{"id":9941,"date":"2020-04-23T03:51:53","date_gmt":"2020-04-23T01:51:53","guid":{"rendered":"https:\/\/www.synevo.ro\/product\/hiv-1-arn-cantitativ\/"},"modified":"2025-01-30T16:33:38","modified_gmt":"2025-01-30T14:33:38","slug":"hiv-1-arn-cantitativ","status":"publish","type":"product","link":"https:\/\/old.synevo.md\/ru\/shop\/hiv-1-arn-cantitativ\/","title":{"rendered":"\u0412\u0418\u0427-1, \u043e\u043f\u0440\u0435\u0434\u0435\u043b\u0435\u043d\u0438\u0435 \u0420\u041d\u041a (\u043a\u043e\u043b\u0438\u0447\u0435\u0441\u0442\u0432\u0435\u043d\u043d\u043e\u0435)"},"content":{"rendered":"<p class=\"translation-block\">\u041e\u0431\u0449\u0430\u044f \u0438\u043d\u0444\u043e\u0440\u043c\u0430\u0446\u0438\u044f<\/p>\n<p>Virusul imunodeficientei umane (HIV), agentul etiologic al sindromului imunodeficientei umane dobandite (SIDA), face parte din familia Retroviridae, subfamilia Lentivirinae.<\/p>\n<p>Exista doua tipuri de HIV, fiecare cu mai multe subtipuri, diferentiate pe zone geografice:<\/p>\n<p><span style=\"text-decoration: underline;\">HIV-1<\/span><\/p>\n<ul>\n<li>mai virulent;<\/li>\n<li>responsabil de epidemia globala actuala;<\/li>\n<li>severitatea infectiei variaza de la o persoana la alta;<\/li>\n<li>include grupul M cu 10 subtipuri, de la A la J, grupul O (secundar, \u201coutlier\u201d) si grupul N (non-M, non-O).<\/li>\n<\/ul>\n<p><span style=\"text-decoration: underline;\">HIV-2<\/span><\/p>\n<ul>\n<li>descoperit initial in vestul Africii, este prezent la ora actuala si in unele tari din Europa si sud-estul Asiei;<\/li>\n<li>tip viral mai atenuat;<\/li>\n<li>genomul sau este mai inrudit cu genomul SIV (virusul imunodeficientei simiene) decat in cazul HIV-1;<\/li>\n<li>este divizat in 5 grupuri, de la A la E.<\/li>\n<\/ul>\n<p>HIV este un virus ARN monocatenar cu polaritate pozitiva, cu o anvelopa pe care sunt prezente numeroase copii ale glicoproteinei de suprafata gp120 care se leaga de receptorul CD4 situat pe limfocitele T helper, macrofage, celule foliculare dendritice. Genomul contine doua filamente de ARN viral monocatenar pe care sunt dispuse urmatoarele 3 categorii de gene:<\/p>\n<p>-<span style=\"text-decoration: underline;\">gene structurale<\/span><\/p>\n<p style=\"padding-left: 30px;\">\u00a0\u25cf <em>gag (genome-associated gene) <\/em>care codifica proteinele ce formeaza miezul sau<\/p>\n<p style=\"padding-left: 30px;\">\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 nucleul virusului: \u2013 p17 (proteina matricei);<\/p>\n<p style=\"padding-left: 30px;\"><em>\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0<\/em>\u2013 p24 (proteina capsidala);<\/p>\n<p style=\"padding-left: 30px;\">\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u2013 p7 (proteina nucleocapsidei);<\/p>\n<p style=\"padding-left: 30px;\">\u25cf <em>pol (polymerase) <\/em>care codifica: \u2013 p11 (proteaza);<\/p>\n<p style=\"padding-left: 30px;\">\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u2013 p66 (reverstranscriptaza);<\/p>\n<p style=\"padding-left: 30px;\">\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u2013 p32 (integraza);<\/p>\n<p style=\"padding-left: 30px;\">\u25cf <em>env (envelope) <\/em>care codifica proteinele ce formeaza anvelopa virionului:<\/p>\n<p style=\"padding-left: 30px;\">\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 -gp 160 \u2013 glicoproteina precursor care prin scindare da nastere la:<\/p>\n<p style=\"padding-left: 30px;\">\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 \u2013 gp 120 (de suprafata);<\/p>\n<p style=\"padding-left: 30px;\">\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 \u2013 gp 41 (transmembranara);<\/p>\n<p>\u00a0-<span style=\"text-decoration: underline;\">gene reglatoare<\/span><em>: rev, nef, tat<\/em>.;<\/p>\n<p><em>-\u00a0<\/em><span style=\"text-decoration: underline;\">gene de maturare <\/span>care sunt esentiale pentru patogenicitate <em>in vivo: vif, vpu, <\/em><em>vpr\/vpx<\/em><sup>1;5<\/sup>.<\/p>\n<p>Patrunderea HIV in organism se face la nivelul:<\/p>\n<ul>\n<li>mucoaselor urogenitale, rectale sau orale, prin contact hetero- sau homosexual;<\/li>\n<li>perinatal, de la mama la fat;<\/li>\n<li>parenteral, prin solutii de continuitate ale tegumentelor si mucoaselor, injectii, tatuaje, transfuzii si transplant de organe de la donatori infectati<sup>1;5<\/sup><span style=\"font-size: 16px;\">.<\/span><\/li>\n<\/ul>\n<p>Modelul comun este infectia prin mucoase, tintele initiale fiind celulele Langerhans din lamina propria subiacenta acestora. Sunt infectate mai ales macrofagele in curs de diferentiere cu susceptibilitate crescuta la replicare si limfocitele T activate. Infectia limfocitelor T CD4+ favorizeaza progresia spre ganglionii teritoriali si tesuturile mai profunde.<\/p>\n<p>O etapa caracteristica pentru ciclul replicativ al retrovirusurilor este conversia ARN-ului viral in ADN proviral bicatenar prin reverstranscriere catalizata de reverstranscriptaza; ADN-ul proviral este translocat in nucleul celulei gazda, transformat in ADN circular si inserat in genomul acesteia cu ajutorul integrazei.\u00a0 Dupa ce are loc integrarea, replicarea si sinteza de noi particule virale sunt dependente de prezenta unor factori celulari si virali necesari activarii promotorilor virali. Factorii externi cum ar fi coinfectia cu alti agenti patogeni, productia de citokine inflamatorii si activarea celulara potenteaza replicarea virala. Mecanismele moleculare care regleaza productia virala includ cai celulare in care sunt implicati factori, cum ar fi familia factorului nuclear-\u03baB (NF- \u03baB) (factori de transcriptie), care genereaza o cascada de evenimente ce conduc in final la expresia genomului viral.<\/p>\n<p>Diseminarea virusului de la situsul de intrare se face pe cale sanguina, fie sub forma de virioni liberi, fie asociat cu limfocitele CD4+ sau monocitele<sup>5<\/sup>.