{"id":9168,"date":"2020-04-23T03:30:04","date_gmt":"2020-04-23T01:30:04","guid":{"rendered":"https:\/\/www.synevo.ro\/product\/arn-viral-hepatita-c-cantitativ\/"},"modified":"2025-07-01T07:56:00","modified_gmt":"2025-07-01T04:56:00","slug":"arn-viral-hepatita-c-cantitativ","status":"publish","type":"product","link":"https:\/\/old.synevo.md\/ru\/shop\/arn-viral-hepatita-c-cantitativ\/","title":{"rendered":"\u0420\u041d\u041a \u0432\u0438\u0440\u0443\u0441\u0430 \u0433\u0435\u043f\u0430\u0442\u0438\u0442\u0430 \u0421, \u043a\u043e\u043b\u0438\u0447\u0435\u0441\u0442\u0432\u0435\u043d\u043d\u044b\u0439"},"content":{"rendered":"<p><em><strong>Informa\u0163ii generale \u015fi recomand\u0103ri<\/strong><\/em><\/p>\n<p>Virusul hepatitei C (HCV), membru al familiei <em>Flaviviridae<\/em>, se transmite \u00een principal pe cale parenteral\u0103, frecven\u0163a infec\u0163iei HCV fiind mare la pacien\u0163ii cu transplant de organe sau transfuzii de s\u00e2nge, la persoanele cu abuz intravenos de droguri \u015fi la cei cu dializa renal\u0103<sup>1;2<\/sup>.<\/p>\n<p>Infec\u0163iile acute sunt \u00een generale u\u015foare sau asimptomatice, dar progresia c\u0103tre hepatita cronic\u0103 se \u00eenregistreaz\u0103 \u00een 60-90% din cazuri.<\/p>\n<p>Caracterizarea genomului HCV \u015fi a proteinelor codificate de acesta a permis dezvoltarea at\u00e2t a metodelor serologice pentru determinarea anticorpilor specifici c\u00e2t \u015fi a testelor moleculare pentru confirmarea diagnosticului \u015fi monitorizarea terapiei. Prezen\u0163a anticorpilor anti-HCV este doar un indicator de expunere la HCV \u015fi nu poate fi considerat\u0103 un marker pentru infec\u0163ia curent\u0103<sup>1<\/sup>.<\/p>\n<p>Dintre markerii biochimici ai afect\u0103rii hepatice, nivelul alaninaminotransferazei (ALT) a fost considerat un element important \u00een decizia de a efectua biopsie hepatic\u0103 \u015fi\/sau de a ini\u0163ia terapia antiviral\u0103. Cu toate acestea, gradul cre\u015fterii ALT-ului nu poate fi direct corelat cu nivelul infec\u0163iei HCV deoarece: la pacien\u0163ii cu hepatit\u0103 cronic\u0103 C nivelul seric al ALT poate fluctua spontan, fiind posibile perioade \u00eendelungate de remisiune biochimic\u0103; nivelul ALT poate fi influen\u0163at de al\u0163i factori cum ar fi consumul de alcool, medica\u0163ia asociat\u0103, prezen\u0163a altor infec\u0163ii virale, steatoza hepatic\u0103 non-alcoolic\u0103; exist\u0103 o categorie de pacien\u0163i (estimat\u0103 la 20-40% din cazurile de infec\u0163ie cronic\u0103 HCV) care prezint\u0103 un nivel persistent normal sau discret crescut al ALT, \u00a0\u00een condi\u0163iile unei replic\u0103ri virale continue<sup>3<\/sup>.<\/p>\n<p>Pe de alt\u0103 parte, detec\u0163ia prin amplificarea acizilor nucleici cu ajutorul reac\u0163iei de polimerizare \u00een lan\u0163 (PCR) ofer\u0103 o m\u0103sur\u0103 a replic\u0103rii virale, fiind util\u0103 at\u00e2t pentru diagnosticul infec\u0163iei active c\u00e2t \u015fi pentru monitorizarea tratamentului. Noile teste care cuantific\u0103 \u00eenc\u0103rc\u0103tura viral\u0103 prin tehnologia \u201dreal-time PCR\u201d au o sensibilitate analitic\u0103 mai mare \u015fi un domeniu de linearitate (m\u0103surabil) mult extins, \u00een compara\u0163ie cu tehnologia\u00a0 PCR conventional\u0103<sup>1;2<\/sup>.