{"id":9899,"date":"2019-05-19T21:20:20","date_gmt":"2019-05-19T14:20:20","guid":{"rendered":"https:\/\/www.vnras.com\/drug\/?p=9899"},"modified":"2019-06-10T14:13:39","modified_gmt":"2019-06-10T07:13:39","slug":"viem-gan-c","status":"publish","type":"post","link":"https:\/\/vnras.com\/drug\/viem-gan-c\/","title":{"rendered":"Vi\u00eam gan C"},"content":{"rendered":"

Vi\u00eam gan C l\u00e0 g\u00ec?<\/h2>\n
Vi\u00eam gan C<\/strong><\/a> l\u00e0 t\u00ecnh tr\u1ea1ng gan b\u1ecb vi\u00eam, g\u00e2y ra b\u1edfi virus HCV \u2013 m\u1ed9t lo\u1ea1i virus c\u00f3 kh\u1ea3 n\u0103ng x\u00e2m nh\u1eadp v\u00e0o t\u00ea b\u00e0o gan qua m\u00e1u. Tri\u1ec7u ch\u1ee9ng th\u00f4ng th\u01b0\u1eddng c\u00f3 th\u1ec3 ch\u1ec9 l\u00e0 m\u1ec7t m\u1ecfi k\u00e9o d\u00e0i trong v\u00e0i tu\u1ea7n ho\u1eb7c m\u1ec7t m\u1ecfi k\u00e9o d\u00e0i. Vi\u00eam gan C \u0111\u01b0\u1ee3c coi l\u00e0 c\u1ea5p t\u00ednh khi m\u1edbi nhi\u1ec5m virus ho\u1eb7c m\u1ea1n t\u00ednh khi nhi\u1ec5m virus su\u1ed1t m\u1ed9t th\u1eddi gian d\u00e0i. Vi\u00eam gan C l\u00e0 m\u1ed9t trong nh\u1eefng nguy\u00ean nh\u00e2n l\u1edbn d\u1eabn t\u1edbi x\u01a1 gan (27%) c\u0169ng nh\u01b0 ung th\u01b0 bi\u1ec3u m\u00f4 t\u1ebf b\u00e0o gan (HCC) (25%) tr\u00ean to\u00e0n th\u1ebf gi\u1edbi. Hi\u1ec7n nay, thu\u1ed1c kh\u00e1ng virus vi\u00eam gan C \u0111\u00e3 c\u00f3 th\u1ec3 ch\u1eefa kh\u1ecfi cho h\u01a1n 95% s\u1ed1 b\u1ec7nh nh\u00e2n vi\u00eam gan C, nh\u1edd \u0111\u00f3 l\u00e0m gi\u1ea3m nguy c\u01a1 t\u1eed vong do x\u01a1 gan v\u00e0 ung th\u01b0 gan ti\u1ebfn tri\u1ec3n nh\u01b0ng s\u1ed1 l\u01b0\u1ee3ng b\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n v\u00e0 ti\u1ebfp c\u1eadn \u0111i\u1ec1u tr\u1ecb c\u00f2n h\u1ea1n ch\u1ebf.<\/p>\n
$\"Vi\u00eam$ H\u00ecnh \u1ea3nh: c\u1ea5u t\u1ea1o virus Vi\u00eam gan C<\/figcaption><\/figure>\n
Tri\u1ec7u ch\u1ee9ng c\u1ee7a b\u1ec7nh vi\u00eam gan C<\/h2>\n
Vi\u00eam gan C c\u1ea5p t\u00ednh x\u1ea3y ra trong v\u00f2ng 6 th\u00e1ng \u0111\u1ea7u sau khi b\u1ec7nh nh\u00e2n ph\u01a1i nhi\u1ec5m v\u1edbi virus HCV. Virus c\u00f3 th\u1ec3 g\u00e2y ra t\u00ecnh tr\u1ea1ng m\u1ec7t m\u1ecfi trong m\u1ed9t kho\u1ea3ng th\u1eddi gian ng\u1eafn. Tuy nhi\u00ean, \u1edf h\u1ea7u h\u1ebft b\u1ec7nh nh\u00e2n (75-85% b\u1ec7nh nh\u00e2n), t\u00ecnh tr\u1ea1ng vi\u00eam gan C c\u1ea5p t\u00ednh s\u1ebd d\u1eabn t\u1edbi vi\u00eam gan C m\u1ea1n t\u00ednh. \u1ede c\u00e1c b\u1ec7nh nh\u00e2n c\u00f2n l\u1ea1i, virus vi\u00eam gan C \u0111\u01b0\u1ee3c lo\u1ea1i b\u1ecf kh\u1ecfi c\u01a1 th\u1ec3 m\u00e0 kh\u00f4ng c\u1ea7n \u0111i\u1ec1u tr\u1ecb v\u00e0 c\u0169ng kh\u00f4ng d\u1eabn t\u1edbi t\u00ecnh tr\u1ea1ng vi\u00eam gan C m\u1ea1n t\u00ednh. C\u00e1c nh\u00e0 khoa h\u1ecdc v\u1eabn ch\u01b0a th\u1ec3 gi\u1ea3i th\u00edch \u0111\u1ea7y \u0111\u1ee7 v\u1ec1 hi\u1ec7n t\u01b0\u1ee3ng n\u00e0y.<\/p>\n
Tri\u1ec7u ch\u1ee9ng c\u1ee7a b\u1ec7nh nh\u00e2n vi\u00eam gan C c\u1ea5p t\u00ednh kh\u00f4ng c\u00f3 g\u00ec kh\u00e1c bi\u1ec7t so v\u1edbi c\u00e1c t\u00ecnh tr\u1ea1ng vi\u00eam gan c\u1ea5p t\u00ednh kh\u00e1c v\u1edbi c\u00e1c tri\u1ec7u ch\u1ee9ng nh\u01b0 m\u1ec7t m\u1ecfi, s\u1ed1t nh\u1eb9, ch\u00e1n \u0103n, n\u00f4n v\u00e0 bu\u1ed3n n\u00f4n, \u0111au \u0111\u1ee5ng,\u2026 H\u1ea7u h\u1ebft c\u00e1c ca vi\u00eam gan C c\u1ea5p t\u00ednh kh\u00f4ng c\u00f3 bi\u1ec3u hi\u1ec7n v\u00e0ng da.<\/p>\n
Vi\u00eam gan C m\u1ea1n t\u00ednh c\u00f3 th\u1ec3 l\u00e0 b\u1ec7nh l\u00fd k\u00e9o d\u00e0i su\u1ed1t \u0111\u1eddi n\u1ebfu b\u1ec7nh nh\u00e2n kh\u00f4ng \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb. Trong t\u00ecnh tr\u1ea1ng kh\u00f4ng \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb, vi\u00eam gan C m\u1ea1n t\u00ednh c\u00f3 th\u1ec3 g\u00e2y ra nhi\u1ec1u v\u1ea5n \u0111\u1ec1 s\u1ee9c kh\u1ecfe nghi\u00eam tr\u1ecdng \u1edf ng\u01b0\u1eddi b\u1ec7nh, ph\u00e1 h\u1ee7y t\u1ebf b\u00e0o gan, x\u01a1 gan, ung th\u01b0 gan, th\u1eadm ch\u00ed t\u1eed vong.<\/p>\n
B\u1ec7nh nh\u00e2n vi\u00eam gan C m\u1ea1n t\u00ednh th\u01b0\u1eddng kh\u00f4ng c\u00f3 tri\u1ec7u ch\u1ee9ng n\u00e0o r\u00f5 r\u1ec7t. C\u00f3 kho\u1ea3ng 10-30% b\u1ec7nh nh\u00e2n vi\u00eam gan C m\u1ea1n t\u00ednh s\u1ebd d\u1eabn t\u1edbi t\u00ecnh tr\u1ea1ng x\u01a1 gan trong kho\u1ea3ng 20 n\u0103m. M\u1ed7i n\u0103m c\u00f3 kho\u1ea3ng 1-5% b\u1ec7nh nh\u00e2n vi\u00eam gan C m\u1ea1n t\u00ednh c\u00f3 x\u01a1 gan s\u1ebd d\u1eabn \u0111\u1ebfn ung th\u01b0 bi\u1ec3u m\u00f4 t\u1ebf b\u00e0o gan (HCC) c\u0169ng nh\u01b0 3-6% s\u1ed1 b\u1ec7nh nh\u00e2n x\u01a1 gan m\u1ea5t b\u00f9 s\u1ebd t\u1eed vong trong n\u0103m k\u1ebf ti\u1ebfp. Nh\u1eefng b\u1ec7nh nh\u00e2n b\u1ecb x\u01a1 gan c\u00f3 nguy c\u01a1 ti\u1ebfn tri\u1ec3n th\u00e0nh ung th\u01b0 bi\u1ec3u m\u00f4 t\u1ebf b\u00e0o gan cao h\u01a1n g\u1ea5p 20 l\u1ea7n so v\u1edbi th\u00f4ng th\u01b0\u1eddng, n\u1ebfu c\u00f3 k\u00e8m th\u00eam nghi\u1ec7n r\u01b0\u1ee3u th\u00ec nguy c\u01a1 s\u1ebd cao g\u1ea5p 100 l\u1ea7n. T\u1ed1c \u0111\u1ed9 ti\u1ebfn tri\u1ec3n b\u1ec7nh vi\u00eam gan C t\u1edbi suy gan c\u00f3 th\u1ec3 t\u0103ng l\u00ean do nhi\u1ec1u y\u1ebfu t\u1ed1. Nam gi\u1edbi th\u01b0\u1eddng c\u00f3 nguy c\u01a1 cao h\u01a1n n\u1eef gi\u1edbi, nh\u1eefng ng\u01b0\u1eddi tr\u00ean 50 tu\u1ed5i c\u0169ng c\u00f3 nguy c\u01a1 cao h\u01a1n. Nh\u1eefng b\u1ec7nh nh\u00e2n c\u00f3 m\u1eafc k\u00e8m HBV\/HIV, nh\u1eefng b\u1ec7nh nh\u00e2n c\u00f3 b\u1ec7nh l\u00fd gan nhi\u1ec5m m\u1ee1 kh\u00f4ng do r\u01b0\u1ee3u, hay nh\u1eefng b\u1ec7nh nh\u00e2n \u0111ang s\u1eed d\u1ee5ng li\u1ec7u ph\u00e1p \u1ee9c ch\u1ebf mi\u1ec5n d\u1ecbch \u0111\u1ec1u c\u00f3 nguy c\u01a1 d\u1eabn t\u1edbi suy gan cao h\u01a1n.<\/p>\n
$\"Vi\u00eam$ <\/p>\n
Vi\u00eam gan C m\u1ea1n t\u00ednh c\u00f3 th\u1ec3 l\u00e0 b\u1ec7nh l\u00fd k\u00e9o d\u00e0i su\u1ed1t \u0111\u1eddi n\u1ebfu b\u1ec7nh nh\u00e2n kh\u00f4ng \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb. Trong t\u00ecnh tr\u1ea1ng kh\u00f4ng \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb, vi\u00eam gan C m\u1ea1n t\u00ednh c\u00f3 th\u1ec3 g\u00e2y ra nhi\u1ec1u v\u1ea5n \u0111\u1ec1 s\u1ee9c kh\u1ecfe nghi\u00eam tr\u1ecdng \u1edf ng\u01b0\u1eddi b\u1ec7nh, ph\u00e1 h\u1ee7y t\u1ebf b\u00e0o gan, x\u01a1 gan, ung th\u01b0 gan, th\u1eadm ch\u00ed t\u1eed vong.<\/p>\n
$\"Vi\u00eam$ <\/p>\n
B\u1ec7nh nh\u00e2n vi\u00eam gan C m\u1ea1n t\u00ednh th\u01b0\u1eddng kh\u00f4ng c\u00f3 tri\u1ec7u ch\u1ee9ng n\u00e0o r\u00f5 r\u1ec7t. C\u00f3 kho\u1ea3ng 10-30% b\u1ec7nh nh\u00e2n vi\u00eam gan C m\u1ea1n t\u00ednh s\u1ebd d\u1eabn t\u1edbi t\u00ecnh tr\u1ea1ng x\u01a1 gan trong kho\u1ea3ng 20 n\u0103m [5]. M\u1ed7i n\u0103m c\u00f3 kho\u1ea3ng 1-5% b\u1ec7nh nh\u00e2n vi\u00eam gan C m\u1ea1n t\u00ednh c\u00f3 x\u01a1 gan s\u1ebd d\u1eabn \u0111\u1ebfn ung th\u01b0 bi\u1ec3u m\u00f4 t\u1ebf b\u00e0o gan (HCC) c\u0169ng nh\u01b0 3-6% s\u1ed1 b\u1ec7nh nh\u00e2n x\u01a1 gan m\u1ea5t b\u00f9 s\u1ebd t\u1eed vong trong n\u0103m k\u1ebf ti\u1ebfp [3]. Nh\u1eefng b\u1ec7nh nh\u00e2n b\u1ecb x\u01a1 gan c\u00f3 nguy c\u01a1 ti\u1ebfn tri\u1ec3n th\u00e0nh ung th\u01b0 bi\u1ec3u m\u00f4 t\u1ebf b\u00e0o gan cao h\u01a1n g\u1ea5p 20 l\u1ea7n so v\u1edbi th\u00f4ng th\u01b0\u1eddng, n\u1ebfu c\u00f3 k\u00e8m th\u00eam nghi\u1ec7n r\u01b0\u1ee3u th\u00ec nguy c\u01a1 s\u1ebd cao g\u1ea5p 100 l\u1ea7n [11]. T\u1ed1c \u0111\u1ed9 ti\u1ebfn tri\u1ec3n b\u1ec7nh vi\u00eam gan C t\u1edbi suy gan c\u00f3 th\u1ec3 t\u0103ng l\u00ean do nhi\u1ec1u y\u1ebfu t\u1ed1. Nam gi\u1edbi th\u01b0\u1eddng c\u00f3 nguy c\u01a1 cao h\u01a1n n\u1eef gi\u1edbi, nh\u1eefng ng\u01b0\u1eddi tr\u00ean 50 tu\u1ed5i c\u0169ng c\u00f3 nguy c\u01a1 cao h\u01a1n. Nh\u1eefng b\u1ec7nh nh\u00e2n c\u00f3 m\u1eafc k\u00e8m HBV\/HIV, nh\u1eefng b\u1ec7nh nh\u00e2n c\u00f3 b\u1ec7nh l\u00fd gan nhi\u1ec5m m\u1ee1 kh\u00f4ng do r\u01b0\u1ee3u, hay nh\u1eefng b\u1ec7nh nh\u00e2n \u0111ang s\u1eed d\u1ee5ng li\u1ec7u ph\u00e1p \u1ee9c ch\u1ebf mi\u1ec5n d\u1ecbch \u0111\u1ec1u c\u00f3 nguy c\u01a1 d\u1eabn t\u1edbi suy gan cao h\u01a1n[3].<\/p>\n