<\/p>\n<p>Aproximativ jumatate dintre pacientii infectati acut cu HIV prezinta un sindrom pasager asemanator mononucleozei infectioase; in faza acuta nivelurile de HIV-ARN sunt crescute in timp ce anticorpii specifici pot fi inca nedetectabili. Din acest motiv, detectarea prin reactia de polimerizare in lant (PCR) a acizilor nucleici HIV-1 s-a dovedit a fi mai sensibila decat testele ELISA de generatia a 3-a in perioada de \u201efereastra imunologica\u201d (in primele 3-4 saptamani de la contactul infectant). Folosirea testelor de generatia a 4-a care combina detectia anticorpilor HIV cu cea a antigenului p24 conduce la o sensibilitate clinica mai mare in faza precoce de seroconversie; totusi detectarea HIV1-ARN este posibila cu 6 zile mai devreme in comparatie cu cea a antigenului p24. In tarile dezvoltate bancile de sange utilizeaza de rutina tehnici moleculare pentru depistarea donatorilor cu infectie HIV in stadiu initial<sup>7;8<\/sup>.<\/p>\n<p>Faza acuta este urmata de o perioada de infectie asimptomatica; in medie, intervalul de timp necesar pentru reducerea marcata a numarului de limfocite CD4+ si dezvoltarea sindromului imunodeficientei dobandite (SIDA) este de 10-11 ani; 5-10% dintre pacienti trec in aceasta faza mult mai rapid, in decurs de 3 ani, in timp ce 5-10% mentin un numar constant de celule CD4+ si raman asimptomatici o perioada de timp indefinita. Etapa SIDA este marcata de evolutia unor infectii cu risc vital, de neoplasme oportuniste sau de manifestari directe ale citopatogenicitatii HIV<sup>8<\/sup>.<\/p>\n<p>Diagnosticul serologic al infectiei HIV in perioada prenatala este complicat de persistenta prelungita a anticorpilor materni (aproximativ 18 luni de la nastere). Din acest motiv, metoda de electie pentru depistarea infectiei neonatale sunt testele moleculare. Acestea se recomanda a fi efectuate dupa 2-3 saptamani de la nastere, la varsta de 1-2 luni si la 4-6 luni, pentru toti copiii nascuti din mame HIV pozitive<sup>3;7<\/sup>.<\/p>\n<p>Sunt descrise doua tipuri de teste care detecteaza incarcatura virala:<\/p>\n<ul>\n<li>un test care detecteaza incarcatura virala celulara, respectiv ADN proviral in celulele mononucleare din sangele periferic prin tehnica PCR;<\/li>\n<li>un test care detecteaza incarcatura de ARN plasmatic prin tehnica RT-PCR care foloseste reverstranscriptaza.<\/li>\n<\/ul>\n<p>Ambele tehnici optimizate evalueaza cantitativ numarul de copii genomice<sup>7<\/sup>.<\/p>\n<p>Testul de detectie a ADN-ului proviral este utilizat pentru diagnosticul infectiei la copiii nascuti din mame HIV pozitive, depistarea precoce a infectiei in perioada in care testele serologice, antigenul p24 si HIV-ARN sunt negative, precum si in cazul obtinerii unui rezultat echivoc la testul Western blot<sup>6<\/sup>. Testul de detectie a ARN-ului plasmatic poate fi utilizat de asemenea in diagnosticul infectiei perinatale (are aceeasi sensibilitate ca testul ADN proviral)<sup>3<\/sup>, insa principala sa utilitate este monitorizarea evolutiei bolii si a terapiei antiretrovirale<sup>6<\/sup>.