<\/p>\n<p>\u00cen ceea ce prive\u015fte diagnosticul, folosind metoda PCR, este posibil\u0103 detec\u0163ia viremiei VHC \u00eenainte de sero-conversia imunologic\u0103<sup>2<\/sup>.<\/p>\n<p>Determinarea viremiei este util\u0103 de asemenea \u00een stabilirea progresiei bolii \u0219i evaluarea eficien\u0163ei terapiei antivirale, at\u00e2t pentru regimul clasic de tratament ce include asocierea unui preparat de interferon pegylat (PegINF\u03b1) cu ribavirin\u0103, c\u00e2t \u0219i pentru protocoalele mai noi ce con\u021bin medicamente cu ac\u021biune antiviral\u0103 direct\u0103<sup>1<\/sup>.<\/p>\n<p>Specimen recoltat \u2013 s\u00e2nge venos<sup>2<\/sup><sub>.<\/sub><\/p>\n<p>Recipient de recoltare\u00a0\u2013 vacutainer ce con\u0163ine EDTA ca anticoagulant<sup>2<\/sup>.<\/p>\n<p><strong><em>Cantitate recoltat\u0103 <\/em><\/strong>\u2013 c\u00e2t permite vacuumul<sup>2<\/sup>.<\/p>\n<p>Cauze de respingere <strong><em>a probei <\/em><\/strong>\u2013 folosirea heparinei ca anticoagulant<sup>2<\/sup>.<\/p>\n<p>Prelucrare necesara dup\u0103 recoltare \u2013 se separ\u0103 plasma \u00een maxim 1 zi de la recoltare prin centrifugare la 800-1600 x g timp de 20 de minute la temperatura camerei, apoi se transfer\u0103 intr-o eprubet\u0103 de polipropilen (sunt necesari min. <strong>2mL<\/strong> de plasm\u0103)<sup> 2<\/sup>.<\/p>\n<p>Stabilitate prob\u0103 \u2013 plasma separat\u0103 poate fi p\u0103strat\u0103 timp de <em>72 de ore<\/em>\u00a0la temperatura camerei, <em>7 zile <\/em>la 2-8\u00b0C sau cel pu\u0163in <em>6 s\u0103pt\u0103m\u00e2ni<\/em> congelat\u0103 la\u00a0 -80\u00b0C. Probele pot fi congelate\/decongelate de maximum cinci ori f\u0103r\u0103 pierderea ARN-ului HCV<sup>2<\/sup>.<\/p>\n<p>Metod\u0103 \u2013 <u>Real-time PCR (TaqMan)<\/u>: reac\u0163ie de polimerizare \u00een lan\u0163 cu detec\u0163ie \u00een timp real a produsului PCR\u00a0 acumulat, prin m\u0103surarea fluorescen\u0163ei emise.<\/p>\n<p>Men\u0163iune: procesarea probelor se face automat<sup>2<\/sup>.<\/p>\n<p><strong><em>Valori de referin\u0163\u0103 <\/em><\/strong>\u2013 ARN-HCV nedetectabil; limita de detec\u0163ie a metodei \u00een domeniul de linearitate este de 15 UI\/mL, valoare ce coincide cu sensibilitatea analitic\u0103. Un rezultat \u00abnedetectabil\u00bb semnific\u0103 faptul c\u0103 este vorba fie de o viremie foarte sc\u0103zut\u0103 (sub limita de cuantificare), fie de o viremie absent\u0103. Un rezultat ARN-VHC &lt; 15 UI\/mL indic\u0103 o viremie detectabil\u0103, dar sub limita cuantific\u0103rii (testul poate fi repetat dup\u0103 1-2 luni \u00een func\u021bie de contextul clinic)s<sup>2<\/sup>.<\/p>\n<p><strong><em>Interpretarea rezultatelor<\/em><\/strong><\/p>\n<p>Rezultatele viremiei sunt exprimate at\u00e2t numeric (UI\/mL) c\u00e2t \u0219i sub form\u0103 logaritmic\u0103 (log UI\/mL). Exprimarea logaritmic\u0103 este util\u0103 pentru evaluarea r\u0103spunsului la tratament. O modificare cu 1 log a viremiei fa\u021b\u0103 de nivelul bazal indic\u0103 o cre\u0219tere sau o sc\u0103dere de 10 ori. Ob\u0163inerea unui rezultat pozitiv indic\u0103 prezen\u0163a unei infec\u0163ii active<sup>1;2<\/sup>.