Virus h\u1ecdc<\/h2>\n
Virus HCV thu\u1ed9c nh\u00f3m Flaviviridea, l\u00e0 nh\u00f3m virus c\u00f3 v\u1eadt ch\u1ea5t di truy\u1ec1n l\u00e0 ARN chu\u1ed7i \u0111\u01a1n. HCV c\u00f3 7 ki\u1ec3u gen ch\u00ednh \u0111\u00e1nh s\u1ed1 k\u00ed hi\u1ec7u t\u1eeb 1 t\u1edbi 7. \u1ede Vi\u1ec7t Nam, type 1, 2, 3, v\u00e0 6 l\u00e0 c\u00e1c type g\u00e2y b\u1ec7nh ch\u1ee7 y\u1ebfu.<\/p>\n
HCV c\u00f3 l\u1edbp ngo\u00e0i c\u00f9ng l\u00e0 m\u00e0ng lipid k\u00e9p kh\u1ea3m c\u00e1c gai Protein E. B\u00ean trong l\u1edbp m\u00e0ng lipid k\u00e9p l\u00e0 l\u1edbp m\u00e0ng l\u00f5i nucleocapsid. B\u00ean trong l\u1edbp m\u00e0ng l\u00f5i l\u00e0 chu\u1ed7i \u0111\u01a1n ARN c\u1ee7a virus.<\/p>\n
ARN c\u1ee7a virus d\u00e0i 9600 nucleotid, m\u00e3 h\u00f3a kho\u1ea3ng 3300 acid amin. Tr\u00ecnh t\u1ef1 acid amin h\u01a1i c\u00f3 s\u1ef1 kh\u00e1c nhau gi\u1eefa c\u00e1c type HCV kh\u00e1c nhau. Chu\u1ed7i ARN c\u00f3 hai \u0111\u1ea7u 5\u2019URT (341 nucleotid) v\u00e0 3\u2019URT (223 nucleotid) kh\u00f4ng m\u00e3 h\u00f3a tr\u1ef1c ti\u1ebfp c\u00e1c acid amin nh\u01b0ng tham gia v\u00e0o kh\u1edfi \u0111\u1ed9ng d\u1ecbch m\u00e3 c\u0169ng nh\u01b0 t\u00edn hi\u1ec7u nh\u00e2n b\u1ea3n virus. Ph\u00e2n t\u1eed ARN virus m\u00e3 h\u00f3a cho 11 ph\u00e2n t\u1eed protein kh\u00e1c nhau, chia l\u00e0m 2 nh\u00f3m. Nh\u00f3m Protein tham gia t\u1ea1o khung c\u1ea5u tr\u00fac virus g\u1ed3m protein l\u00f5i C, protein v\u1ecf E1, v\u00e0 E2. Nh\u00f3m protein kh\u00f4ng tham gia v\u00e0o c\u1ea5u tr\u00fac virus g\u1ed3m P7, NS2, NS3, NS4A, NS4B, NS5A, NS5; tham gia v\u00e0o c\u00e1c qu\u00e1 tr\u00ecnh t\u01b0\u01a1ng t\u00e1c v\u1edbi h\u1ec7 mi\u1ec5n d\u1ecbch c\u1ee7a c\u01a1 th\u1ec3 c\u0169ng nh\u01b0 c\u00e1c qu\u00e1 tr\u00ecnh x\u00e2m nh\u1eadp, nh\u00e2n l\u00ean, ho\u00e0n thi\u1ec7n virus m\u1edbi.<\/p>\n
HCV x\u00e2m nh\u1eadp v\u00e0o t\u1ebf b\u00e0o gan sau khi li\u00ean k\u1ebft v\u1edbi m\u1ed9t receptor \u0111\u1eb7c hi\u1ec7u \u0111\u1ec3 nh\u1eadp b\u00e0o (endocytosis). Sau khi ph\u00e1 v\u1ecf virus, RNA c\u1ee7a virus \u0111\u01b0\u1ee3c d\u1ecbch m\u00e3 th\u00e0nh ti\u1ec1n protein c\u1ee7a virus. Ph\u00e2n t\u1eed ti\u1ec1n protein n\u00e0y \u0111\u01b0\u1ee3c c\u1eaft th\u00e0nh c\u00e1c nhi\u1ec1u \u0111o\u1ea1n nh\u1ecf, c\u00f3 \u0111o\u1ea1n s\u1ebd c\u1ea5u tr\u00fac l\u1ea1i th\u00e0nh c\u00e1c protein c\u1ea5u tr\u00fac c\u1ee7a virus (C, E1, E2), c\u00e1c \u0111o\u1ea1n kh\u00f4ng m\u00e3 h\u00f3a protein c\u0169ng c\u00f3 nh\u1eefng vai tr\u00f2 trong vi\u1ec7c \u1ee9c ch\u1ebf ho\u1ea1t \u0111\u1ed9ng c\u1ee7a h\u1ec7 th\u1ed1ng mi\u1ec5n d\u1ecbch. C\u00e1c th\u00e0nh ph\u1ea7n c\u1ea5u t\u1ea1o c\u1ee7a virus \u0111\u01b0\u1ee3c t\u1ea1o ra v\u00e0 gi\u1ea3i ph\u00f3ng \u1edf l\u01b0\u1edbi n\u1ed9i ch\u00e2t, \u0111\u01b0\u1ee3c t\u1ed5ng h\u1ee3p v\u00e0 t\u1ea1o th\u00e0nh virus ho\u00e0n ch\u1ec9nh sau khi \u0111i qua b\u1ed9 m\u00e1y Golgi. Virus ho\u00e0n ch\u1ec9nh s\u1ebd ph\u00e1 b\u1ecf v\u1ecf t\u1ebf t\u1ebf b\u00e0o gan v\u00e0 ti\u1ebfp t\u1ee5c x\u00e2m nhi\u1ec5m c\u00e1c t\u1ebf b\u00e0o l\u00e0nh kh\u00e1c.<\/p>\n
C\u01a1 ch\u1ebf mi\u1ec5n d\u1ecbch<\/h2>\n
H\u1ec7 mi\u1ec5n d\u1ecbch c\u00f3 m\u1ed9t vai tr\u00f2 quan tr\u1ecdng trong vi\u1ec7c ki\u1ec3m so\u00e1t s\u1ef1 l\u00e2y nhi\u1ec5m HCV trong c\u01a1 th\u1ec3 c\u0169ng nh\u01b0 ng\u0103n ch\u1eb7n s\u1ef1 ph\u00e1t tri\u1ec3n c\u1ee7a vi\u00eam gan C m\u1ea1n t\u00ednh th\u00e0nh x\u01a1 gan. Ng\u01b0\u1ee3c l\u1ea1i, b\u1ea3n th\u00e2n virus HCV c\u0169ng c\u00f3 nh\u1eefng c\u01a1 ch\u1ebf t\u01b0\u01a1ng t\u00e1c ph\u1ee9c t\u1ea1p v\u1edbi h\u1ec7 mi\u1ec5n d\u1ecbch. \u0110\u00e1p \u1ee9ng mi\u1ec5n d\u1ecbch (c\u1ea3 \u0111\u00e1p \u1ee9ng t\u1ef1 nhi\u00ean v\u00e0 \u0111\u00e1p \u1ee9ng \u0111\u1eb7c hi\u1ec7u) l\u00e0 h\u00e0ng r\u00e0o \u0111\u1ea7u ti\u00ean ng\u0103n ch\u1eb7n qu\u00e1 tr\u00ecnh nh\u00e2n l\u00ean c\u1ee7a virus.<\/p>\n
T\u1eeb 1-2 tu\u1ea7n sau khi ph\u01a1i nhi\u1ec5m, c\u00f3 th\u1ec3 ph\u00e1t hi\u1ec7n \u0111\u01b0\u1ee3c HCV-RNA trong huy\u1ebft thanh ng\u01b0\u1eddi b\u1ec7nh v\u00e0 nhanh ch\u00f3ng t\u0103ng l\u00ean quanh m\u1ee9c 10^{6<\/sup>UI\/ml. Tuy nhi\u00ean, nh\u1eefng \u0111\u00e1p \u1ee9ng mi\u1ec5n d\u1ecbch \u0111\u1eb7c hi\u1ec7u \u0111\u1ea7u ti\u00ean quan s\u00e1t \u0111\u01b0\u1ee3c \u1edf m\u1ee9c \u0111\u1ed9 t\u1ebf b\u00e0o l\u00e0 sau kho\u1ea3ng 1-2 th\u00e1ng v\u00e0 \u1edf m\u1ee9c \u0111\u1ed9 to\u00e0n th\u00e2n l\u00e0 2-3 th\u00e1ng. N\u1ed3ng \u0111\u1ed9 c\u00e1c aminotransferase (ALAT, ASAT) t\u0103ng t\u1eeb tu\u1ea7n 2 t\u1edbi 8 sau khi ph\u01a1i nhi\u1ec5m, \u0111\u1ea1t cao nh\u1ea5t \u1edf tu\u1ea7n 8 t\u1edbi 12.<\/p>\n}
C\u01a1 ch\u1ebf mi\u1ec5n d\u1ecbch \u0111\u1ea7u ti\u00ean c\u1ee7a c\u01a1 th\u1ec3 l\u00e0 vi\u1ec7c mi\u1ec5n d\u1ecbch t\u1ef1 nhi\u00ean ti\u1ebft ra c\u00e1c interferon v\u00e0 gi\u1ea3i ph\u00f3ng c\u00e1c t\u1ebf b\u00e0o di\u1ec7t t\u1ef1 nhi\u00ean NK. C\u00e1c interferon l\u00e0m gi\u1ea3m m\u1ee9c \u0111\u1ed9 t\u1ed5ng h\u1ee3p protein trong c\u00e1c t\u1ebf b\u00e0o \u0111\u00e3 b\u1ecb x\u00e2m nhi\u1ec5m, l\u00e0m t\u0103ng bi\u1ec3u hi\u1ec7n gen t\u1ed5ng h\u1ee3p tr\u00ecnh di\u1ec7n kh\u00e1ng nguy\u00ean MHC \u1edf c\u00e1c t\u1ebf b\u00e0o, \u1ee9c ch\u1ebf t\u00e1i b\u1ea3n virus, ho\u1ea1t h\u00f3a qu\u00e1 tr\u00ecnh mi\u1ec5n d\u1ecbch \u0111\u1eb7c hi\u1ec7u, v\u00e0 \u0111\u1ea9y nhanh qu\u00e1 tr\u00ecnh t\u1ef1 h\u1ee7y t\u1ebf b\u00e0o. Tuy nhi\u00ean, HCV c\u0169ng c\u00f3 nh\u1eefng c\u01a1 ch\u1ebf ng\u0103n c\u00e1c ho\u1ea1t \u0111\u1ed9ng c\u1ee7a interferon. C\u00e1c c\u1ea5u tr\u00fac kh\u00f4ng m\u00e3 h\u00f3a protein ng\u0103n ch\u1eb7n qu\u00e1 tr\u00ecnh t\u1ed5ng h\u1ee3p interferon c\u1ee7a t\u1ebf b\u00e0o. T\u1ebf b\u00e0o di\u1ec7t t\u1ef1 nhi\u00ean NK gi\u1ea3i ph\u00f3ng ra c\u00e1c cytokin ti\u00eau di\u1ec7t t\u1ebf b\u00e0o b\u1ec7nh \u0111\u1ed3ng th\u1eddi k\u00edch ho\u1ea1t c\u00e1c ho\u1ea1t \u0111\u1ed9ng c\u1ee7a h\u1ec7 th\u1ed1ng mi\u1ec5n d\u1ecbch \u0111\u1eb7c hi\u00eau. Tuy nhi\u00ean, c\u00e1c proteins b\u1ec1 m\u1eb7t v\u1ecf c\u1ee7a HCV n\u1ebfu li\u00ean k\u1ebft v\u1edbi b\u1ec1 m\u1eb7t t\u1ebf b\u00e0o NK c\u0169ng c\u00f3 th\u1ec3 \u1ee9c ch\u1ebf qu\u00e1 tr\u00ecnh ho\u1ea1t \u0111\u1ed9ng c\u1ee7a t\u1ebf b\u00e0o NK.<\/p>\n
T\u00ecnh h\u00ecnh b\u1ec7nh vi\u00eam gan si\u00eau vi C tr\u00ean th\u1ebf gi\u1edbi v\u00e0 Vi\u1ec7t Nam<\/h2>\n
Theo WHO, tr\u00ean th\u1ebf gi\u1edbi hi\u1ec7n nay c\u00f3 kho\u1ea3ng 71 tri\u1ec7u ng\u01b0\u1eddi m\u1eafc vi\u00eam gan C m\u1ea1n t\u00ednh. Trong n\u0103m 2015, theo \u01b0\u1edbc t\u00ednh c\u1ee7a WHO, tr\u00ean th\u1ebf gi\u1edbi c\u00f3 kho\u1ea3ng 1,75 tri\u1ec7u ca m\u1eafc m\u1edbi v\u00e0 c\u00f3 kho\u1ea3ng 399000 ng\u01b0\u1eddi ch\u1ebft do virus vi\u00eam gan C m\u1ed7i n\u0103m, h\u1ea7u h\u1ebft do b\u1ec7nh ti\u1ebfn tri\u1ec3n th\u00e0nh x\u01a1 gan v\u00e0 ung th\u01b0 gan (HCC). B\u1edfi v\u00ec h\u1ea7u h\u1ebft nh\u1eefng ng\u01b0\u1eddi m\u1eafc b\u1ec7nh \u0111\u1ec1u kh\u00f4ng c\u00f3 c\u00e1c tri\u1ec7u ch\u1ee9ng r\u00f5 r\u1ec7t c\u0169ng nh\u01b0 kh\u00f4ng bi\u1ebft m\u00ecnh b\u1ecb ph\u01a1i nhi\u1ec5m, t\u00ecnh tr\u1ea1ng m\u1ec7t m\u1ecfi c\u1ee7a ng\u01b0\u1eddi b\u1ec7nh th\u01b0\u1eddng b\u1ecb b\u1ecf qua v\u00e0 b\u1ec7nh nh\u00e2n vi\u00eam gan C s\u1ebd kh\u00f4ng \u0111\u01b0\u1ee3c ghi nh\u1eadn, theo d\u00f5i v\u00e0 \u0111i\u1ec1u tr\u1ecb. T\u1ec9 l\u1ec7 m\u1eb7c b\u1ec7nh vi\u00eam gan C \u1edf c\u00e1c n\u01b0\u1edbc M\u1ef9 Latin, \u0110\u00f4ng \u00c2u, v\u00e0 m\u1ed9t s\u1ed1 n\u01b0\u1edbc \u1edf Trung \u0111\u00f4ng, ch\u00e2u \u00c1 v\u00e0 ch\u00e2u Phi th\u01b0\u1eddng cao h\u01a1n 1,5%. Theo th\u1ed1ng k\u00ea, Ai C\u1eadp l\u00e0 n\u01b0\u1edbc c\u00f3 t\u1ec9 l\u1ec7 cao nh\u1ea5t l\u00ean t\u1edbi 10%. Theo \u01b0\u1edbc t\u00ednh c\u1ee7a CDC (trung t\u00e2m ph\u00f2ng v\u00e0 ki\u1ec3m so\u00e1t d\u1ecbch b\u1ec7nh Hoa K\u1ef3), c\u00f3 kho\u1ea3ng 41200 ca vi\u00eam gan C c\u1ea5p t\u00ednh tr\u00ean l\u00e3nh th\u1ed5 Hoa K\u1ef3. \u1ede Vi\u1ec7t Nam, th\u00f4ng tin d\u1ecbch t\u1ec5 v\u1ec1 HCV v\u1eabn c\u00f2n h\u1ea1n ch\u1ebf. C\u0169ng theo CDC, t\u1ec9 l\u1ec7 m\u1eafc m\u1edbi HCV \u1edf Vi\u1ec7t Nam v\u00e0o kho\u1ea3ng 2,0-2,9%. Trong m\u1ed9t s\u1ed1 nghi\u00ean c\u1ee9u g\u1ea7n \u0111\u00e2y, t\u1ec9 l\u1ec7 hi\u1ec7n m\u1eafc HCV \u1edf Vi\u1ec7t Nam \u0111\u01b0\u1ee3c \u01b0\u1edbc t\u00ednh v\u00e0o kho\u1ea3ng 2%. Nh\u1eefng ng\u01b0\u1eddi t\u1eeb 50 tu\u1ed5i tr\u1edf l\u00ean \u0111\u01b0\u1ee3c x\u00e1c \u0111\u1ecbnh l\u00e0 nh\u00f3m \u0111\u1ed1i t\u01b0\u1ee3ng c\u00f3 nguy c\u01a1 cao d\u01b0\u01a1ng t\u00ednh v\u1edbi kh\u00e1ng th\u1ec3 anti HCV.<\/p>\n