<\/p>\n<p>Monitorizarea viremiei este necesara pentru a evalua raspunsul la tratament si durabilitatea supresiei virusologice. \u00a0Tinta terapiei antiretrovirale, atat la pacienti \u201enaivi\u201d cat si la cei cu tratamente anterioare, este supresia HIV-ARN pana la nivele nedetectabile. Viremia trebuie determinata inaintea initierii terapiei, dupa 2-8 saptamani si apoi la intervale de 4-8 saptamani pana in momentul in care HIV-ARN devine nedetectabil. La 4 saptamani de la inceperea tratamentului trebuie sa se obtina o scadere a viremiei cu cel putin 1 log<sub>10<\/sub>, iar dupa 16-24 saptamani este necesar sa se ajunga la valori nedetectabile. Viremiile tranzitorii, acele cresteri de ordinul a 50-1000 copii\/mL, produse la pacienti cu valori anterioare suprimate, sunt ocazional intalnite dar nu par sa fie asociate cu un esec al raspunsului virusologic si nu necesita modificarea tratamentului. Un esec real al raspunsului virusologic este definit prin persistenta unei viremii detectabile la un pacient care a prezentat anterior o suprimare a viremiei sau prin incapacitatea de a obtine o viremie nedetectabila dupa 24-48 saptamani de tratament. Desi pot exista cauze multiple pentru acest esec virusologic trebuie suspectata in primul rand o rezistenta la tratamentul antiretroviral.<\/p>\n<p>In clinicile unde monitorizarea viremiei nu este disponibila, folosirea numai a criteriilor clinice si eventual a numararii celulelor CD4 pozitive poate avea drept consecinta lipsa identificarii unei rezistente la antivirale si continuarea unui tratament numai partial eficient<sup>2<\/sup>.<\/p>\n<p><strong><em>Recomandari pentru determinarea HIV-1\u00a0 ARN <\/em><\/strong><\/p>\n<p style=\"padding-left: 30px;\">\u25cf diagnosticul infectiei la nou-nascuti din mame seropozitive (cateva studii au demonstrat o sensibilitate de 25-40% a testului in primele saptamani de viata, care creste la 90-100% pana la varsta de 2-3 luni)<sup>3<\/sup>;<\/p>\n<p style=\"padding-left: 30px;\">\u25cf\u00a0 monitorizarea evolutiei bolii (in prezenta sau in absenta terapiei antiretrovirale);<\/p>\n<p style=\"padding-left: 30px;\">\u25cf\u00a0 evaluarea eficacitatii diferitelor tratamente antivirale: inaintea initierii terapiei (valori bazale), monitorizare indirecta pentru detectarea unei posibile rezistente antiretrovirale, lipsa compliantei la tratament<sup>6<\/sup>.<\/p>\n<p><em><span style=\"text-decoration: underline;\">Avantajele testului<\/span><\/em><\/p>\n<ul>\n<li>sensibilitate si specificitate comparabile cu izolarea virusului;<\/li>\n<li>utilizarea unor cantitati mici de probe de testat;<\/li>\n<li>testul este rapid si se observa un paralelism cert intre incarcatura virala plasmatica sau celulara, depletia de celule T CD4 si progresia bolii, elemente ce trebuie luate in considerare la aplicarea tratamentului<sup>7<\/sup><span style=\"font-size: 16px;\">.<\/span><em style=\"font-size: 16px;\">\u00a0<\/em><\/li>\n<\/ul>\n<p><strong><em>Pregatire pacient<\/em><\/strong> \u2013 nu este necesara<sup>4<\/sup>.