<\/p>\n<p><strong><u>Monitorizarea viremiei pentru regimul clasic de tratament antiviral<\/u><\/strong><\/p>\n<p>PegINF\u03b1 \u00een asociere cu ribavirina este indicat pentru tratamentul hepatitei cronice tip C la pacien\u0163ii adul\u0163i cu ARN-VHC pozitiv, precum \u015fi la pacien\u0163ii cu\u00a0 ciroz\u0103 hepatic\u0103 compensat\u0103 postinfec\u0163ie viral\u0103 C.<\/p>\n<p>\u0162inta tratamentului antiviral este <strong>r\u0103spunsul virusologic sus\u0163inut (\u201esustained virusological response\u201d, SVR)<\/strong> definit ca ARN-HCV nedetectabil la 6 luni dup\u0103 \u00eencheierea tratamentului.<\/p>\n<p>R\u0103spunsul la tratamentul antiviral este influen\u0163at de numero\u015fi factori, fie virologici (genotipul HVC, nivelul viremiei bazale), fie care \u0163in de gazd\u0103 (ras\u0103, severitatea afec\u0163iunii hepatice, rezisten\u0163a la insulin\u0103). Al\u0103turi de ace\u015ftia exist\u0103 \u015fi factori corectabili, care au ap\u0103rut \u00een cursul terapiei ini\u0163iale dar asupra c\u0103rora se poate interveni la a doua \u00eencercare de tratment (reducerile mari de doze sau chiar \u00eentreruperea tratamentului ca urmare a unor reac\u0163ii adverse hematologice sau a depresiei; complian\u0163\u0103 redus\u0103)<sup>4<\/sup>.<\/p>\n<p>\u00cen func\u0163ie de momentul la care s-a produs clearance-ul viral, r\u0103spunsul virusologic poate fi \u00eencadrat \u00een una din urm\u0103toarele categorii:<\/p>\n<p>- <em><u>r\u0103spuns virusologic rapid (\u201erapid virusological response\u201d, RVR)<\/u><\/em>: ob\u0163inerea unui ARN-HCV nedetectabil la 4 s\u0103pt\u0103m\u00e2ni de la ini\u0163ierea terapiei; pacien\u0163ii sunt considera\u0163i \u201crapid-responders\u201d;<\/p>\n<p>- <em><u>r\u0103spuns virusologic precoce (<\/u><\/em><u>\u201e<em>early virusological response<\/em>\u201d,<em> EVR) complet<\/em><\/u>: definit printr-o viremie nedetectabil\u0103 la 12 s\u0103pt\u0103m\u00e2ni de la ini\u0163ierea terapiei; pacien\u0163ii sunt considera\u0163i \u201cstandard-responders\u201d;<\/p>\n<p><em>- <u>r\u0103spuns virusologic lent (<\/u><\/em><u>\u201e<em>slow virusological response<\/em>\u201d)<em> sau r\u0103spuns virusologic precoce par\u0163ial<\/em><\/u>: definit printr-o sc\u0103dere a viremiei cu \u22652 log<sub>10<\/sub> fa\u0163\u0103 de nivelul de baz\u0103 la 12 s\u0103pt\u0103m\u00e2ni de la \u00eenceputul tratamentului \u015fi ob\u0163inerea unui ARN HCV nedetectabil \u00een s\u0103pt\u0103m\u00e2na 24; pacien\u0163ii sunt considera\u0163i \u201cslow-responders\u201d<sup>3;4<\/sup>.<\/p>\n<p>Pe de alt\u0103 parte, exist\u0103 urm\u0103toarele categorii asociate cu e\u015fecul terapiei antivirale:<\/p>\n<p>- <em><u>lips\u0103 de r\u0103spuns virusologic (\u201cnon-response\u201d)<\/u>:<\/em> definit printr-o sc\u0103dere a viremiei cu &lt;2 log<sub>10<\/sub> fa\u0163\u0103 de nivelul de baz\u0103 la 12 s\u0103pt\u0103m\u00e2ni de la \u00eenceputul tratamentului; \u00een cadrul acestei categorii mai exist\u0103 un grup de pacien\u0163i, considera\u0163i ca fiind cei mai refractari la tratamentul antiviral, la care se constat\u0103 \u00een orice moment o sc\u0103dere a viremiei &lt;0.5 log<sub>10<\/sub> fa\u0163\u0103 de nivelul de baz\u0103 (\u201cnull-response\u201d); pacien\u0163ii sunt considera\u0163i \u201cnon-responders\u201d \u015fi se \u00eentrerupe tratmentul antiviral \u00een s\u0103pt\u0103m\u00e2na 12;<\/p>\n<p>- <em><u>r\u0103spuns virusologic par\u0163ial<\/u><\/em>: definit printr-o