$\"Vi\u00eam$ <\/p>\n
\u1ede Vi\u1ec7t Nam, th\u00f4ng tin d\u1ecbch t\u1ec5 v\u1ec1 HCV v\u1eabn c\u00f2n h\u1ea1n ch\u1ebf. C\u0169ng theo CDC, t\u1ec9 l\u1ec7 m\u1eafc m\u1edbi HCV \u1edf Vi\u1ec7t Nam v\u00e0o kho\u1ea3ng 2,0-2,9% [4]. Trong m\u1ed9t s\u1ed1 nghi\u00ean c\u1ee9u g\u1ea7n \u0111\u00e2y, t\u1ec9 l\u1ec7 hi\u1ec7n m\u1eafc HCV \u1edf Vi\u1ec7t Nam \u0111\u01b0\u1ee3c \u01b0\u1edbc t\u00ednh v\u00e0o kho\u1ea3ng 2%[2]. Nh\u1eefng ng\u01b0\u1eddi t\u1eeb 50 tu\u1ed5i tr\u1edf l\u00ean \u0111\u01b0\u1ee3c x\u00e1c \u0111\u1ecbnh l\u00e0 nh\u00f3m \u0111\u1ed1i t\u01b0\u1ee3ng c\u00f3 nguy c\u01a1 cao d\u01b0\u01a1ng t\u00ednh v\u1edbi kh\u00e1ng th\u1ec3 anti HCV[1].<\/p>\n
$\"Vi\u00eam$ <\/p>\n
B\u1ec7nh vi\u00eam gan C l\u00e2y qua \u0111\u01b0\u1eddng n\u00e0o?<\/h2>\n
Theo CDC, nh\u1eefng \u0111\u1ed1i t\u01b0\u1ee3ng sau \u0111\u00e2y d\u1ec5 b\u1ecb l\u00e2y nhi\u1ec5m virus HCV\u00a0:<\/p>\n
\n
Nh\u1eefng ng\u01b0\u1eddi \u0111\u00e3 v\u00e0 \u0111ang ti\u00eam ch\u00edch ma t\u00fay, bao g\u1ed3m c\u1ea3 nh\u1eefng \u0111\u1ed1i t\u01b0\u1ee3ng ch\u1ec9 ti\u00eam m\u1ed9t m\u0169i t\u1eeb nhi\u1ec1u n\u0103m tr\u01b0\u1edbc. Theo m\u1ed9t nghi\u00ean c\u1ee9u n\u0103m 2008, vi\u1ec7c ti\u00eam ch\u00edch ma t\u00fay l\u00e0 nguy\u00ean nh\u00e2n g\u00e2y nhi\u1ec5m vi\u00eam gan C ch\u1ee7 y\u1ebfu \u1edf nhi\u1ec1u n\u01b0\u1edbc, \u0111\u1eb7c bi\u1ec7t \u1edf c\u00e1c n\u01b0\u1edbc \u0111ang ph\u00e1t tri\u1ec3n. M\u1ed9t nghi\u00ean c\u1ee9u kh\u00e1c v\u00e0o n\u0103m 2011 sau khi kh\u1ea3o s\u00e1t 77 qu\u1ed1c gia tr\u00ean th\u1ebf gi\u1edbi ch\u1ec9 ra c\u00f3 t\u1edbi 25 n\u01b0\u1edbc c\u00f3 t\u1ec9 l\u1ec7 vi\u00eam gan C trong kho\u1ea3ng 60-80% \u1edf c\u00e1c \u0111\u1ed1i t\u01b0\u1ee3ng ti\u00eam ch\u00edch m\u00e0 t\u00fay, v\u00e0 c\u00f3 12 qu\u1ed1c gia kh\u00e1c c\u00f3 t\u1ec9 l\u1ec7 n\u00e0y v\u01b0\u1ee3t tr\u00ean 80%.<\/li>\n
Nh\u1eefng ng\u01b0\u1eddi \u0111\u00e3 t\u1eebng nh\u1eadn c\u00e1c y\u1ebfu t\u1ed1 \u0111\u00f4ng m\u00e1u t\u1eeb tr\u01b0\u1edbc n\u0103m 1987, khi m\u00e0 c\u00e1c c\u00f4ng ngh\u1ec7 s\u1ea3n xu\u1ea5t nh\u1eefng ch\u1ebf ph\u1ea9m n\u00e0y c\u00f2n ch\u01b0a hi\u1ec7n \u0111\u1ea1i.<\/li>\n
Nh\u1eefng ng\u01b0\u1eddi \u0111\u00e3 t\u1eebng \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb truy\u1ec1n m\u00e1u hay c\u1ea5y gh\u00e9p c\u00e1c c\u01a1 quan n\u1ed9i t\u1ea1ng t\u1eeb tr\u01b0\u1edbc n\u0103m 1992 (tr\u01b0\u1edbc th\u1eddi \u0111i\u1ec3m c\u00e1c x\u00e9t nghi\u1ec7m HCV \u1edf ng\u01b0\u1eddi t\u00ecnh nguy\u1ec7n hi\u1ebfn m\u00e1u th\u1ef1c s\u1ef1 hi\u1ec7u qu\u1ea3)<\/li>\n
Nh\u1eefng b\u1ec7nh nh\u00e2n ch\u1ea1y th\u1eadn nh\u00e2n t\u1ea1o<\/li>\n
Nh\u1eefng ng\u01b0\u1eddi c\u00f3 ph\u01a1i nhi\u1ec5m v\u1edbi virus HCV nh\u01b0\n
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Nh\u00e2n vi\u00ean y t\u1ebf sau khi l\u1ea5y c\u00e1c m\u1eabu b\u1ec7nh ph\u1ea9m c\u00f3 li\u00ean quan t\u1edbi m\u00e1u \u1edf b\u1ec7nh nh\u00e2n d\u01b0\u01a1ng t\u00ednh HCV<\/li>\n
Nh\u1eefng ng\u01b0\u1eddi nh\u1eadn m\u00e1u hay nh\u1eadn c\u00e1c c\u01a1 quan kh\u00e1c t\u1eeb ng\u01b0\u1eddi t\u00ecnh nguy\u1ec7n d\u01b0\u01a1ng t\u00ednh v\u1edbi HCV<\/li>\n<\/ul>\n<\/li>\n
Nh\u1eefng ng\u01b0\u1eddi nhi\u1ec5m HIV<\/li>\n
Tr\u1ebb em c\u00f3 m\u1eb9 d\u01b0\u01a1ng t\u00ednh HCV. Vi\u1ec7c l\u00e2y nhi\u1ec5m x\u1ea3y ra trong giai \u0111o\u1ea1n n\u00e0o c\u1ee7a qu\u00e1 tr\u00ecnh mang thai hi\u1ec7n ch\u01b0a bi\u1ebft r\u00f5, c\u0169ng ch\u01b0a c\u00f3 bi\u1ec7n ph\u00e1p \u0111\u1ec3 gi\u1ea3m thi\u1ec3u nguy c\u01a1 l\u00e2y b\u1ec7nh qua con \u0111\u01b0\u1eddng n\u00e0y. T\u1ec9 l\u1ec7 l\u00e2y truy\u1ec1n theo con \u0111\u01b0\u1eddng t\u1eeb m\u1eb9 sang con t\u1eeb 4 \u2013 7%, c\u00f3 th\u1ec3 t\u0103ng l\u00ean khi n\u1ed3ng \u0111\u1ed9 HCV trong m\u00e1u c\u1ee7a m\u1eb9 t\u0103ng cao hay m\u1eb9 c\u00f3 m\u1eafc k\u00e8m HIV.<\/li>\n<\/ul>\n
Th\u00eam v\u00e0o \u0111\u00f3, virus HCV c\u0169ng c\u00f3 th\u1ec3 l\u00e2y truy\u1ec1n quan \u0111\u01b0\u1eddng t\u00ecnh d\u1ee5c. Tuy nhi\u00ean, virus ch\u1ee7 y\u1ebfu nh\u1ea5t l\u00e2y qua \u0111\u01b0\u1eddng m\u00e1u, \u0111\u01b0\u1eddng l\u00e2y t\u1eeb m\u1eb9 sang con v\u00e0 \u0111\u01b0\u1eddng t\u00ecnh d\u1ee5c \u00edt ph\u1ed5 bi\u1ebfn h\u01a1n.<\/p>\n
M\u1ed9t nguy\u00ean nh\u00e2n l\u00e2y b\u1ec7nh kh\u00e1c c\u0169ng ch\u01b0a \u0111\u01b0\u1ee3c nh\u1eafc t\u1edbi trong danh s\u00e1ch tr\u00ean\u00a0: x\u0103m m\u00ecnh. X\u0103m m\u00ecnh l\u00e0m t\u0103ng nguy c\u01a1 m\u1eafc HCV l\u00ean 2 t\u1edbi 3 l\u1ea7n. Nguy c\u01a1 gia t\u0103ng n\u00e0y c\u0169ng c\u00f3 th\u1ec3 gi\u1ea3i th\u00edch t\u01b0\u01a1ng t\u1ef1 tr\u01b0\u1eddng h\u1ee3p ti\u00eam ch\u00edch ma t\u00fay, \u0111\u00f3 l\u00e0 do d\u1ee5ng c\u1ee5 kh\u00f4ng v\u00f4 khu\u1ea9n c\u0169ng nh\u01b0 kh\u00f4ng \u00e1p d\u1ee5ng c\u00e1c k\u1ef9 thu\u1eadt v\u00f4 tr\u00f9ng c\u1ea7n thi\u1ebft. K\u00edch th\u01b0\u1edbc h\u00ecnh x\u0103m c\u0169ng \u1ea3nh h\u01b0\u1edfng t\u1edbi nguy c\u01a1 l\u00e2y nhi\u1ec5m, h\u00ecnh x\u0103m l\u1edbn h\u01a1n c\u00f3 nguy c\u00f3 nhi\u1ec5m b\u1ec7nh cao h\u01a1n.<\/p>\n
M\u1ed9t \u0111i\u1ec3m c\u1ea7n ch\u00fa \u00fd kh\u00e1c, m\u1eb7c d\u00f9 virus HCV kh\u00f4ng l\u00e2y qua s\u1eefa m\u1eb9 (tr\u1eeb tr\u01b0\u1eddng h\u1ee3p n\u00fam v\u00fa b\u1ecb n\u1ee9t hay ch\u1ea3y m\u00e1u), th\u1ef1c ph\u1ea9m, n\u01b0\u1edbc u\u1ed1ng hay c\u00e1c ti\u1ebfp x\u00fac th\u00f4ng th\u01b0\u1eddng nh\u01b0 \u00f4m, h\u00f4n, chia s\u1ebb th\u1ef1c ph\u1ea9m v\u1edbi ng\u01b0\u1eddi b\u1ec7nh nh\u01b0ng HCV c\u0169ng c\u00f3 th\u1ec3 l\u00e2y truy\u1ec1n qua c\u00e1c v\u1eadt d\u1ee5ng\/d\u1ee5ng c\u1ee5 gia \u0111\u00ecnh n\u1ebfu nh\u01b0 nh\u1eefng d\u1ee5ng c\u1ee5 n\u00e0y th\u01b0\u1eddng xuy\u00ean ho\u1eb7c v\u1eeba m\u1edbi ti\u1ebfp x\u00fac v\u1edbi m\u00e1u c\u1ee7a th\u00e0nh vi\u00ean gia \u0111\u00ecnh mang virus HCV (v\u00ed d\u1ee5\u00a0: b\u00e0n ch\u1ea3i \u0111\u00e1nh r\u0103ng, dao c\u1ea1o r\u00e2u,\u2026).<\/p>\n
X\u00e9t nghi\u1ec7m ch\u1ea9n \u0111o\u00e1n b\u1ec7nh vi\u00eam gan C<\/h2>\n
C\u00f3 c\u00e1c x\u00e9t nghi\u1ec7m ch\u1ea9n \u0111o\u00e1n vi\u00eam gan si\u00eau vi C nh\u01b0 ph\u1ea3n \u1ee9ng mi\u1ec5n d\u1ecbch \u0111\u1eb7c hi\u1ec7u b\u1eb1ng enzym ELISA t\u00ecm ki\u1ebfm kh\u00e1ng th\u1ec3 HCV, ph\u1ea3n \u1ee9ng \u0111\u1ecbnh l\u01b0\u1ee3ng chu\u1ed7i RNA virus (HCV-RNA PCR). Nh\u01b0 \u0111\u00e3 tr\u00ecnh b\u00e0y \u1edf m\u1ee5c 3 (C\u01a1 ch\u1ebf mi\u1ec5n d\u1ecbch), ph\u1ea3n \u1ee9ng PCR c\u00f3 th\u1ec3 ph\u00e1t hi\u1ec7n HCV t\u1eeb 1-2 sau khi ph\u01a1i nhi\u1ec5m, ph\u1ea3n \u1ee9ng kh\u00e1ng th\u1ec3 ELISA c\u1ea7n th\u1eddi gian l\u00e2u h\u01a1n \u0111\u1ec3 ph\u00e1t hi\u1ec7n. Hi\u1ec7n nay v\u1eabn ch\u01b0a c\u00f3 x\u00e9t nghi\u1ec7m n\u00e0o ph\u00e2n bi\u1ec7t \u0111\u01b0\u1ee3c vi\u00eam gan C c\u1ea5p t\u00ednh hay \u0111\u1ee3t c\u1ea5p c\u1ee7a vi\u00eam gan C m\u1ea1n t\u00ednh.<\/p>\n
Theo CDC, vi\u1ec7c theo d\u00f5i s\u00e0ng l\u1ecdc ng\u01b0\u1eddi b\u1ec7nh HCV c\u00f3 th\u1ec3 th\u1ef1c hi\u1ec7n theo s\u01a1 \u0111\u1ed3:<\/p>\n