<\/p>\n<p><strong><em>Specimen recoltat<\/em><\/strong> \u2013 sange venos<sup>4<\/sup>.<\/p>\n<p><strong><em>Recipient de recoltare<\/em><\/strong>\u00a0\u2013 vacutainer ce contine EDTA ca anticoagulant<sup>4<\/sup>;<\/p>\n<p><strong><em>Prelucrare necesara dupa recoltare <\/em><\/strong>\u2013 se separa plasma prin centrifugare<sup>4<\/sup>.<\/p>\n<p><strong><em>Volum de proba <\/em><\/strong>\u2013 minim 2 mL plasma<sup>4<\/sup>.<\/p>\n<p><strong><em>Stabilitate proba <\/em><\/strong>\u2013 probele de plasma sunt stabile <em>1 luna la \u2013<\/em>20\u00b0C<sup>4<\/sup>.<\/p>\n<p><strong><em>Metoda<\/em><\/strong> - <span style=\"text-decoration: underline;\">Real-time PCR (TaqMan)<\/span>: reactie de polimerizare in lant cu detectie in timp real a produsului PCR\u00a0 acumulat, prin masurarea fluorescentei emise (test cantitativ).<sup>4<\/sup><\/p>\n<p><strong><em>Valori de referinta <\/em><\/strong>\u2013 HIV-1ARN: nedetectabil<sup>4<\/sup>.<\/p>\n<p><strong><em>Limita de detectie<\/em><\/strong> \u2013 40 copii\/mL<sup>4<\/sup>.<\/p>\n<p><strong><em>Interpretarea rezultatelor<\/em><\/strong><\/p>\n<p>Un rezultat nedetectabil indica faptul ca testul nu a detectat HIV-1 ARN in proba analizata. Un rezultat avand comentariul \u201eHIV-1 ARN detectabil, dar &lt;20 copii\/mL\u201d indica faptul ca a fost detectat HIV-1 ARN in proba, dar nivelul sau se afla sub limita inferioara de detectie a metodei; acest rezultat se poate datora unei viremii foarte mici, unei infectii HIV1 in stadiu precoce (&lt;3 saptamani de la contactul infectant) sau a unei false pozitivitati (datorate unei imprecizii a testului in absenta infectiei)<sup>6<\/sup>.<\/p>\n<p>In cazul copiilor nascuti din mame HIV pozitive rezultatele vor fi interpretate astfel:<\/p>\n<ul>\n<li>obtinerea a doua valori negative pentru HIV1-ARN la varsta de minimum 1 luna si respectiv la 4 luni (sau mai mult) infirma infectia;<\/li>\n<li>obtinerea a doua valori pozitive pentru HIV1-ARN la varsta de minimum 1 luna si respectiv la 4 luni (sau mai mult) confirma infectia<sup>3<\/sup><span style=\"font-size: 16px;\">.<\/span><\/li>\n<\/ul>\n<p><strong><em>Limite si interferente<\/em><\/strong><\/p>\n<p>Nu se recomanda stabilirea unor decizii terapeutice pe baza unei singure valori a viremiei. Rezultatele viremiei trebuie interpretate intotdeauna in contextul clinic si corelate cu numarul celulelor CD4 pozitive<sup>6<\/sup>.<\/p>\n<p>Variatiile diurne ale HIV ARN sunt mai mari la copii comparativ cu adultii; din acest motiv numai cresteri de peste 5 ori (0.7 log<sub>10<\/sub>) pot fi semnificative la copiii &lt;2 ani, fata de cresterile de peste 3 ori\u00a0 (0.5 log<sub>10<\/sub>) considerate ca fiind relevante la copiii mari si adulti<sup>3<\/sup>.<\/p>\n<p>Introducerea tratamentului antiretroviral imediat dupa nastere poate suprima nivelele ARN-ului si interfera cu diagnosticul infectiei<sup>7<\/sup>.