sc\u0103dere a viremiei cu \u22652 log<sub>10<\/sub> fa\u0163\u0103 de nivelul de baz\u0103 la 12 s\u0103pt\u0103m\u00e2ni de la \u00eenceputul tratamentului, \u00eens\u0103 cu un ARN HCV detectabil \u00een s\u0103pt\u0103m\u00e2na 24; la ace\u015fti pacien\u0163i se \u00eentrerupe de tratamentul antiviral \u00een s\u0103pt\u0103m\u00e2na 24;<\/p>\n<p>- <em><u>reapari\u0163ia viremiei (\u201ebreakthrough\u201d)<\/u><\/em>: ARN HCV detectabil \u00een cursul tratamentului, dup\u0103 un r\u0103spuns virusologic ini\u0163ial;<\/p>\n<p>- <u>rec\u0103dere <em>(\u201erelapse\u201d)<\/em><\/u>: ARN-HCV detectabil dup\u0103 sf\u00e2r\u015fitul terapiei la pacien\u0163i care au niveluri nedetectabile \u00a0sus\u0163inute ale viremiei \u00een cursul tratamentului<sup>4<\/sup>.<\/p>\n<p>Durata tratamentului combinat este \u00een func\u0163ie de genotipul viral. Conform programelor standard de terapie antiviral\u0103, pacien\u0163ii infecta\u0163i cu HCV genotip 1 sau genotip 4, indiferent de nivelul viremiei de baz\u0103, trebuie s\u0103 primeasc\u0103 tratament timp de 48 s\u0103pt\u0103m\u00e2ni. Studiile clinice multina\u0163ionale au ar\u0103tat c\u0103 la pacien\u0163ii infecta\u0163i cu genotipurile 2 sau 3 durata tratamentului combinat poate fi redus\u0103 la 24 s\u0103pt\u0103m\u00e2ni, f\u0103r\u0103 compromiterea eficien\u0163ei (rata r\u0103spunsului virusologic sus\u0163inut este de 84%)<sup>5<\/sup>.<\/p>\n<p>Datele studiul INDIV-2 indic\u0103 posibilitatea instituirii unei terapii individualizate, ghidat\u0103 de r\u0103spunsul virusologic, la pacien\u0163ii cu genotip 1\/4, astfel:<\/p>\n<ul>\n<li>durata tratamentului va fi de 24 s\u0103pt\u0103m\u00e2ni la pacien\u0163ii \u201crapid-responders\u201d, cu viremie bazal\u0103 sc\u0103zut\u0103 (&lt;600 000 \u2013 800 000 UI);<\/li>\n<li>\u00een cazul pacien\u0163ilor \u201cstandard-responders\u201d durata tratamentului va fi de 48 s\u0103pt\u0103m\u00e2ni;<\/li>\n<li>pacien\u0163ii \u201cslow-responders\u201d pot beneficia de prelungirea tratamentului la 72 s\u0103pt\u0103m\u00e2ni.<\/li>\n<\/ul>\n<p>Comparativ cu lotul martor care a primit tratamentul standard de 48 s\u0103pt\u0103m\u00e2ni, rata SVR \u00een cazul terapiei individualizate a fost de 55%, versus 48%<sup>6<\/sup>.<\/p>\n<p><strong><u>Monitorizarea viremiei pentru protocoalele ce includ antivirale cu ac\u021biune direct\u0103 (terapie interferon-free) <\/u><\/strong><\/p>\n<p>Viremia va fi determinat\u0103 \u00eenainte de \u00eenceperea terapiei, op\u021bional dup\u0103 2-4 s\u0103pt\u0103m\u00e2ni, la \u00eencheierea tratamentului (dup\u0103 8, 12, 16 sau 24 s\u0103pt\u0103m\u00e2ni, \u00een func\u021bie de regimul terapeutic) \u0219i dup\u0103 12 sau 24 s\u0103pt\u0103m\u00e2ni\u00a0 de la \u00eencheierea tratamentului<sup>7<\/sup>.<\/p>\n<p>Limite \u015fi interferen\u0163e<\/p>\n<p>Heparina inhib\u0103 PCR-ul, de aceea aceasta nu trebuie folosit\u0103 ca anticoagulant<sup>2<\/sup>.<\/p>\n<p><strong>\u0411\u0438\u0431\u043b\u0438\u043e\u0433\u0440\u0430\u0444\u0438\u044f<\/strong><\/p>\n<ol>\n<li>ARUP\u2019s Guide to Clinical Laboratory Testing. Hepatitis C Virus RNA Quantitative, Real-Time PCR. <a href=\"http:\/\/www.aruplab.com\/guides\" rel=\"nofollow noopener\" target=\"_blank\">www.aruplab.com\/guides<\/a><strong>.\u00a0<\/strong>2017 Ref Type: Internet Communication.