B\u1ec7nh nh\u00e2n \u0111\u1ea7u ti\u00ean \u0111\u01b0\u1ee3c x\u00e9t nghi\u1ec7m m\u00e1u t\u00ecm anti- HCV. N\u1ebfu k\u1ebft qu\u1ea3 \u00e2m t\u00ednh th\u00f4ng th\u01b0\u1eddng s\u1ebd kh\u00f4ng c\u1ea7n ph\u1ea3i ti\u1ebfn h\u00e0nh th\u00eam c\u00e1c x\u00e9t nghi\u1ec7m kh\u00e1c. Trong tr\u01b0\u1eddng h\u1ee3p d\u01b0\u01a1ng t\u00ednh, b\u1ec7nh nh\u1eadn c\u1ea7n l\u00e0m th\u00eam c\u00e1c x\u00e9t nghi\u1ec7m ki\u1ec3m ch\u1ee9ng k\u1ebft qu\u1ea3 x\u00e9t nghi\u1ec7m ELISA \u0111\u00e3 c\u00f3. X\u00e9t nghi\u1ec7m \u0111\u1ecbnh l\u01b0\u1ee3ng RNA virus b\u1eb1ng PCR \u0111\u01b0\u1ee3c ti\u1ebfn h\u00e0nh. N\u1ebfu k\u1ebft qu\u1ea3 kh\u00f4ng t\u00ecm th\u1ea5y HCV-RNA, b\u1ec7nh nh\u00e2n c\u00f3 th\u1ec3 \u0111\u00e3 nhi\u1ec5m virus HCV nh\u01b0ng \u0111\u00e3 t\u1ef1 kh\u1ecfi ho\u1eb7c \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb kh\u1ecfi. Ng\u01b0\u1ee3c l\u1ea1i, ph\u00e1t hi\u1ec7n HCV-RNA trong m\u00e1u b\u1ec7nh nh\u00e2n \u0111\u1ed3ng ngh\u0129a v\u1edbi vi\u1ec7c b\u1ec7nh nh\u00e2n c\u1ea7n \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb ph\u00f9 h\u1ee3p.<\/p>\n
Trong tr\u01b0\u1eddng h\u1ee3p \u00e2m t\u00ednh v\u1edbi anti HCV nh\u01b0ng c\u00f3 ph\u01a1i nhi\u1ec5m trong v\u00f2ng 6 th\u00e1ng tr\u1edf l\u1ea1i, n\u00ean ti\u1ebfn h\u00e0nh th\u00eam x\u00e9t nghi\u1ec7m HCV-RNA PCR \u0111\u1ec3 c\u00f3 th\u1ec3 kh\u1eb3ng \u0111\u1ecbnh ch\u1eafc ch\u1eafn. Ph\u1ea3n \u1ee9ng ELISA c\u00f3 th\u1ec3 ph\u00e1t hi\u1ec7n >97% ng\u01b0\u1eddi b\u1ecb ph\u01a1i nhi\u1ec5m v\u1edbi HCV sau 6 th\u00e1ng ph\u01a1i nhi\u1ec5m.<\/p>\n
\u0110\u1ed1i v\u1edbi tr\u1ebb em, ti\u1ebfn h\u00e0nh x\u00e9t nghi\u1ec7m HCV-ARN l\u00fac 6 th\u00e1ng v\u00e0 12 th\u00e1ng. N\u1ebfu c\u00f3 \u00edt nh\u1ea5t 2 l\u1ea7n ph\u00e1t hi\u1ec7n HCV-ARN th\u00ec \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n l\u00e0 HCV d\u01b0\u01a1ng t\u00ednh.<\/p>\n
B\u1ec7nh nh\u00e2n d\u01b0\u01a1ng t\u00ednh HCV n\u00ean ti\u1ebfn h\u00e0nh th\u00eam c\u00e1c x\u00e9t nghi\u1ec7m kh\u00e1c \u0111\u1ec3 \u0111\u00e1nh gi\u00e1 c\u00e1c b\u1ec7nh l\u00fd v\u1ec1 gan k\u00e8m theo nh\u01b0 vi\u1ec3m gan A, B, D, E, c\u00e1c b\u1ec7nh gan t\u1ef1 mi\u1ec5n, b\u1ec7nh gan do r\u01b0\u1ee3u,\u2026\u00a0; c\u0169ng nh\u01b0 c\u00e1c x\u00e9t nghi\u1ec7m x\u00e1c \u0111\u1ecbnh type c\u1ee7a HCV. Vi\u1ec7c x\u00e1c \u0111\u1ecbnh \u0111\u01b0\u1ee3c type c\u1ee7a HCV v\u00e0 m\u1ee9c \u0111\u1ed9 b\u1ec7nh l\u00fd \u1edf gan cho ph\u00e9p l\u1ef1a ch\u1ecdn ch\u00ednh x\u00e1c v\u00e0 hi\u1ec7u qu\u1ea3 ph\u00e1c \u0111\u1ed3 \u0111i\u1ec1u tr\u1ecb vi\u00eam gan C.<\/p>\n
\u0110\u1ed1i v\u1edbi c\u00e1c x\u00e9t nghi\u1ec7m aminotransferase trong m\u00e1u, x\u00e9t nghi\u1ec7m n\u00e0y kh\u00f4ng c\u00f3 \u00fd ngh\u0129a ch\u1ea9n \u0111o\u00e1n. N\u1ed3ng \u0111\u1ed9 ALAT v\u00e0 ASAT \u1edf b\u1ec7nh nh\u00e2n vi\u00eam gan C m\u1ea1n t\u00ednh c\u00f3 th\u1ec3 t\u0103ng gi\u1ea3m trong th\u1eddi gian mang b\u1ec7nh, th\u01b0\u1eddng quanh m\u1ee9c trung b\u00ecnh v\u00e0 duy b\u00ecnh th\u01b0\u1eddng trong su\u1ed1t nhi\u1ec1u n\u0103m d\u00f9 mang b\u1ec7nh l\u00fd gan m\u1ea1n t\u00ednh.<\/p>\n
\u0110i\u1ec1u tr\u1ecb vi\u00eam gan si\u00eau vi C<\/h2>\n
Hi\u1ec7n nay, thu\u1ed1c kh\u00e1ng virus vi\u00eam gan C \u0111\u00e3 c\u00f3 th\u1ec3 ch\u1eefa kh\u1ecfi cho h\u01a1n 95% s\u1ed1 b\u1ec7nh nh\u00e2n vi\u00eam gan C, nh\u1edd \u0111\u00f3 l\u00e0m gi\u1ea3m nguy c\u01a1 t\u1eed vong do x\u01a1 gan v\u00e0 ung th\u01b0 gan ti\u1ebfn tri\u1ec3n nh\u01b0ng s\u1ed1 l\u01b0\u1ee3ng b\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c ch\u1ea9n \u0111o\u00e1n v\u00e0 ti\u1ebfp c\u1eadn \u0111i\u1ec1u tr\u1ecb c\u00f2n h\u1ea1n ch\u1ebf [5].<\/p>\n
Danh s\u00e1ch c\u00e1c thu\u1ed1c \u0111i\u1ec1u tr\u1ecb vi\u00eam gan C \u0111ang \u0111\u01b0\u1ee3c b\u00e1n t\u1ea1i Vi\u1ec7t Nam: Thu\u1ed1c MyVelpa<\/a>, Ledvir<\/a>,\u00a0 MyHep<\/a> c\u1ee7a c\u00f4ng ty d\u01b0\u1ee3c ph\u1ea9m MyLan \u0111\u1ebfn t\u1eeb \u1ea4n \u0110\u1ed9.<\/p>\n
Ph\u00e1c \u0111\u1ed3 \u0111i\u1ec1u tr\u1ecb vi\u00eam gan C m\u1edbi nh\u1ea5t 2019<\/h2>\n
Hi\u1ec7n nay, v\u1eabn ch\u01b0a c\u00f3 vaccin \u0111\u1ec3 ph\u00f2ng ng\u1eeba b\u1ec7nh vi\u00eam gan C. C\u00e1c b\u1ec7nh nh\u00e2n d\u01b0\u01a1ng t\u00ednh v\u1edbi HCV c\u1ea7n \u0111\u01b0\u1ee3c \u0111\u00e1nh gi\u00e1 k\u0129 l\u01b0\u1ee1ng v\u1ec1 t\u00ecnh tr\u1ea1ng c\u00e1c b\u1ec7nh l\u00fd m\u1ea1n t\u00ednh kh\u00e1c v\u1ec1 gan, ki\u1ec3m tra c\u00e1c ch\u1ee9c n\u0103ng gan \u0111\u1ec3 c\u00f3 h\u01b0\u1edbng \u0111i\u1ec1u tr\u1ecb c\u1ee5 th\u1ec3 c\u0169ng nh\u01b0 xem x\u00e9t kh\u1ea3 n\u0103ng ph\u1ea3i ti\u00eam ph\u00f2ng vi\u00eam gan A v\u00e0 vi\u00eam gan B.<\/p>\n
Tr\u01b0\u1edbc kia, vi\u1ec7c \u0111i\u1ec1u tr\u1ecb vi\u00eam gan C th\u01b0\u1eddng s\u1eed d\u1ee5ng Interferon nh\u01b0ng hi\u1ec7u qu\u1ea3 th\u1ea5p. Ph\u00e1c \u0111\u1ed3 s\u1eed d\u1ee5ng k\u1ebft h\u1ee3p Interferon v\u00e0 Ribavirin (m\u1ed9t thu\u1ed9c kh\u00e1ng virus ph\u1ed5 r\u1ed9ng) c\u1ea3i thi\u1ec7n hi\u1ec7u qu\u1ea3 cho ph\u00e1c \u0111\u1ed3 Interferon \u0111\u01a1n \u0111\u1ed9c nh\u01b0ng hi\u1ec7u qu\u1ea3 v\u1eabn ch\u1ec9 \u0111\u1ea1t 30% v\u1edbi HCV type 1 v\u00e0 kho\u1ea3ng 60% v\u1edbi HCV type 2 v\u00e0 3. M\u1eb7t kh\u00e1c, interferon c\u0169ng c\u00f3 nhi\u1ec1u t\u00e1c d\u1ee5ng kh\u00f4ng mong mu\u1ed1n nghi\u00eam tr\u1ecdng n\u00ean kh\u00f3 \u0111\u1ea3m b\u1ea3o \u0111\u01b0\u1ee3c v\u1ea5n \u0111\u1ec1 tu\u00e2n th\u1ee7 \u0111i\u1ec1u tr\u1ecb. Cho t\u1edbi n\u0103m 2011, telaprevir v\u00e0 boceprevir \u0111\u01b0\u1ee3c FDA ph\u00ea duy\u1ec7t l\u00e0 nh\u1eefng thu\u1ed1c \u0111i\u1ec1u tr\u1ecb HCV b\u1eb1ng c\u00e1ch \u1ee9c ch\u1ebf tr\u1ef1c ti\u1ebfp virus (DAA). T\u1eeb \u0111\u00f3 t\u1edbi nay, li\u00ean t\u1ee5c c\u00f3 c\u00e1c thu\u1ed1c \u1ee9c ch\u1ebf HCV tr\u1ef1c ti\u1ebfp (DAAs) \u0111\u01b0\u1ee3c ph\u00ea duy\u1ec7t, n\u00e2ng cao hi\u1ec7u qu\u1ea3 \u0111i\u1ec1u tr\u1ecb HCV. C\u00e1c thu\u1ed1c n\u00e0y \u0111\u1ec1u t\u00e1c \u0111\u1ed9ng l\u00ean c\u00e1c protein kh\u00f4ng c\u1ea5u tr\u00fac c\u1ee7a HCV, qua \u0111\u00f3 t\u0103ng c\u01b0\u1eddng ho\u1ea1t \u0111\u1ed9ng mi\u1ec5n d\u1ecbch c\u1ee7a c\u01a1 th\u1ec3 c\u0169ng nh\u01b0 l\u00e0m gi\u00e1n \u0111o\u1ea1n qu\u00e1 tr\u00ecnh nh\u00e2n l\u00ean, ho\u00e0n thi\u1ec7n c\u1ee7a virus.<\/p>\n
C\u00e1c thu\u1ed1c \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 \u0111i\u1ec1u tr\u1ecb HCV \u1edf Vi\u1ec7t Nam hi\u1ec7n nay\u00a0theo h\u01b0\u1edbng d\u1eabn c\u1ee7a B\u1ed9 Y T\u1ebf:<\/p>\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n
T\u00ean thu\u1ed1c<\/td>\n D\u1ea1ng b\u00e0o ch\u1ebf<\/td>\n Li\u1ec1u d\u00f9ng<\/td>\n<\/tr>\n
Peginterferon (PegIFN) a\u00a02a<\/td>\n B\u01a1m dung d\u1ecbch 0,5ml ch\u1ee9a 180\u00a0mg, 135\u00a0mg,\u00a090\u00a0mg<\/td>\n 180mg\/l\u1ea7n\/tu\u1ea7n, ti\u00eam d\u01b0\u1edbi da b\u1ee5ng, 12-24 tu\u1ea7n (gi\u1ea3m li\u1ec1u n\u1ebfu c\u00f3 t\u00e1c d\u1ee5ng b\u1ea5t l\u1ee3i)<\/td>\n<\/tr>\n
Peginterferon (PegIFN)\u00a0a\u00a02b<\/td>\n L\u1ecd b\u1ed9t ho\u1eb7c b\u01a1m ti\u00eam ch\u1ee9a 100\u00a0mg,\u00a080\u00a0mg,\u00a050mg<\/td>\n 1,5\u00a0mg\/kg\/l\u1ea7n\/tu\u1ea7n, ti\u00eam d\u01b0\u1edbi da b\u1ee5ng, 12-24 tu\u1ea7n (gi\u1ea3m li\u1ec1u n\u1ebfu c\u00f3 t\u00e1c d\u1ee5ng b\u1ea5t l\u1ee3i)<\/td>\n<\/tr>\n
Ribavirin (RBV)<\/td>\n Vi\u00ean nang 200, vi\u00ean n\u00e9n 400 v\u00e0 500mg<\/td>\n 1000 mg cho ng\u01b0\u1eddi d\u01b0\u1edbi 75kg; 1200mg cho ng\u01b0\u1eddi tr\u00ean 75kg; u\u1ed1ng h\u00e0ng ng\u00e0y trong 12, 24 tu\u1ea7n t\u00f9y ph\u00e1c \u0111\u1ed3 (gi\u1ea3m li\u1ec1u n\u1ebfu c\u00f3 t\u00e1c d\u1ee5ng b\u1ea5t l\u1ee3i)<\/td>\n<\/tr>\n
Sofosbuvir (SOF)<\/td>\n Vi\u00ean n\u00e9n 400mg<\/td>\n 1 vi\u00ean\/ng\u00e0y, u\u1ed1ng, bu\u1ed5i\u00a0s\u00e1ng\u00a0(kh\u00f4ng\u00a0s\u1eed\u00a0d\u1ee5ng cho\u00a0ng\u01b0\u1eddi b\u1ec7nh c\u00f3 m\u1ee9c\u00a0l\u1ecdc c\u1ea7u th\u1eadn <30ml\/ph\u00fat\/1,73m^{2<\/sup>).<\/td>\n<\/tr>\n}
Daclatasvir (DCV)<\/td>\n Vi\u00ean n\u00e9n 30mg, 60mg<\/td>\n 1 vi\u00ean\/ng\u00e0y, u\u1ed1ng, bu\u1ed5i\u00a0s\u00e1ng<\/td>\n<\/tr>\n