<\/p>\n<p>Testul este optimizat doar pentru cuantificarea viremiei in infectia HIV-1 determinata de grupul M, subtipurile A-H si nu prezinta acuratete in detectarea infectiei cauzata de HIV-1 grupurile N si O, precum si a infectiei HIV-2.<\/p>\n<p>Un rezultat negativ nu indica in mod necesar absenta replicarii virale<sup>4;6<\/sup>.<\/p>\n<p><span style=\"font-size: small;\">\u00a0<\/span><span style=\"font-size: small;\">\u0411\u0438\u0431\u043b\u0438\u043e\u0433\u0440\u0430\u0444\u0438\u044f<\/span><\/p>\n<p><span style=\"font-size: small;\">1. ARUP Laboratories. Test Directory: Human Immunodeficiency Virus 1 RNA Quantitative Real-Time PCR. www.aruplab.com 2015. Ref Type: Internet Communication.<\/span><\/p>\n<p><span style=\"font-size: small;\">2. Athe M.N. Tsibris. Martin S. Hirsch. Antiretroviral Therapy for Human Immunodeficiency Virus Infection. In Mandell, Douglas,and Bennett\u2019s Principles and Practice of Infectious Diseases, 7th edition, Churchill Livingstone, Elsevier, 2010, 1847-1848.<\/span><\/p>\n<p><span style=\"font-size: small;\">3. Geoffrey A. Weinberg, George K. Siberry. Pediatric Human Immunodeficiency Virus. In Mandell, Douglas,and Bennett\u2019s Principles and Practice of Infectious Diseases, 7th edition, Churchill Livingstone, Elsevier, 2010, 1818-1819.<\/span><\/p>\n<p><span style=\"font-size: small;\">4. Laborator Synevo. Referintele specifice tehnologiei de lucru utilizate 2015. Ref Type: Catalog.<\/span><\/p>\n<p><span style=\"font-size: small;\">5. Marvin S. Reitz, JR. Robert C.Gallo. Human Immunodeficiency Viruses. In Mandell, Douglas,and Bennett\u2019s Principles and Practice of Infectious Diseases, 7th edition, Churchill Livingstone, Elsevier, 2010, 2323-2333.<\/span><\/p>\n<p><span style=\"font-size: small;\">6. Mayo Clinic. Mayo Medical Laboratories. Test Catalog: HIV Type 1 Proviral DNA Qualitative Detection by PCR, Blood. HIV Type 1 RNA Quantification, Plasma. www.mayomedicallaboratories.com. Ref Type: Internet Communication.<\/span><\/p>\n<p><span style=\"font-size: small;\">7. Robin Dewar, Deborah Goldstein, Frank Maldarelli. Diagnosis of Human Immnuodeficiency Virus Infection. In Mandell, Douglas,and Bennett\u2019s Principles and Practice of Infectious Diseases, 7th edition, Churchill Livingstone, Elsevier, 2010, 1663-1681.<\/span><\/p>\n<p><span style=\"font-size: small;\">8. Timothy R. Sterling, Richard E. Chaisson. General Clinical Manifestations of Human Immunodeficiency Virus infection. In Mandell, Douglas,and Bennett\u2019s Principles and Practice of Infectious Diseases, 7th edition, Churchill Livingstone, Elsevier, 2010, 1705-1721.