<\/li>\n<li>Laborator Synevo. Referin\u0163ele specifice tehnologiei de lucru utilizate. 2017. Ref Type: Catalog.<\/li>\n<li>Alberti A. Towards more individualized management of hepatitis C virus patients with initially or persistently norma alanineamniotransferase levels. Hepatol. 2005 Feb;42(2):266-74.2.<\/li>\n<li>Graham R. Foster, K. Rajender Reddy. Clinical Dilemas in Viral Liver Disease, Blackwell Publishing, 2010, 34-42.<\/li>\n<li>Hadziyannis SJ, Sette H Jr, Morgan TR, Balan V, Diago M, Marcellin P, Ramadori G, Bodenheimer H Jr, Bernstein D, Rizzetto M, Zeuzem S, Pockros PJ, Lin A, Ackrill AM; PEGASYS International Study Group. Peginterferon-alpha2a and ribavirin combination therapy in chronic hepatitis C: a randomized study of treatment duration and ribavirin dose. Ann Intern Med. 2004 Mar 2;140(5):346-55.<\/li>\n<li>Sarrazin C, Berg T, Ross RS, Schirmacher P, Wedemeyer H, Neumann U, Schmidt HH, Spengler U, Wirth S, Kessler HH, Peck-Radosavljevic M, Ferenci P, Vogel W, Moradpour D, Heim M, Cornberg M, Protzer U, Manns MP, Fleig WE, Dollinger MM, Zeuzem S. Prophylaxis, diagnosis and therapy of hepatitis C virus (HCV) infection: the German guidelines on the management of HCV infection. Z Gastroenterol. 2010 Feb;48(2):289-351.<\/li>\n<li>European Association for the Study of the Liver. EASL recommendations on treatment of hepatitis C 2016. J Hepatol. 2017 Jan;66(1):153-194.<\/li>\n<\/ol>","protected":false},"excerpt":{"rendered":"<p>\u0413\u0435\u043f\u0430\u0442\u0438\u0442 \u0421 \u2013 \u044d\u0442\u043e \u0432\u0438\u0440\u0443\u0441\u043d\u043e\u0435 \u0437\u0430\u0431\u043e\u043b\u0435\u0432\u0430\u043d\u0438\u0435 \u043f\u0435\u0447\u0435\u043d\u0438, \u043a\u043e\u0442\u043e\u0440\u043e\u0435 \u0447\u0430\u0441\u0442\u043e \u043f\u0435\u0440\u0435\u0445\u043e\u0434\u0438\u0442 \u0432 \u0445\u0440\u043e\u043d\u0438\u0447\u0435\u0441\u043a\u0443\u044e \u0444\u043e\u0440\u043c\u0443 (55-85% \u0438\u043d\u0444\u0438\u0446\u0438\u0440\u043e\u0432\u0430\u043d\u043d\u044b\u0445). \u0412\u0438\u0440\u0443\u0441 \u043f\u0435\u0440\u0435\u0434\u0430\u0435\u0442\u0441\u044f \u043f\u0430\u0440\u0435\u043d\u0442\u0435\u0440\u0430\u043b\u044c\u043d\u043e (\u0438\u0441\u043f\u043e\u043b\u044c\u0437\u043e\u0432\u0430\u043d\u0438\u0435 \u0437\u0430\u0433\u0440\u044f\u0437\u043d\u0435\u043d\u043d\u044b\u0445 \u0438\u0433\u043b, \u0448\u043f\u0440\u0438\u0446\u0435\u0432 \u0438 \u0434\u0440\u0443\u0433\u0438\u0445 \u043c\u0435\u0434\u0438\u0446\u0438\u043d\u0441\u043a\u0438\u0445 \u0438\u043d\u0441\u0442\u0440\u0443\u043c\u0435\u043d\u0442\u043e\u0432), \u0440\u0435\u0436\u0435 \u2013 \u043f\u043e\u043b\u043e\u0432\u044b\u043c \u043f\u0443\u0442\u0435\u043c, \u0430 \u0442\u0430\u043a\u0436\u0435 \u0432\u0435\u0440\u0442\u0438\u043a\u0430\u043b\u044c\u043d\u044b\u043c \u043f\u0443\u0442\u0435\u043c \u043e\u0442 \u0438\u043d\u0444\u0438\u0446\u0438\u0440\u043e\u0432\u0430\u043d\u043d\u043e\u0439 \u043c\u0430\u0442\u0435\u0440\u0438 \u0440\u0435\u0431\u0435\u043d\u043a\u0443 (4-6% \u0441\u043b\u0443\u0447\u0430\u0435\u0432).