Sofosbuvir\/ Ledipasvir (LDV)<\/td>\n Vi\u00ean n\u00e9n ch\u1ee9a 400mg SOF \/90mg LDV<\/td>\n 1 vi\u00ean\/ng\u00e0y, u\u1ed1ng, bu\u1ed5i\u00a0s\u00e1ng,tr\u00e1nh c\u00e1c thu\u1ed1c kh\u00e1ng a\u00a0x\u00edt<\/td>\n<\/tr>\n
Sofosbuvir\/ Velpatasvir (VEL)<\/td>\n Vi\u00ean n\u00e9n ch\u1ee9a 400mg SOF \/100mg VEL<\/td>\n 1 vi\u00ean\/ng\u00e0y, u\u1ed1ng, bu\u1ed5i\u00a0s\u00e1ng<\/td>\n<\/tr>\n
Paritaprevir (PTV)\/ Ombitasvir (OBV)\/ Ritonavir<\/td>\n Vi\u00ean n\u00e9n ch\u1ee9a: 75mg PTV\/12,5mgOBV\/ 50mg ritonavir<\/td>\n 2 vi\u00ean\/ng\u00e0y, u\u1ed1ng, bu\u1ed5i s\u00e1ng, u\u1ed1ng trong b\u1eefa \u0103n<\/td>\n<\/tr>\n
Dasabuvir (DSV)<\/td>\n Vi\u00ean n\u00e9n 250mg<\/td>\n 2 vi\u00ean\/ng\u00e0y, u\u1ed1ng, 1 vi\u00ean bu\u1ed5i s\u00e1ng, 1 vi\u00ean bu\u1ed5i chi\u1ec1u, u\u1ed1ng trong b\u1eefa \u0103n.<\/td>\n<\/tr>\n
Simeprevir (SMV)<\/td>\n Vi\u00ean nang 150 mg<\/td>\n 1 vi\u00ean\/ng\u00e0y, u\u1ed1ng trong b\u1eefa \u0103n<\/td>\n<\/tr>\n
Grazoprevir<\/p>\n
(GZR)\/elbasvir<\/p>\n
(EBR)<\/td>\n
Vi\u00ean n\u00e9n ch\u1ee9a Grazoprevir\u00a0100mg \/elbasvir 50mg<\/td>\n 1 vi\u00ean\/ng\u00e0y<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n
\u0110\u1ed1i v\u1edbi nh\u1eefng b\u1ec7nh nh\u00e2n vi\u00eam gan C c\u1ea5p t\u00ednh, th\u01b0\u1eddng kh\u00f4ng c\u00f3 khuy\u1ebfn c\u00e1o \u0111i\u1ec1u tr\u1ecb. B\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c theo d\u00f5i v\u00e0 c\u00e2n nh\u1eafc \u0111i\u1ec1u tr\u1ecb n\u1ebfu sau 6 th\u00e1ng v\u1eabn c\u00f2n ph\u00e1t hi\u1ec7n HCV-RNA.<\/p>\n
\u0110\u1ed1i v\u1edbi nh\u1eefng b\u1ec7nh nh\u00e2n vi\u00eam gan C m\u1ea1n t\u00ednh, vi\u1ec7c \u0111i\u1ec1u tr\u1ecb \u0111\u1ec1u s\u1eed d\u1ee5ng c\u00e1c DAAs. C\u00e1c ph\u00e1c \u0111\u1ed3 c\u1ee5 th\u1ec3 trong \u0111i\u1ec1u tr\u1ecb HCV ph\u1ee5 thu\u1ed9c v\u00e0o type HCV c\u0169ng nh\u01b0 t\u00ecnh tr\u1ea1ng x\u01a1 gan c\u1ee7a ng\u01b0\u1eddi b\u1ec7nh. Hi\u1ec7u qu\u1ea3 c\u1ee7a c\u00e1c ph\u00e1c \u0111\u1ed3 hay t\u00ecnh tr\u1ea1ng kh\u1ecfi b\u1ec7nh c\u1ee7a b\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c th\u1ec3 hi\u1ec7n th\u00f4ng qua vi\u1ec7c kh\u00f4ng ph\u00e1t hi\u1ec7n \u0111\u01b0\u1ee3c c\u00e1c HCV-RNA trong huy\u1ebft thanh ng\u01b0\u1eddi b\u1ec7nh sau 12 tu\u1ea7n \u0111i\u1ec1u tr\u1ecb. C\u00e1c ph\u00e1c \u0111\u1ed3 \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb khuy\u1ebfn c\u00e1o c\u1ee7a Hi\u1ec7p h\u1ed9i nghi\u00ean c\u1ee9u b\u1ec7nh gan Hoa K\u1ef3 (AASLD) v\u00e0 Hi\u1ec7p h\u1ed9i b\u1ec7nh truy\u1ec1n nhi\u1ec5m Hoa K\u1ef3 (IDSA) hi\u1ec7n nay c\u00f3 th\u1ec3 ch\u1eefa kh\u1ecfi 90% b\u1ec7nh nh\u00e2n c\u00f3 HCV m\u1ea1n t\u00ednh sau kho\u1ea3ng 8-16 tu\u1ea7n s\u1eed d\u1ee5ng thu\u1ed1c \u1ee9c ch\u1ebf HCV tr\u1ef1c ti\u1ebfp (DAAs) \u0111\u01b0\u1eddng u\u1ed1ng. C\u00e1c ph\u00e1c \u0111\u1ed3 \u0111i\u1ec1u tr\u1ecb l\u1ea7n \u0111\u1ea7u l\u00e0 c\u00e1c ph\u00e1c \u0111\u1ed3 d\u00e0nh cho nh\u1eefng b\u1ec7nh nh\u00e2n HCV m\u1ea1n t\u00ednh ch\u01b0a t\u1eebng nh\u1eadn \u0111\u01b0\u1ee3c b\u1ea5t c\u1ee9 \u0111i\u1ec1u tr\u1ecb n\u00e0o b\u1eb1ng interferon hay c\u00e1c DAAs. N\u1ebfu \u0111i\u1ec1u tr\u1ecb l\u1ea7n \u0111\u1ea7u th\u1ea5t b\u1ea1i, c\u00f3 th\u1ec3 ti\u1ebfp t\u1ee5c \u0111i\u1ec1u tr\u1ecb theo ph\u00e1c \u0111\u1ed3 \u0111i\u1ec1u tr\u1ecb l\u1ea1i t\u00f9y theo c\u00e1c type c\u1ee7a virus. C\u00e1c ph\u00e1c \u0111\u1ed3, h\u01b0\u1edbng d\u1eabn chi ti\u1ebft \u0111\u00e3 \u0111\u01b0\u1ee3c B\u1ed9 Y T\u1ebf h\u01b0\u1edbng d\u1eabn chi ti\u1ebft. M\u1ed7i ph\u00e1c \u0111\u1ed3 \u0111\u1ec1u c\u00f3 c\u00e1c ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh t\u01b0\u01a1ng \u0111\u1ed1i v\u00e0 tuy\u1ec7t \u0111\u1ed1i c\u1ea7n l\u01b0u \u00fd tr\u01b0\u1edbc khi ch\u1ec9 \u0111\u1ecbnh cho c\u00e1c b\u1ec7nh nh\u00e2n c\u1ee5 th\u1ec3.<\/p>\n
M\u1ed9t s\u1ed1 b\u00e1o c\u00e1o cho th\u1ea5y nguy c\u01a1 t\u00e1i ho\u1ea1t \u0111\u1ed9ng c\u1ee7a HBV khi \u0111i\u1ec1u tr\u1ecb HCV \u1edf b\u1ec7nh nh\u00e2n m\u1eb7c \u0111\u1ed3ng th\u1eddi HCV v\u00e0 HBV m\u1ea1n t\u00ednh. Do v\u1eady, t\u1ea5t c\u1ea3 c\u00e1c b\u1ec7nh nh\u00e2n \u0111i\u1ec1u tr\u1ecb HCV b\u1eb1ng DAAs \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o ki\u1ec3m tra HBsAg, anti-HBs v\u00e0 anti HBc th\u01b0\u1eddng xuy\u00ean trong qu\u00e1 tr\u00ecnh \u0111i\u1ec1u tr\u1ecb HCV.<\/p>\n
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C\u00e1c v\u1ea5n \u0111\u1ec1 li\u00ean quan kh\u00e1c<\/li>\n<\/ol>\n
B\u1ec7nh nh\u00e2n HCV n\u00ean \u0111\u01b0\u1ee3c nh\u00e2n vi\u00ean y t\u1ebf th\u00f4ng b\u00e1o \u0111\u1ea7y \u0111\u1ee7 v\u1ec1 t\u00ednh hi\u1ec7u qu\u1ea3 c\u1ee7a c\u00e1c ph\u00e1c \u0111\u1ed3 s\u1eed d\u1ee5ng DAAs v\u00e0 n\u00ean \u0111\u01b0\u1ee3c \u0111\u00e1nh gi\u00e1 hi\u1ec7u qu\u1ea3 \u0111i\u1ec1u tr\u1ecb th\u01b0\u1eddng xuy\u00ean. B\u1ec7nh nh\u00e2n c\u0169ng c\u00e2n \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o tr\u00e1nh c\u00e1c \u0111\u1ed3 u\u1ed1ng c\u00f3 c\u1ed3n v\u00ec ch\u00fang \u0111\u1ea9y nhanh qu\u00e1 tr\u00ecnh x\u01a1 gan. \u0110\u1ed3ng th\u1eddi, c\u1ea7n nh\u1eafc nh\u1edf b\u1ec7nh nh\u00e2n lu\u00f4n tham kh\u1ea3o \u00fd ki\u1ebfn c\u1ee7a c\u00e1c nh\u00e2n vi\u00ean y t\u1ebf khi mu\u1ed1n s\u1eed d\u1ee5ng m\u1ed9t thu\u1ed1c hay b\u1ea5t c\u1ee9 m\u1ed9t th\u1ef1c ph\u1ea9m b\u1ed5 sung n\u00e0o kh\u00e1c. M\u1ed9t s\u1ed1 thu\u1ed1c hay th\u1ef1c ph\u1ea9m b\u1ed5 sung c\u00f3 th\u1ec3 t\u1ea1o ra nguy c\u01a1 g\u00e2y h\u1ea1i t\u1edbi c\u00e1c t\u00e9 b\u00e0o gan.<\/p>\n
B\u1ec7nh nh\u00e2n n\u00ean \u0111\u01b0\u1ee3c gi\u00e1o d\u1ee5c \u0111\u1ea7y \u0111\u1ee7 v\u1ec1 c\u00e1c con \u0111\u01b0\u1eddng l\u00e2y b\u1ec7nh, bi\u1ebft \u0111\u01b0\u1ee3c nguy c\u01a1 l\u00e2y b\u1ec7nh cho b\u1ea1n t\u00ecnh, nguy c\u01a1 l\u00e2y b\u1ec7nh cho ng\u01b0\u1eddi kh\u00e1c khi d\u00f9ng chung c\u00e1c d\u1ee5ng c\u1ee5 c\u00e1 nh\u00e2n c\u00f3 d\u00ednh m\u00e1u (b\u00e0n ch\u1ea3i \u0111\u00e1nh r\u0103ng, b\u00e0n c\u1ea1o r\u00e2u, m\u00e1y c\u1ea1o r\u00e2u,\u2026). C\u00e1c v\u1ebft th\u01b0\u01a1ng tr\u00ean b\u1ec1 m\u1eb7t da n\u00ean \u0111\u01b0\u1ee3c b\u0103ng \u0111\u1ec3 tr\u00e1nh ph\u00e1t t\u00e1n virus.<\/p>\n
Tuy nhi\u00ean HCV kh\u00f4ng l\u00e2y qua ti\u1ebfp x\u00fac th\u1ed1ng th\u01b0\u1eddng nh\u01b0 \u00f4m, b\u1eaft tay, ho, chia s\u1ebb th\u1ee9c \u0103n\/\u0111\u1ed3 u\u1ed3ng. V\u00ec v\u1eady kh\u00f4ng c\u1ea7n thi\u1ebft ph\u1ea3i t\u1ea1o ra nh\u1eefng quy \u0111\u1ecbnh h\u1ea1n ch\u1ebf hay gi\u1edbi h\u1ea1n \u0111\u1ed1i v\u1edbi nh\u1eefng ng\u01b0\u1eddi lao \u0111\u1ed9ng d\u01b0\u01a1ng t\u00ednh v\u1edbi HCV. Tuy nhi\u00ean, nguy c\u01a1 l\u00e2y nhi\u1ec5m kh\u00f4ng ph\u1ea3i ho\u00e0n to\u00e0n kh\u00f4ng c\u00f3, n\u00ean c\u1ea7n ph\u1ea3i th\u1ef1c hi\u1ec7n c\u00e1c k\u0129 thu\u1eadt \u0111\u1ea3m b\u1ea3o v\u1ec7 sinh c\u1ea7n thi\u1ebft, \u0111\u1eb7c bi\u1ec7t \u0111\u1ed1i v\u1edbi nh\u1eefng nh\u00e2n vi\u00ean y t\u1ebf th\u01b0\u1eddng xuy\u00ean ti\u1ebfp x\u00fac v\u1edbi b\u1ec7nh nh\u00e2n v\u00e0 c\u00e1c m\u1eabu b\u1ec7nh ph\u1ea9m.<\/p>\n
M\u1ed9t v\u1ea5n \u0111\u1ec1 kh\u00e1c c\u1ea7n l\u01b0u \u00fd trong \u0111i\u1ec1u tr\u1ecb HCV l\u00e0 chi ph\u00ed \u0111i\u1ec1u tr\u1ecb. Chi ph\u00ed \u0111i\u1ec1u tr\u1ecb \u0111\u1eaft \u0111\u1ecf l\u00e0 m\u1ed9t nguy\u00ean nh\u00e2n ch\u1ee7 y\u1ec3u trong vi\u1ec7c t\u1eeb ch\u1ed1i \u0111i\u1ec1u tr\u1ecb HCV b\u1eb1ng DAAs \u1edf Hoa K\u00ec. Th\u1eadm ch\u00ed, \u1edf m\u1ed9t qu\u1ed1c gia gi\u00e0u c\u00f3 nh\u01b0 M\u1ef9, c\u00f3 34 trong 50 bang \u0111\u01b0\u1ee3c kh\u1ea3o s\u00e1t kh\u00f4ng th\u1ec3 cung c\u1ea5p \u0111i\u1ec1u tr\u1ecb \u0111\u1ea7y \u0111\u1ee7 cho to\u00e0n b\u1ed9 c\u00e1c b\u1ec7nh nh\u00e2n HCV. Kh\u00f3 kh\u0103n n\u00e0y ch\u1eafc ch\u1eafn s\u1ebd tr\u1edf n\u00ean n\u1eb7ng n\u1ec1 h\u01a1n \u1edf nh\u1eefng qu\u1ed1c gia \u0111ang ph\u00e1t tri\u1ec3n. \u1ede Vi\u1ec7n Nam, B\u1ea3o hi\u1ec3m X\u00e3 h\u1ed9i v\u1eabn ch\u01b0a chi tr\u1ea3 chi ph\u00ed cho b\u1ec7nh nh\u00e2n \u0111i\u1ec1u tr\u1ecb HCV. V\u00ec v\u1eady, vi\u1ec7c gi\u1ea3i quy\u1ebft tri\u1ec7t \u0111\u1ec3 vi\u00eam gan virus C v\u1eabn l\u00e0 m\u1ed9t nhi\u1ec7m v\u1ee5 kh\u00f3 kh\u0103n m\u1eb7c d\u00f9 \u0111\u00e3 c\u00f3 nh\u1eefng thu\u1ed1c \u0111i\u1ec1u tr\u1ecb hi\u1ec7u qu\u1ea3 cho c\u0103n b\u1ec7nh n\u00e0y.<\/p>\n
