. Vi\u1ec7c x\u00e9t nghi\u1ec7m n\u00e0y gi\u00fap \u0111\u00e1nh gi\u00e1 m\u1ee9c \u0111\u1ed9 nghi\u00eam tr\u1ecdng c\u1ee7a b\u1ec7nh.<\/p>\n\n\n\n

      \"\"<\/figure>\n\n\n\n

      2.2 X\u00e9t nghi\u1ec7m anti-HCV<\/strong><\/h3>\n\n\n\n

      X\u00e9t nghi\u1ec7m n\u00e0y gi\u00fap s\u00e0ng l\u1ecdc b\u1ec7nh nh\u00e2n vi\u00eam gan C, m\u1ed9t trong nh\u1eefng nguy\u00ean nh\u00e2n d\u1eabn \u0111\u1ebfn ung th\u01b0 gan. Anti-HCV l\u00e0 kh\u00e1ng th\u1ec3 ch\u1ed1ng l\u1ea1i virus HCV. K\u1ebft qu\u1ea3 x\u00e9t nghi\u1ec7m c\u00f3 th\u1ec3 nh\u01b0 sau:<\/p>\n\n\n\n