<\/p>\n<p>\u0412\u0438\u0440\u0443\u0441 \u0433\u0435\u043f\u0430\u0442\u0438\u0442\u0430 \u0421 \u043f\u0440\u043e\u044f\u0432\u043b\u044f\u0435\u0442 \u0431\u043e\u043b\u044c\u0448\u0443\u044e \u0432\u0430\u0440\u0438\u0430\u0431\u0435\u043b\u044c\u043d\u043e\u0441\u0442\u044c \u0433\u0435\u043d\u043e\u043c\u0430, \u0443 \u0438\u043d\u0444\u0438\u0446\u0438\u0440\u043e\u0432\u0430\u043d\u043d\u044b\u0445 \u043f\u0440\u043e\u0438\u0441\u0445\u043e\u0434\u0438\u0442 \u0431\u044b\u0441\u0442\u0440\u0430\u044f \u043c\u0443\u0442\u0430\u0446\u0438\u044f \u0432\u0438\u0440\u0443\u0441\u0430, \u0441 \u0447\u0435\u043c, \u0432\u043e\u0437\u043c\u043e\u0436\u043d\u043e, \u0441\u0432\u044f\u0437\u0430\u043d\u043e \u0443\u0441\u043a\u043e\u043b\u044c\u0437\u0430\u043d\u0438\u0435 \u0435\u0433\u043e \u043e\u0442 \u043c\u0435\u0445\u0430\u043d\u0438\u0437\u043c\u043e\u0432 \u0438\u043c\u043c\u0443\u043d\u043d\u043e\u0439 \u0437\u0430\u0449\u0438\u0442\u044b \u0438 \u0431\u043e\u043b\u044c\u0448\u0430\u044f \u0447\u0430\u0441\u0442\u043e\u0442\u0430 \u0445\u0440\u043e\u043d\u0438\u0437\u0430\u0446\u0438\u0438 \u0438\u043d\u0444\u0435\u043a\u0446\u0438\u0438. \u0425\u0440\u043e\u043d\u0438\u0447\u0435\u0441\u043a\u0430\u044f \u0438\u043d\u0444\u0435\u043a\u0446\u0438\u044f \u0432\u0438\u0440\u0443\u0441\u043e\u043c \u0433\u0435\u043f\u0430\u0442\u0438\u0442\u0430 \u0421 \u0445\u0430\u0440\u0430\u043a\u0442\u0435\u0440\u0438\u0437\u0443\u0435\u0442\u0441\u044f, \u0441 \u043e\u0434\u043d\u043e\u0439 \u0441\u0442\u043e\u0440\u043e\u043d\u044b, \u043f\u043e\u0441\u0442\u043e\u044f\u043d\u043d\u043e\u0439 \u0440\u0435\u043f\u043b\u0438\u043a\u0430\u0446\u0438\u0435\u0439 \u0432\u0438\u0440\u0443\u0441\u0430, \u0430 \u0441 \u0434\u0440\u0443\u0433\u043e\u0439 \u2013 \u0430\u043a\u0442\u0438\u0432\u043d\u044b\u043c, \u043d\u043e \u043d\u0435\u0434\u043e\u0441\u0442\u0430\u0442\u043e\u0447\u043d\u044b\u043c \u0438\u043c\u043c\u0443\u043d\u043d\u044b\u043c \u043e\u0442\u0432\u0435\u0442\u043e\u043c \u043e\u0440\u0433\u0430\u043d\u0438\u0437\u043c\u0430. \u0412 \u043e\u0442\u043b\u0438\u0447\u0438\u0435 \u043e\u0442 \u0433\u0435\u043f\u0430\u0442\u0438\u0442\u0430 \u0412, \u0430\u043d\u0442\u0438\u0433\u0435\u043d\u044b \u0432\u0438\u0440\u0443\u0441\u0430 \u0433\u0435\u043f\u0430\u0442\u0438\u0442\u0430 \u0421 \u0432 \u043a\u0440\u043e\u0432\u0438 \u043d\u0435 \u0443\u043b\u0430\u0432\u043b\u0438\u0432\u0430\u044e\u0442\u0441\u044f \u0432 \u0434\u043e\u0441\u0442\u0430\u0442\u043e\u0447\u043d\u044b\u0445 \u043a\u043e\u043b\u0438\u0447\u0435\u0441\u0442\u0432\u0430\u0445 (\u0438\u0445 \u043e\u0431\u043d\u0430\u0440\u0443\u0436\u0438\u0432\u0430\u044e\u0442 \u0432 \u0431\u0438\u043e\u043f\u0442\u0430\u0442\u0430\u0445 \u043f\u0435\u0447\u0435\u043d\u0438). \u042d\u0442\u043e \u043e\u0433\u0440\u0430\u043d\u0438\u0447\u0438\u0432\u0430\u0435\u0442 \u0432\u043e\u0437\u043c\u043e\u0436\u043d\u043e\u0441\u0442\u0438 \u043b\u0430\u0431\u043e\u0440\u0430\u0442\u043e\u0440\u043d\u043e\u0439 \u043e\u0446\u0435\u043d\u043a\u0438 \u0442\u0435\u0447\u0435\u043d\u0438\u044f \u0438 \u0430\u043a\u0442\u0438\u0432\u043d\u043e\u0441\u0442\u0438 \u0438\u043d\u0444\u0435\u043a\u0446\u0438\u043e\u043d\u043d\u043e\u0433\u043e \u043f\u0440\u043e\u0446\u0435\u0441\u0441\u0430.