T\u00e0i li\u1ec7u tham kh\u1ea3o<\/h2>\n
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B\u1ed9 Y T\u1ebf, Quy\u1ebft \u0111\u1ecbnh 5012\/Q\u0110-BYT: Quy\u1ebft \u0111\u1ecbnh v\u1ec1 vi\u1ec7c ban h\u00e0nh h\u01b0\u1edbng d\u1eabn ch\u1ea9n \u0111o\u00e1n, \u0111i\u1ec1u tr\u1ecb b\u1ec7nh vi\u00eam gan vi r\u00fat C, 20\/9\/2016. https:\/\/thuvienphapluat.vn\/van-ban\/The-thao-Y-te\/Quyet-dinh-5012-QD-BYT-chan-doan-dieu-tri-benh-viem-gan-vi-rut-c-2016-322718.aspx<\/a><\/li>\n
Caruntu F.A, Benea L (2006), Acute Hepatitis C Virus Infection: Diagnosis, Pathogenesis, treatment<\/em>, Journal Gastrointestin Liver Disease, 15(3), 249-256. https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/17013450<\/a><\/li>\n<\/ol>\n
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Do SH, Yamada H, Fujimoto M; 2014, \u201cHigh prevalences of hepatitis B and C virus infections among adults living in Binh Thuan province, Vietnam\u201d Hepatology Research, 45(3), 259-68. https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/24799322<\/a><\/li>\n<\/ol>\n
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Gish RG, Bui TD, Nguyen CT; 2012, \u201cLiver disease in Viet Nam: screening, surveillance, management and education: a 5-year plan and call to action.\u201d Journal of Gastroenterology and Hepatology, 27(2), 238-47. https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/22098550<\/a><\/li>\n<\/ol>\n
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Hepatitis C FAQs for Health Professionals, Centers for Disease Control and Prevention (truy c\u1eadp ng\u00e0y 04\/05\/2018). https:\/\/www.cdc.gov\/hepatitis\/hcv\/hcvfaq.htm#section1<\/a><\/li>\n<\/ol>\n
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Hepatitis C, World Health organization (WHO). (truy c\u1eadp 04\/05\/2018). https:\/\/www.who.int\/en\/news-room\/fact-sheets\/detail\/hepatitis-c<\/a><\/li>\n<\/ol>\n
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Mast EE; 2004, \u201cMother-to-infant hepatitis C virus transmission and breastfeeding\u201d.\u00a0Advances in Experimental Medicine and Biology554: 211\u20136. https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/15384578<\/a><\/li>\n<\/ol>\n
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Miriam J Alter; 2007, \u201cEpidemiology of hepatitis C virus infection\u201d, world journal of gastroenterology, 13(17), 2436-41. https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/17552026<\/a><\/li>\n<\/ol>\n
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Moriishi, K., & Matsuura, Y. (2003).\u00a0Mechanisms of Hepatitis C Virus Infection. <\/em>Antiviral Chemistry and Chemotherapy, 14(6), 285\u2013297 https:\/\/journals.sagepub.com\/doi\/abs\/10.1177\/095632020301400601<\/a><\/li>\n<\/ol>\n
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M\u1ed9t s\u1ed1 ti\u1ebfn b\u1ed9 trong \u0111i\u1ec1u tr\u1ecb vi\u00eam gan C. Vinmec International Hospital (Truy c\u1eadp ng\u00e0y 10\/06\/2019). https:\/\/www.vinmec.com\/vi\/tin-tuc\/thong-tin-suc-khoe\/mot-so-tien-bo-trong-dieu-tri-viem-gan-c\/<\/a><\/li>\n<\/ol>\n
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Nakano T, Lau G.M.G, Lau G.M.L, Sugiyama M., Mizokami M (2011).\u00a0An updated analysis of hepatitis C virus genotypes and subtypes based on the complete coding region. <\/em>Liver International, 32(2), 339\u2013345.\u00a0<\/em>https:\/\/onlinelibrary.wiley.com\/doi\/abs\/10.1111\/j.1478-3231.2011.02684.x<\/a><\/li>\n<\/ol>\n
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Nguyet Cam Vu Lam, Patricia B.Gotsch, Robert C.Langan\u00a0; 2010, \u201cCaring for pregnant women and newborns with hepatitis B or C\u201d, American family physician, 82(10), 1225-9. https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/21121533<\/a><\/li>\n<\/ol>\n
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Paul Nelson, Bradley Mathers, Benjamin Cowie, Holly Hagan, Don Des Jarlaris, Danielle Horyniak, Louisa Degehardt; 2012, \u201cThe epidemiology of viral hepatitis among who inject drugs: results of global systematic reviews\u201d, Lancet, 378(9791), 571-83. https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC3285467\/<\/a><\/li>\n<\/ol>\n
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Sebastian Mueller, Gunda Millonig, Helmut K Seitz; 2009, \u201cAlcoholic liver disease and hepatitis C: a frequent underestimated combination\u201d,\u00a0World journal of gastroenterology, WJG15(28): 3462\u201371. https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC2715970\/<\/a><\/li>\n<\/ol>\n
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Shahid I, AlMalki W.H, Hassan S, Hafeez M.H (2017).\u00a0Real-world challenges for hepatitis C virus medications: a critical overview. <\/em>Critical Reviews in Microbiology, 44(2), 143\u2013160.\u00a0<\/em>https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/28539069<\/a><\/li>\n<\/ol>\n
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Siavash Jafari, Ray Copes, Souzan Bahariou, Mahyar Etminan, Jane Buxton; 2010, \u201cTattooing and the risk of transmission of hepatitis C: a systematic review and metaanalysis\u201d, 14(11), 928-40. https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/20678951<\/a><\/li>\n<\/ol>\n
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Vi\u00eam gan C l\u00e0 g\u00ec? Vi\u00eam gan C l\u00e0 t\u00ecnh tr\u1ea1ng gan b\u1ecb vi\u00eam, g\u00e2y ra b\u1edfi virus HCV \u2013 m\u1ed9t lo\u1ea1i virus c\u00f3 kh\u1ea3 n\u0103ng x\u00e2m nh\u1eadp v\u00e0o t\u00ea b\u00e0o gan qua m\u00e1u. Tri\u1ec7u ch\u1ee9ng th\u00f4ng th\u01b0\u1eddng c\u00f3 th\u1ec3 ch\u1ec9 l\u00e0 m\u1ec7t m\u1ecfi k\u00e9o d\u00e0i trong v\u00e0i tu\u1ea7n ho\u1eb7c m\u1ec7t m\u1ecfi k\u00e9o d\u00e0i. Vi\u00eam […]\n","protected":false},"author":1,"featured_media":9906,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[1],"tags":[],"class_list":["post-9899","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-y-te-suc-khoe"],"acf":[],"_links":{"self":[{"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/posts\/9899","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/comments?post=9899"}],"version-history":[{"count":0,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/posts\/9899\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/media\/9906"}],"wp:attachment":[{"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/media?parent=9899"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/categories?post=9899"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/tags?post=9899"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}

T\u00ean thu\u1ed1c<\/td>\n	D\u1ea1ng b\u00e0o ch\u1ebf<\/td>\n	Li\u1ec1u d\u00f9ng<\/td>\n<\/tr>\n
Peginterferon (PegIFN) a\u00a02a<\/td>\n	B\u01a1m dung d\u1ecbch 0,5ml ch\u1ee9a 180\u00a0mg, 135\u00a0mg,\u00a090\u00a0mg<\/td>\n	180mg\/l\u1ea7n\/tu\u1ea7n, ti\u00eam d\u01b0\u1edbi da b\u1ee5ng, 12-24 tu\u1ea7n (gi\u1ea3m li\u1ec1u n\u1ebfu c\u00f3 t\u00e1c d\u1ee5ng b\u1ea5t l\u1ee3i)<\/td>\n<\/tr>\n
Peginterferon (PegIFN)\u00a0a\u00a02b<\/td>\n	L\u1ecd b\u1ed9t ho\u1eb7c b\u01a1m ti\u00eam ch\u1ee9a 100\u00a0mg,\u00a080\u00a0mg,\u00a050mg<\/td>\n	1,5\u00a0mg\/kg\/l\u1ea7n\/tu\u1ea7n, ti\u00eam d\u01b0\u1edbi da b\u1ee5ng, 12-24 tu\u1ea7n (gi\u1ea3m li\u1ec1u n\u1ebfu c\u00f3 t\u00e1c d\u1ee5ng b\u1ea5t l\u1ee3i)<\/td>\n<\/tr>\n
Ribavirin (RBV)<\/td>\n	Vi\u00ean nang 200, vi\u00ean n\u00e9n 400 v\u00e0 500mg<\/td>\n	1000 mg cho ng\u01b0\u1eddi d\u01b0\u1edbi 75kg; 1200mg cho ng\u01b0\u1eddi tr\u00ean 75kg; u\u1ed1ng h\u00e0ng ng\u00e0y trong 12, 24 tu\u1ea7n t\u00f9y ph\u00e1c \u0111\u1ed3 (gi\u1ea3m li\u1ec1u n\u1ebfu c\u00f3 t\u00e1c d\u1ee5ng b\u1ea5t l\u1ee3i)<\/td>\n<\/tr>\n