<\/span><\/p>","protected":false},"excerpt":{"rendered":"<p>\u0412\u0438\u0440\u0443\u0441 \u0438\u043c\u043c\u0443\u043d\u043e\u0434\u0435\u0444\u0438\u0446\u0438\u0442\u0430 \u0447\u0435\u043b\u043e\u0432\u0435\u043a\u0430 (\u0412\u0418\u0427) \u044f\u0432\u043b\u044f\u0435\u0442\u0441\u044f \u044d\u0442\u0438\u043e\u043b\u043e\u0433\u0438\u0447\u0435\u0441\u043a\u0438\u043c \u0430\u0433\u0435\u043d\u0442\u043e\u043c \u0441\u0438\u043d\u0434\u0440\u043e\u043c\u0430 \u043f\u0440\u0438\u043e\u0431\u0440\u0435\u0442\u0435\u043d\u043d\u043e\u0433\u043e \u0438\u043c\u043c\u0443\u043d\u043e\u0434\u0435\u0444\u0438\u0446\u0438\u0442\u0430 (\u0421\u041f\u0418\u0414). \u0412\u0418\u0427-\u0438\u043d\u0444\u0435\u043a\u0446\u0438\u044f \u043c\u043e\u0436\u0435\u0442 \u043f\u0435\u0440\u0435\u0434\u0430\u0432\u0430\u0442\u044c\u0441\u044f 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\u0441\u043b\u0443\u0447\u0430\u044f\u0445 \u043f\u0440\u043e\u0432\u043e\u0434\u044f\u0442 \u0430\u043d\u0430\u043b\u0438\u0437 \u00ab\u0412\u0438\u0440\u0443\u0441 \u0438\u043c\u043c\u0443\u043d\u043e\u0434\u0435\u0444\u0438\u0446\u0438\u0442\u0430 \u0447\u0435\u043b\u043e\u0432\u0435\u043a\u0430, \u0442\u0438\u043f 1, \u043e\u043f\u0440\u0435\u0434\u0435\u043b\u0435\u043d\u0438\u0435 \u0420\u041d\u041a (\u043a\u043e\u043b.) \u0432 \u0441\u044b\u0432\u043e\u0440\u043e\u0442\u043a\u0435 \u043a\u0440\u043e\u0432\u0438\u00bb:<\/strong><\/p>\n<ul>\n<li>\u043c\u043e\u043d\u0438\u0442\u043e\u0440\u0438\u043d\u0433 \u0442\u0435\u0447\u0435\u043d\u0438\u044f \u0412\u0418\u0427-\u0438\u043d\u0444\u0435\u043a\u0446\u0438\u0438;<\/li>\n<li>\u0440\u0435\u0448\u0435\u043d\u0438\u044f \u0432\u043e\u043f\u0440\u043e\u0441\u0430 \u043e \u043d\u0430\u0447\u0430\u043b\u0435 \u0430\u043d\u0442\u0438\u0440\u0435\u0442\u0440\u043e\u0432\u0438\u0440\u0443\u0441\u043d\u043e\u0439 \u0442\u0435\u0440\u0430\u043f\u0438\u0438;<\/li>\n<li>\u043e\u0446\u0435\u043d\u043a\u0430 \u044d\u0444\u0444\u0435\u043a\u0442\u0438\u0432\u043d\u043e\u0441\u0442\u0438 \u0430\u043d\u0442\u0438\u0440\u0435\u0442\u0440\u043e\u0432\u0438\u0440\u0443\u0441\u043d\u043e\u0439 \u0442\u0435\u0440\u0430\u043f\u0438\u0438.<\/li>\n<\/ul>\n<p><strong>\u0415\u0434\u0438\u043d\u0438\u0446\u044b \u0438\u0437\u043c\u0435\u0440\u0435\u043d\u0438\u044f<\/strong>: \u041c\u0415\/\u043c\u043b.<\/p>\n<p><strong>\u0420\u0435\u0444\u0435\u0440\u0435\u043d\u0441\u043d\u044b\u0435 \u0437\u043d\u0430\u0447\u0435\u043d\u0438\u044f<\/strong>: \u043d\u0435\u0442.<\/p>\n<p><strong>\u0422\u0440\u0430\u043a\u0442\u043e\u0432\u043a\u0430 \u0440\u0435\u0437\u0443\u043b\u044c\u0442\u0430\u0442\u043e\u0432 \u0438\u0441\u0441\u043b\u0435\u0434\u043e\u0432\u0430\u043d\u0438\u044f \u00ab\u0412\u0438\u0440\u0443\u0441 \u0438\u043c\u043c\u0443\u043d\u043e\u0434\u0435\u0444\u0438\u0446\u0438\u0442\u0430 \u0447\u0435\u043b\u043e\u0432\u0435\u043a\u0430, \u0442\u0438\u043f 1, \u043e\u043f\u0440\u0435\u0434\u0435\u043b\u0435\u043d\u0438\u0435 \u0420\u041d\u041a (\u043a\u043e\u043b.) \u0432 \u0441\u044b\u0432\u043e\u0440\u043e\u0442\u043a\u0435 \u043a\u0440\u043e\u0432\u0438<\/strong>\u00bb<\/p>\n<p>\u041d\u0435 \u043e\u0431\u043d\u0430\u0440\u0443\u0436\u0435\u043d\u043e. \u0420\u041d\u041a \u0412\u0438\u0440\u0443\u0441 \u0438\u043c\u043c\u0443\u043d\u043e\u0434\u0435\u0444\u0438\u0446\u0438\u0442\u0430 \u0447\u0435\u043b\u043e\u0432\u0435\u043a\u0430 (\u0412\u0418\u0427) \u043d\u0435 \u0432\u044b\u044f\u0432\u043b\u0435\u043d\u0430 \u0438\u043b\u0438 \u0437\u043d\u0430\u0447\u0435\u043d\u0438\u0435 \u043d\u0438\u0436\u0435 \u043f\u0440\u0435\u0434\u0435\u043b\u0430 \u0447\u0443\u0432\u0441\u0442\u0432\u0438\u0442\u0435\u043b\u044c\u043d\u043e\u0441\u0442\u0438 \u043c\u0435\u0442\u043e\u0434\u0430 (80 \u041c\u0415\/\u043c\u043b). \u0420\u0435\u0437\u0443\u043b\u044c\u0442\u0430\u0442 \u0438\u043d\u0442\u0435\u0440\u043f\u0440\u0435\u0442\u0438\u0440\u0443\u044e\u0442 \u043a\u0430\u043a \u00ab\u0420\u041d\u041a \u0412\u0418\u0427 \u043d\u0435 \u0432\u044b\u044f\u0432\u043b\u0435\u043d\u0430\u00bb.<\/p>\n<p>&lt; 10^2 \u041c\u0415\/\u043c\u043b. \u0420\u0435\u0437\u0443\u043b\u044c\u0442\u0430\u0442 \u043f\u043e\u043b\u043e\u0436\u0438\u0442\u0435\u043b\u044c\u043d\u044b\u0439 \u0441 \u043a\u043e\u043d\u0446\u0435\u043d\u0442\u0440\u0430\u0446\u0438\u0435\u0439 \u0420\u041d\u041a \u0412\u0438\u0440\u0443\u0441\u0430 \u0438\u043c\u043c\u0443\u043d\u043e\u0434\u0435\u0444\u0438\u0446\u0438\u0442\u0430 \u0447\u0435\u043b\u043e\u0432\u0435\u043a\u0430 (\u0412\u0418\u0427) \u043c\u0435\u043d\u0435\u0435 10^2 \u041c\u0415\/\u043c\u043b.<br \/>\n\u043e\u0442 10^2 \u0434\u043e 1\u044510^8 \u041c\u0415\/\u043c\u043b. \u0420\u0435\u0437\u0443\u043b\u044c\u0442\u0430\u0442 \u043f\u043e\u043b\u043e\u0436\u0438\u0442\u0435\u043b\u044c\u043d\u044b\u0439. \u041f\u043e\u043b\u0443\u0447\u0435\u043d\u043d\u043e\u0435 \u0437\u043d\u0430\u0447\u0435\u043d\u0438\u0435 \u043d\u0430\u0445\u043e\u0434\u0438\u0442\u0441\u044f \u0432 \u043f\u0440\u0435\u0434\u0435\u043b\u0430\u0445 \u043b\u0438\u043d\u0435\u0439\u043d\u043e\u0433\u043e \u0434\u0438\u0430\u043f\u0430\u0437\u043e\u043d\u0430.<br \/>\n&gt; 10^8 \u041c\u0415\/\u043c\u043b. \u0420\u0435\u0437\u0443\u043b\u044c\u0442\u0430\u0442 \u043f\u043e\u043b\u043e\u0436\u0438\u0442\u0435\u043b\u044c\u043d\u044b\u0439 \u0441 \u043a\u043e\u043d\u0446\u0435\u043d\u0442\u0440\u0430\u0446\u0438\u0435\u0439 \u0420\u041d\u041a \u0412\u0438\u0440\u0443\u0441\u0430 \u0438\u043c\u043c\u0443\u043d\u043e\u0434\u0435\u0444\u0438\u0446\u0438\u0442\u0430 \u0447\u0435\u043b\u043e\u0432\u0435\u043a\u0430 (\u0412\u0418\u0427) \u0431\u043e\u043b\u0435\u0435 10^8 \u041c\u0415\/\u043c\u043b.<\/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-9941","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\/9941","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=9941"}],"wp:attachment":[{"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/media?parent=9941"}],"wp:term":[{"taxonomy":"product_brand","embeddable":true,"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/product_brand?post=9941"},{"taxonomy":"product_cat","embeddable":true,"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/product_cat?post=9941"},{"taxonomy":"product_tag","embeddable":true,"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/product_tag?post=9941"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}