<\/p>\n<p>\u0414\u0438\u0430\u0433\u043d\u043e\u0437 \u0433\u0435\u043f\u0430\u0442\u0438\u0442\u0430 \u0421 \u0432 \u043d\u0430\u0441\u0442\u043e\u044f\u0449\u0435\u0435 \u0432\u0440\u0435\u043c\u044f \u043e\u0441\u043d\u043e\u0432\u044b\u0432\u0430\u0435\u0442\u0441\u044f \u043d\u0430 \u043f\u0440\u044f\u043c\u043e\u043c \u043e\u0431\u043d\u0430\u0440\u0443\u0436\u0435\u043d\u0438\u0438 \u0432\u0438\u0440\u0443\u0441\u043d\u043e\u0439 \u0420\u041d\u041a \u043c\u0435\u0442\u043e\u0434\u043e\u043c \u041f\u0426\u0420 \u0438 \u043e\u0431\u043d\u0430\u0440\u0443\u0436\u0435\u043d\u0438\u0438 anti-HCV \u0430\u043d\u0442\u0438\u0442\u0435\u043b.<\/p>\n<p>\u041a\u043e\u043b\u0438\u0447\u0435\u0441\u0442\u0432\u0435\u043d\u043d\u0430\u044f \u0445\u0430\u0440\u0430\u043a\u0442\u0435\u0440\u0438\u0441\u0442\u0438\u043a\u0430 \u0441\u043e\u0434\u0435\u0440\u0436\u0430\u043d\u0438\u044f \u0420\u041d\u041a \u0432\u0438\u0440\u0443\u0441\u0430 \u0433\u0435\u043f\u0430\u0442\u0438\u0442\u0430 \u0421 \u0432 \u043a\u043b\u0438\u043d\u0438\u0447\u0435\u0441\u043a\u0438\u0445 \u043e\u0431\u0440\u0430\u0437\u0446\u0430\u0445 \u0432\u0430\u0436\u043d\u0430 \u0434\u043b\u044f \u043e\u0446\u0435\u043d\u043a\u0438 \u044d\u0444\u0444\u0435\u043a\u0442\u0438\u0432\u043d\u043e\u0441\u0442\u0438 \u043f\u0440\u043e\u0442\u0438\u0432\u043e\u0432\u0438\u0440\u0443\u0441\u043d\u043e\u0439 \u0442\u0435\u0440\u0430\u043f\u0438\u0438 \u0438 \u0438\u043c\u0435\u0435\u0442 \u043f\u0440\u043e\u0433\u043d\u043e\u0441\u0442\u0438\u0447\u0435\u0441\u043a\u043e\u0435 \u0437\u043d\u0430\u0447\u0435\u043d\u0438\u0435 \u0434\u043b\u044f \u043e\u043f\u0440\u0435\u0434\u0435\u043b\u0435\u043d\u0438\u044f \u0445\u0440\u043e\u043d\u0438\u0437\u0430\u0446\u0438\u0438 \u044d\u0442\u043e\u0433\u043e \u0433\u0435\u043f\u0430\u0442\u0438\u0442\u0430. \u0412 \u0434\u0430\u043d\u043d\u043e\u043c \u0438\u0441\u0441\u043b\u0435\u0434\u043e\u0432\u0430\u043d\u0438\u0438 \u043e\u043f\u0440\u0435\u0434\u0435\u043b\u0435\u043d\u0438\u0435 \u0420\u041d\u041a \u0432\u0438\u0440\u0443\u0441\u0430 \u0433\u0435\u043f\u0430\u0442\u0438\u0442\u0430 \u0421 \u0432 \u0441\u044b\u0432\u043e\u0440\u043e\u0442\u043a\u0435 \u043a\u0440\u043e\u0432\u0438 \u043f\u0440\u043e\u0432\u043e\u0434\u0438\u0442\u0441\u044f \u043c\u0435\u0442\u043e\u0434\u043e\u043c \u043f\u043e\u043b\u0438\u043c\u0435\u0440\u0430\u0437\u043d\u043e\u0439 \u0446\u0435\u043f\u043d\u043e\u0439 \u0440\u0435\u0430\u043a\u0446\u0438\u0438 (\u041f\u0426\u0420) \u0441 \u0434\u0435\u0442\u0435\u043a\u0446\u0438\u0435\u0439 \u0432 \u0440\u0435\u0436\u0438\u043c\u0435 \u0440\u0435\u0430\u043b\u044c\u043d\u043e\u0433\u043e \u0432\u0440\u0435\u043c\u0435\u043d\u0438.<\/p>\n<p>\u041f\u043e \u0440\u0435\u043a\u043e\u043c\u0435\u043d\u0434\u0430\u0446\u0438\u0438 \u0412\u0441\u0435\u043c\u0438\u0440\u043d\u043e\u0439 \u043e\u0440\u0433\u0430\u043d\u0438\u0437\u0430\u0446\u0438\u0438 \u0437\u0434\u0440\u0430\u0432\u043e\u043e\u0445\u0440\u0430\u043d\u0435\u043d\u0438\u044f, \u0443\u0441\u0442\u0430\u043d\u043e\u0432\u0438\u0442\u044c \u0434\u0438\u0430\u0433\u043d\u043e\u0437 \u0433\u0435\u043f\u0430\u0442\u0438\u0442\u0430 \u0421 \u0432\u043e\u0437\u043c\u043e\u0436\u043d\u043e \u043d\u0430 \u043e\u0441\u043d\u043e\u0432\u0430\u043d\u0438\u0438 \u0442\u0440\u043e\u0435\u043a\u0440\u0430\u0442\u043d\u043e\u0433\u043e \u043e\u0431\u043d\u0430\u0440\u0443\u0436\u0435\u043d\u0438\u044f \u0420\u041d\u041a \u0432\u0438\u0440\u0443\u0441\u043d\u043e\u0433\u043e \u0433\u0435\u043f\u0430\u0442\u0438\u0442\u0430 C \u0432 \u0441\u044b\u0432\u043e\u0440\u043e\u0442\u043a\u0435 \u043a\u0440\u043e\u0432\u0438 \u043f\u0440\u0438 \u043e\u0442\u0441\u0443\u0442\u0441\u0442\u0432\u0438\u0438 \u0434\u0440\u0443\u0433\u0438\u0445 \u043c\u0430\u0440\u043a\u0435\u0440\u043e\u0432 \u0433\u0435\u043f\u0430\u0442\u0438\u0442\u0430. \u0412 \u043e\u0441\u0442\u0440\u0443\u044e \u0444\u0430\u0437\u0443 \u0433\u0435\u043f\u0430\u0442\u0438\u0442\u0430 \u0420\u041d\u041a \u0432\u0438\u0440\u0443\u0441\u0430 \u0432\u044b\u044f\u0432\u043b\u044f\u0435\u0442\u0441\u044f \u0432 \u043a\u0440\u043e\u0432\u0438 \u0443\u0436\u0435 \u0447\u0435\u0440\u0435\u0437 1-2 \u043d\u0435\u0434\u0435\u043b\u0438 \u043f\u043e\u0441\u043b\u0435 \u0437\u0430\u0440\u0430\u0436\u0435\u043d\u0438\u044f, \u0442\u043e \u0435\u0441\u0442\u044c \u0437\u0430\u0434\u043e\u043b\u0433\u043e \u0434\u043e \u043f\u043e\u044f\u0432\u043b\u0435\u043d\u0438\u044f \u0430\u043d\u0442\u0438\u0442\u0435\u043b \u043a \u0432\u0438\u0440\u0443\u0441\u0443 \u0433\u0435\u043f\u0430\u0442\u0438\u0442\u0430 \u0421.<\/p>\n<p>\u0412\u044b\u044f\u0432\u043b\u0435\u043d\u0438\u0435 \u0420\u041d\u041a \u0433\u0435\u043f\u0430\u0442\u0438\u0442\u0430 \u0421 \u0432 \u0441\u044b\u0432\u043e\u0440\u043e\u0442\u043a\u0435 \u043a\u0440\u043e\u0432\u0438 \u0438\u0441\u043f\u043e\u043b\u044c\u0437\u0443\u0435\u0442\u0441\u044f \u043f\u0440\u0438 \u0432\u0435\u0434\u0435\u043d\u0438\u0438 \u043f\u0430\u0446\u0438\u0435\u043d\u0442\u043e\u0432 \u0441 \u0445\u0440\u043e\u043d\u0438\u0447\u0435\u0441\u043a\u043e\u0439 \u0412\u0413\u0421-\u0438\u043d\u0444\u0435\u043a\u0446\u0438\u0435\u0439 \u0434\u043b\u044f \u043e\u0446\u0435\u043d\u043a\u0438 \u0432\u0438\u0440\u0443\u0441\u043e\u043b\u043e\u0433\u0438\u0447\u0435\u0441\u043a\u043e\u0433\u043e \u043e\u0442\u0432\u0435\u0442\u0430 \u043d\u0430 \u0440\u0430\u043d\u043d\u0438\u0445 \u044d\u0442\u0430\u043f\u0430\u0445 \u043a\u0443\u0440\u0441\u0430 \u0430\u043d\u0442\u0438\u0432\u0438\u0440\u0443\u0441\u043d\u043e\u0439 \u0442\u0435\u0440\u0430\u043f\u0438\u0438.<\/p>","protected":false},"featured_media":0,"comment_status":"closed","ping_status":"closed","template":"","meta":[],"product_brand":[],"product_cat":[968,971],"product_tag":[],"class_list":{"0":"post-9168","1":"product","2":"type-product","3":"status-publish","5":"product_cat-teste-de-biologie-moleculara","6":"product_cat-teste-moleculare-pentru-diagnosticul-infectiilor","8":"first","9":"instock","10":"sold-individually","11":"shipping-taxable","12":"purchasable","13":"product-type-simple"},"_links":{"self":[{"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/product\/9168","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/product"}],"about":[{"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/types\/product"}],"replies":[{"embeddable":true,"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/comments?post=9168"}],"wp:attachment":[{"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/media?parent=9168"}],"wp:term":[{"taxonomy":"product_brand","embeddable":true,"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/product_brand?post=9168"},{"taxonomy":"product_cat","embeddable":true,"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/product_cat?post=9168"},{"taxonomy":"product_tag","embeddable":true,"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/product_tag?post=9168"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}