Sofosbuvir (SOF)<\/td>\n	Vi\u00ean n\u00e9n 400mg<\/td>\n	1 vi\u00ean\/ng\u00e0y, u\u1ed1ng, bu\u1ed5i\u00a0s\u00e1ng\u00a0(kh\u00f4ng\u00a0s\u1eed\u00a0d\u1ee5ng cho\u00a0ng\u01b0\u1eddi b\u1ec7nh c\u00f3 m\u1ee9c\u00a0l\u1ecdc c\u1ea7u th\u1eadn <30ml\/ph\u00fat\/1,73m^{2<\/sup>).<\/td>\n<\/tr>\n}
Daclatasvir (DCV)<\/td>\n	Vi\u00ean n\u00e9n 30mg, 60mg<\/td>\n	1 vi\u00ean\/ng\u00e0y, u\u1ed1ng, bu\u1ed5i\u00a0s\u00e1ng<\/td>\n<\/tr>\n
Sofosbuvir\/ Ledipasvir (LDV)<\/td>\n	Vi\u00ean n\u00e9n ch\u1ee9a 400mg SOF \/90mg LDV<\/td>\n	1 vi\u00ean\/ng\u00e0y, u\u1ed1ng, bu\u1ed5i\u00a0s\u00e1ng,tr\u00e1nh c\u00e1c thu\u1ed1c kh\u00e1ng a\u00a0x\u00edt<\/td>\n<\/tr>\n
Sofosbuvir\/ Velpatasvir (VEL)<\/td>\n	Vi\u00ean n\u00e9n ch\u1ee9a 400mg SOF \/100mg VEL<\/td>\n	1 vi\u00ean\/ng\u00e0y, u\u1ed1ng, bu\u1ed5i\u00a0s\u00e1ng<\/td>\n<\/tr>\n
Paritaprevir (PTV)\/ Ombitasvir (OBV)\/ Ritonavir<\/td>\n	Vi\u00ean n\u00e9n ch\u1ee9a: 75mg PTV\/12,5mgOBV\/ 50mg ritonavir<\/td>\n	2 vi\u00ean\/ng\u00e0y, u\u1ed1ng, bu\u1ed5i s\u00e1ng, u\u1ed1ng trong b\u1eefa \u0103n<\/td>\n<\/tr>\n
Dasabuvir (DSV)<\/td>\n	Vi\u00ean n\u00e9n 250mg<\/td>\n	2 vi\u00ean\/ng\u00e0y, u\u1ed1ng, 1 vi\u00ean bu\u1ed5i s\u00e1ng, 1 vi\u00ean bu\u1ed5i chi\u1ec1u, u\u1ed1ng trong b\u1eefa \u0103n.<\/td>\n<\/tr>\n
Simeprevir (SMV)<\/td>\n	Vi\u00ean nang 150 mg<\/td>\n	1 vi\u00ean\/ng\u00e0y, u\u1ed1ng trong b\u1eefa \u0103n<\/td>\n<\/tr>\n
Grazoprevir<\/p>\n (GZR)\/elbasvir<\/p>\n (EBR)<\/td>\n	Vi\u00ean n\u00e9n ch\u1ee9a Grazoprevir\u00a0100mg \/elbasvir 50mg<\/td>\n	1 vi\u00ean\/ng\u00e0y<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n \u0110\u1ed1i v\u1edbi nh\u1eefng b\u1ec7nh nh\u00e2n vi\u00eam gan C c\u1ea5p t\u00ednh, th\u01b0\u1eddng kh\u00f4ng c\u00f3 khuy\u1ebfn c\u00e1o \u0111i\u1ec1u tr\u1ecb. B\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c theo d\u00f5i v\u00e0 c\u00e2n nh\u1eafc \u0111i\u1ec1u tr\u1ecb n\u1ebfu sau 6 th\u00e1ng v\u1eabn c\u00f2n ph\u00e1t hi\u1ec7n HCV-RNA.<\/p>\n \u0110\u1ed1i v\u1edbi nh\u1eefng b\u1ec7nh nh\u00e2n vi\u00eam gan C m\u1ea1n t\u00ednh, vi\u1ec7c \u0111i\u1ec1u tr\u1ecb \u0111\u1ec1u s\u1eed d\u1ee5ng c\u00e1c DAAs. C\u00e1c ph\u00e1c \u0111\u1ed3 c\u1ee5 th\u1ec3 trong \u0111i\u1ec1u tr\u1ecb HCV ph\u1ee5 thu\u1ed9c v\u00e0o type HCV c\u0169ng nh\u01b0 t\u00ecnh tr\u1ea1ng x\u01a1 gan c\u1ee7a ng\u01b0\u1eddi b\u1ec7nh. Hi\u1ec7u qu\u1ea3 c\u1ee7a c\u00e1c ph\u00e1c \u0111\u1ed3 hay t\u00ecnh tr\u1ea1ng kh\u1ecfi b\u1ec7nh c\u1ee7a b\u1ec7nh nh\u00e2n \u0111\u01b0\u1ee3c th\u1ec3 hi\u1ec7n th\u00f4ng qua vi\u1ec7c kh\u00f4ng ph\u00e1t hi\u1ec7n \u0111\u01b0\u1ee3c c\u00e1c HCV-RNA trong huy\u1ebft thanh ng\u01b0\u1eddi b\u1ec7nh sau 12 tu\u1ea7n \u0111i\u1ec1u tr\u1ecb. C\u00e1c ph\u00e1c \u0111\u1ed3 \u0111\u01b0\u1ee3c \u0111i\u1ec1u tr\u1ecb khuy\u1ebfn c\u00e1o c\u1ee7a Hi\u1ec7p h\u1ed9i nghi\u00ean c\u1ee9u b\u1ec7nh gan Hoa K\u1ef3 (AASLD) v\u00e0 Hi\u1ec7p h\u1ed9i b\u1ec7nh truy\u1ec1n nhi\u1ec5m Hoa K\u1ef3 (IDSA) hi\u1ec7n nay c\u00f3 th\u1ec3 ch\u1eefa kh\u1ecfi 90% b\u1ec7nh nh\u00e2n c\u00f3 HCV m\u1ea1n t\u00ednh sau kho\u1ea3ng 8-16 tu\u1ea7n s\u1eed d\u1ee5ng thu\u1ed1c \u1ee9c ch\u1ebf HCV tr\u1ef1c ti\u1ebfp (DAAs) \u0111\u01b0\u1eddng u\u1ed1ng. C\u00e1c ph\u00e1c \u0111\u1ed3 \u0111i\u1ec1u tr\u1ecb l\u1ea7n \u0111\u1ea7u l\u00e0 c\u00e1c ph\u00e1c \u0111\u1ed3 d\u00e0nh cho nh\u1eefng b\u1ec7nh nh\u00e2n HCV m\u1ea1n t\u00ednh ch\u01b0a t\u1eebng nh\u1eadn \u0111\u01b0\u1ee3c b\u1ea5t c\u1ee9 \u0111i\u1ec1u tr\u1ecb n\u00e0o b\u1eb1ng interferon hay c\u00e1c DAAs. N\u1ebfu \u0111i\u1ec1u tr\u1ecb l\u1ea7n \u0111\u1ea7u th\u1ea5t b\u1ea1i, c\u00f3 th\u1ec3 ti\u1ebfp t\u1ee5c \u0111i\u1ec1u tr\u1ecb theo ph\u00e1c \u0111\u1ed3 \u0111i\u1ec1u tr\u1ecb l\u1ea1i t\u00f9y theo c\u00e1c type c\u1ee7a virus. C\u00e1c ph\u00e1c \u0111\u1ed3, h\u01b0\u1edbng d\u1eabn chi ti\u1ebft \u0111\u00e3 \u0111\u01b0\u1ee3c B\u1ed9 Y T\u1ebf h\u01b0\u1edbng d\u1eabn chi ti\u1ebft. M\u1ed7i ph\u00e1c \u0111\u1ed3 \u0111\u1ec1u c\u00f3 c\u00e1c ch\u1ed1ng ch\u1ec9 \u0111\u1ecbnh t\u01b0\u01a1ng \u0111\u1ed1i v\u00e0 tuy\u1ec7t \u0111\u1ed1i c\u1ea7n l\u01b0u \u00fd tr\u01b0\u1edbc khi ch\u1ec9 \u0111\u1ecbnh cho c\u00e1c b\u1ec7nh nh\u00e2n c\u1ee5 th\u1ec3.<\/p>\n M\u1ed9t s\u1ed1 b\u00e1o c\u00e1o cho th\u1ea5y nguy c\u01a1 t\u00e1i ho\u1ea1t \u0111\u1ed9ng c\u1ee7a HBV khi \u0111i\u1ec1u tr\u1ecb HCV \u1edf b\u1ec7nh nh\u00e2n m\u1eb7c \u0111\u1ed3ng th\u1eddi HCV v\u00e0 HBV m\u1ea1n t\u00ednh. Do v\u1eady, t\u1ea5t c\u1ea3 c\u00e1c b\u1ec7nh nh\u00e2n \u0111i\u1ec1u tr\u1ecb HCV b\u1eb1ng DAAs \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o ki\u1ec3m tra HBsAg, anti-HBs v\u00e0 anti HBc th\u01b0\u1eddng xuy\u00ean trong qu\u00e1 tr\u00ecnh \u0111i\u1ec1u tr\u1ecb HCV.<\/p>\n \n C\u00e1c v\u1ea5n \u0111\u1ec1 li\u00ean quan kh\u00e1c<\/li>\n<\/ol>\n B\u1ec7nh nh\u00e2n HCV n\u00ean \u0111\u01b0\u1ee3c nh\u00e2n vi\u00ean y t\u1ebf th\u00f4ng b\u00e1o \u0111\u1ea7y \u0111\u1ee7 v\u1ec1 t\u00ednh hi\u1ec7u qu\u1ea3 c\u1ee7a c\u00e1c ph\u00e1c \u0111\u1ed3 s\u1eed d\u1ee5ng DAAs v\u00e0 n\u00ean \u0111\u01b0\u1ee3c \u0111\u00e1nh gi\u00e1 hi\u1ec7u qu\u1ea3 \u0111i\u1ec1u tr\u1ecb th\u01b0\u1eddng xuy\u00ean. B\u1ec7nh nh\u00e2n c\u0169ng c\u00e2n \u0111\u01b0\u1ee3c khuy\u1ebfn c\u00e1o tr\u00e1nh c\u00e1c \u0111\u1ed3 u\u1ed1ng c\u00f3 c\u1ed3n v\u00ec ch\u00fang \u0111\u1ea9y nhanh qu\u00e1 tr\u00ecnh x\u01a1 gan. \u0110\u1ed3ng th\u1eddi, c\u1ea7n nh\u1eafc nh\u1edf b\u1ec7nh nh\u00e2n lu\u00f4n tham kh\u1ea3o \u00fd ki\u1ebfn c\u1ee7a c\u00e1c nh\u00e2n vi\u00ean y t\u1ebf khi mu\u1ed1n s\u1eed d\u1ee5ng m\u1ed9t thu\u1ed1c hay b\u1ea5t c\u1ee9 m\u1ed9t th\u1ef1c ph\u1ea9m b\u1ed5 sung n\u00e0o kh\u00e1c. M\u1ed9t s\u1ed1 thu\u1ed1c hay th\u1ef1c ph\u1ea9m b\u1ed5 sung c\u00f3 th\u1ec3 t\u1ea1o ra nguy c\u01a1 g\u00e2y h\u1ea1i t\u1edbi c\u00e1c t\u00e9 b\u00e0o gan.<\/p>\n B\u1ec7nh nh\u00e2n n\u00ean \u0111\u01b0\u1ee3c gi\u00e1o d\u1ee5c \u0111\u1ea7y \u0111\u1ee7 v\u1ec1 c\u00e1c con \u0111\u01b0\u1eddng l\u00e2y b\u1ec7nh, bi\u1ebft \u0111\u01b0\u1ee3c nguy c\u01a1 l\u00e2y b\u1ec7nh cho b\u1ea1n t\u00ecnh, nguy c\u01a1 l\u00e2y b\u1ec7nh cho ng\u01b0\u1eddi kh\u00e1c khi d\u00f9ng chung c\u00e1c d\u1ee5ng c\u1ee5 c\u00e1 nh\u00e2n c\u00f3 d\u00ednh m\u00e1u (b\u00e0n ch\u1ea3i \u0111\u00e1nh r\u0103ng, b\u00e0n c\u1ea1o r\u00e2u, m\u00e1y c\u1ea1o r\u00e2u,\u2026). C\u00e1c v\u1ebft th\u01b0\u01a1ng tr\u00ean b\u1ec1 m\u1eb7t da n\u00ean \u0111\u01b0\u1ee3c b\u0103ng \u0111\u1ec3 tr\u00e1nh ph\u00e1t t\u00e1n virus.<\/p>\n Tuy nhi\u00ean HCV kh\u00f4ng l\u00e2y qua ti\u1ebfp x\u00fac th\u1ed1ng th\u01b0\u1eddng nh\u01b0 \u00f4m, b\u1eaft tay, ho, chia s\u1ebb th\u1ee9c \u0103n\/\u0111\u1ed3 u\u1ed3ng. V\u00ec v\u1eady kh\u00f4ng c\u1ea7n thi\u1ebft ph\u1ea3i t\u1ea1o ra nh\u1eefng quy \u0111\u1ecbnh h\u1ea1n ch\u1ebf hay gi\u1edbi h\u1ea1n \u0111\u1ed1i v\u1edbi nh\u1eefng ng\u01b0\u1eddi lao \u0111\u1ed9ng d\u01b0\u01a1ng t\u00ednh v\u1edbi HCV. Tuy nhi\u00ean, nguy c\u01a1 l\u00e2y nhi\u1ec5m kh\u00f4ng ph\u1ea3i ho\u00e0n to\u00e0n kh\u00f4ng c\u00f3, n\u00ean c\u1ea7n ph\u1ea3i th\u1ef1c hi\u1ec7n c\u00e1c k\u0129 thu\u1eadt \u0111\u1ea3m b\u1ea3o v\u1ec7 sinh c\u1ea7n thi\u1ebft, \u0111\u1eb7c bi\u1ec7t \u0111\u1ed1i v\u1edbi nh\u1eefng nh\u00e2n vi\u00ean y t\u1ebf th\u01b0\u1eddng xuy\u00ean ti\u1ebfp x\u00fac v\u1edbi b\u1ec7nh nh\u00e2n v\u00e0 c\u00e1c m\u1eabu b\u1ec7nh ph\u1ea9m.<\/p>\n M\u1ed9t v\u1ea5n \u0111\u1ec1 kh\u00e1c c\u1ea7n l\u01b0u \u00fd trong \u0111i\u1ec1u tr\u1ecb HCV l\u00e0 chi ph\u00ed \u0111i\u1ec1u tr\u1ecb. Chi ph\u00ed \u0111i\u1ec1u tr\u1ecb \u0111\u1eaft \u0111\u1ecf l\u00e0 m\u1ed9t nguy\u00ean nh\u00e2n ch\u1ee7 y\u1ec3u trong vi\u1ec7c t\u1eeb ch\u1ed1i \u0111i\u1ec1u tr\u1ecb HCV b\u1eb1ng DAAs \u1edf Hoa K\u00ec. Th\u1eadm ch\u00ed, \u1edf m\u1ed9t qu\u1ed1c gia gi\u00e0u c\u00f3 nh\u01b0 M\u1ef9, c\u00f3 34 trong 50 bang \u0111\u01b0\u1ee3c kh\u1ea3o s\u00e1t kh\u00f4ng th\u1ec3 cung c\u1ea5p \u0111i\u1ec1u tr\u1ecb \u0111\u1ea7y \u0111\u1ee7 cho to\u00e0n b\u1ed9 c\u00e1c b\u1ec7nh nh\u00e2n HCV. Kh\u00f3 kh\u0103n n\u00e0y ch\u1eafc ch\u1eafn s\u1ebd tr\u1edf n\u00ean n\u1eb7ng n\u1ec1 h\u01a1n \u1edf nh\u1eefng qu\u1ed1c gia \u0111ang ph\u00e1t tri\u1ec3n. \u1ede Vi\u1ec7n Nam, B\u1ea3o hi\u1ec3m X\u00e3 h\u1ed9i v\u1eabn ch\u01b0a chi tr\u1ea3 chi ph\u00ed cho b\u1ec7nh nh\u00e2n \u0111i\u1ec1u tr\u1ecb HCV. V\u00ec v\u1eady, vi\u1ec7c gi\u1ea3i quy\u1ebft tri\u1ec7t \u0111\u1ec3 vi\u00eam gan virus C v\u1eabn l\u00e0 m\u1ed9t nhi\u1ec7m v\u1ee5 kh\u00f3 kh\u0103n m\u1eb7c d\u00f9 \u0111\u00e3 c\u00f3 nh\u1eefng thu\u1ed1c \u0111i\u1ec1u tr\u1ecb hi\u1ec7u qu\u1ea3 cho c\u0103n b\u1ec7nh n\u00e0y.<\/p>\n T\u00e0i li\u1ec7u tham kh\u1ea3o<\/h2>\n \n B\u1ed9 Y T\u1ebf, Quy\u1ebft \u0111\u1ecbnh 5012\/Q\u0110-BYT: Quy\u1ebft \u0111\u1ecbnh v\u1ec1 vi\u1ec7c ban h\u00e0nh h\u01b0\u1edbng d\u1eabn ch\u1ea9n \u0111o\u00e1n, \u0111i\u1ec1u tr\u1ecb b\u1ec7nh vi\u00eam gan vi r\u00fat C, 20\/9\/2016. https:\/\/thuvienphapluat.vn\/van-ban\/The-thao-Y-te\/Quyet-dinh-5012-QD-BYT-chan-doan-dieu-tri-benh-viem-gan-vi-rut-c-2016-322718.aspx<\/a><\/li>\n Caruntu F.A, Benea L (2006), Acute Hepatitis C Virus Infection: Diagnosis, Pathogenesis, treatment<\/em>, Journal Gastrointestin Liver Disease, 15(3), 249-256. https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/17013450<\/a><\/li>\n<\/ol>\n \n Do SH, Yamada H, Fujimoto M; 2014, \u201cHigh prevalences of hepatitis B and C virus infections among adults living in Binh Thuan province, Vietnam\u201d Hepatology Research, 45(3), 259-68. https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/24799322<\/a><\/li>\n<\/ol>\n \n Gish RG, Bui TD, Nguyen CT; 2012, \u201cLiver disease in Viet Nam: screening, surveillance, management and education: a 5-year plan and call to action.\u201d Journal of Gastroenterology and Hepatology, 27(2), 238-47. https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/22098550<\/a><\/li>\n<\/ol>\n \n Hepatitis C FAQs for Health Professionals, Centers for Disease Control and Prevention (truy c\u1eadp ng\u00e0y 04\/05\/2018). https:\/\/www.cdc.gov\/hepatitis\/hcv\/hcvfaq.htm#section1<\/a><\/li>\n<\/ol>\n \n Hepatitis C, Chapter 3, Infectious Disease related to travel, Centers for Disease Control and Prevention (truy c\u1eadp ng\u00e0y 04\/05\/2018). https:\/\/wwwnc.cdc.gov\/travel\/yellowbook\/2018\/infectious-diseases-related-to-travel\/hepatitis-c<\/a><\/li>\n<\/ol>\n \n Hepatitis C, World Health organization (WHO). (truy c\u1eadp 04\/05\/2018). https:\/\/www.who.int\/en\/news-room\/fact-sheets\/detail\/hepatitis-c<\/a><\/li>\n<\/ol>\n \n Mast EE; 2004, \u201cMother-to-infant hepatitis C virus transmission and breastfeeding\u201d.\u00a0Advances in Experimental Medicine and Biology554: 211\u20136. https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/15384578<\/a><\/li>\n<\/ol>\n \n Miriam J Alter; 2007, \u201cEpidemiology of hepatitis C virus infection\u201d, world journal of gastroenterology, 13(17), 2436-41. https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/17552026<\/a><\/li>\n<\/ol>\n \n Moriishi, K., & Matsuura, Y. (2003).\u00a0Mechanisms of Hepatitis C Virus Infection. <\/em>Antiviral Chemistry and Chemotherapy, 14(6), 285\u2013297 https:\/\/journals.sagepub.com\/doi\/abs\/10.1177\/095632020301400601<\/a><\/li>\n<\/ol>\n \n M\u1ed9t s\u1ed1 ti\u1ebfn b\u1ed9 trong \u0111i\u1ec1u tr\u1ecb vi\u00eam gan C. Vinmec International Hospital (Truy c\u1eadp ng\u00e0y 10\/06\/2019). https:\/\/www.vinmec.com\/vi\/tin-tuc\/thong-tin-suc-khoe\/mot-so-tien-bo-trong-dieu-tri-viem-gan-c\/<\/a><\/li>\n<\/ol>\n \n Nakano T, Lau G.M.G, Lau G.M.L, Sugiyama M., Mizokami M (2011).\u00a0An updated analysis of hepatitis C virus genotypes and subtypes based on the complete coding region. <\/em>Liver International, 32(2), 339\u2013345.\u00a0<\/em>https:\/\/onlinelibrary.wiley.com\/doi\/abs\/10.1111\/j.1478-3231.2011.02684.x<\/a><\/li>\n<\/ol>\n \n Nguyet Cam Vu Lam, Patricia B.Gotsch, Robert C.Langan\u00a0; 2010, \u201cCaring for pregnant women and newborns with hepatitis B or C\u201d, American family physician, 82(10), 1225-9. https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/21121533<\/a><\/li>\n<\/ol>\n \n Paul Nelson, Bradley Mathers, Benjamin Cowie, Holly Hagan, Don Des Jarlaris, Danielle Horyniak, Louisa Degehardt; 2012, \u201cThe epidemiology of viral hepatitis among who inject drugs: results of global systematic reviews\u201d, Lancet, 378(9791), 571-83. https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC3285467\/<\/a><\/li>\n<\/ol>\n \n Roberio Amorim de Almeida Ponde; 2011, \u201cHidden hazards of HCV transmission\u201d, Medical microbiology and immunology200(1): 7\u201311. https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/20461405<\/a><\/li>\n<\/ol>\n \n Rosen, H. R. (2011).\u00a0Chronic Hepatitis C Infection. <\/em>New England Journal of Medicine, 364(25), 2429\u20132438.\u00a0<\/em>https:\/\/www.nejm.org\/doi\/full\/10.1056\/NEJMcp1006613<\/a><\/li>\n<\/ol>\n \n Sebastian Mueller, Gunda Millonig, Helmut K Seitz; 2009, \u201cAlcoholic liver disease and hepatitis C: a frequent underestimated combination\u201d,\u00a0World journal of gastroenterology, WJG15(28): 3462\u201371. https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC2715970\/<\/a><\/li>\n<\/ol>\n \n Shahid I, AlMalki W.H, Hassan S, Hafeez M.H (2017).\u00a0Real-world challenges for hepatitis C virus medications: a critical overview. <\/em>Critical Reviews in Microbiology, 44(2), 143\u2013160.\u00a0<\/em>https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/28539069<\/a><\/li>\n<\/ol>\n \n Siavash Jafari, Ray Copes, Souzan Bahariou, Mahyar Etminan, Jane Buxton; 2010, \u201cTattooing and the risk of transmission of hepatitis C: a systematic review and metaanalysis\u201d, 14(11), 928-40. https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/20678951<\/a><\/li>\n<\/ol>\n \n Xian Xia; Luo Jun, Bai Jianling, Yu Rongbi; 2008, \u201cEpidemiology of HCV infection among injection drug users in China: systematic review and metaanalysis\u201d, Public health, 122(10), 990-1003. https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/18486955<\/a><\/li>\n<\/ol>\n <\/p>\n <\/p>\n <\/p>\n <\/p>\n <\/p>\n <\/p>\n <\/p>\n <\/p>\n <\/p>\n <\/p>\n <\/p>\n <\/p>\n","protected":false},"excerpt":{"rendered":" Vi\u00eam gan C l\u00e0 g\u00ec? Vi\u00eam gan C l\u00e0 t\u00ecnh tr\u1ea1ng gan b\u1ecb vi\u00eam, g\u00e2y ra b\u1edfi virus HCV \u2013 m\u1ed9t lo\u1ea1i virus c\u00f3 kh\u1ea3 n\u0103ng x\u00e2m nh\u1eadp v\u00e0o t\u00ea b\u00e0o gan qua m\u00e1u. Tri\u1ec7u ch\u1ee9ng th\u00f4ng th\u01b0\u1eddng c\u00f3 th\u1ec3 ch\u1ec9 l\u00e0 m\u1ec7t m\u1ecfi k\u00e9o d\u00e0i trong v\u00e0i tu\u1ea7n ho\u1eb7c m\u1ec7t m\u1ecfi k\u00e9o d\u00e0i. Vi\u00eam […]\n","protected":false},"author":1,"featured_media":9906,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[1],"tags":[],"class_list":["post-9899","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-y-te-suc-khoe"],"acf":[],"_links":{"self":[{"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/posts\/9899","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/comments?post=9899"}],"version-history":[{"count":0,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/posts\/9899\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/media\/9906"}],"wp:attachment":[{"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/media?parent=9899"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/categories?post=9899"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/vnras.com\/drug\/wp-json\/wp\/v2\/tags?post=9899"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}

B\u1ec7nh vi\u00eam gan C l\u00e2y qua \u0111\u01b0\u1eddng n\u00e0o?<\/h2>\nTheo CDC, nh\u1eefng \u0111\u1ed1i t\u01b0\u1ee3ng sau \u0111\u00e2y d\u1ec5 b\u1ecb l\u00e2y nhi\u1ec5m virus HCV\u00a0:<\/p>\n