{"id":10428,"date":"2007-11-16T12:41:26","date_gmt":"2007-11-16T10:41:26","guid":{"rendered":"https:\/\/www.synevo.ro\/afectiuni\/profil-hepatita-virala-c-diagnostic-si-monitorizare\/"},"modified":"2020-07-10T14:14:21","modified_gmt":"2020-07-10T11:14:21","slug":"profil-hepatita-virala-c-diagnostic-si-monitorizare","status":"publish","type":"synevo_diseases","link":"https:\/\/old.synevo.md\/ru\/afectiuni\/profil-hepatita-virala-c-diagnostic-si-monitorizare\/","title":{"rendered":"Profil hepatit\u0103 viral\u0103 C (diagnostic \u015fi monitorizare)"},"content":{"rendered":"<p style=\"text-align: justify;\"><span style=\"color: #00539f;\"><strong>Hepatita viral\u0103 C<\/strong><\/span> are cea mai mare probabilitate de cronicizare dintre hepatitele virale, de 75-80%, de\u015fi afectarea ini\u0163ial\u0103 pare (\u00een mod paradoxal) moderat\u0103. <!--more-->De obicei, hepatita cronic\u0103 ce rezult\u0103 este benign\u0103 \u015fi subclinic\u0103, dar \u00een final <strong>ciroza se dezvolt\u0103 la cel pu\u0163in 20% dintre pacien\u0163ii infecta\u0163i cu VHC<\/strong>; pot s\u0103 treac\u0103 zeci de ani p\u00e2n\u0103 s\u0103 apar\u0103. Carcinomul hepatocelular reprezint\u0103 un risc la pacien\u0163ii cu ciroz\u0103 indus\u0103 de VHC; tumorile apar rar \u00een cazurile noncirotice ale infec\u0163iei cronice (spre deosebire de infec\u0163ia cu VHB).<sup>1<\/sup><\/p>\n<p style=\"text-align: justify;\">Virusul hepatitei C este r\u0103spunz\u0103tor de aproximativ<strong> 60-70 % din hepatitele cronice<\/strong> \u015fi aproximativ <strong>30% din cirozele<\/strong> \u015fi <strong>cancerele hepatic<\/strong>e.<\/p>\n<p style=\"text-align: justify;\">Rata \u00eenalt\u0103 a muta\u0163iilor VHC este cauza evolu\u0163iei insiduoase \u015fi \u00een general variabile a infec\u0163iei cronice HCV, caracterizate prin alternarea fazelor de replicare viral\u0103 (faze cu pronun\u0163at\u0103 replicare viral\u0103 respectiv cu replicare viral\u0103 sc\u0103zut\u0103\/ absent\u0103).<sup>2<\/sup><\/p>\n<p style=\"text-align: justify;\"><strong>Diagnosticul de hepatit\u0103 viral\u0103 C se bazeaz\u0103 pe prezen\u0163a anticorpilor serici (anti-VHC)<\/strong>; la pacien\u0163ii infecta\u0163i cu HVC nu s-au eviden\u0163iat antigene virale3.<\/p>\n<p style=\"text-align: justify;\"><strong>Detectarea anticorpilor anti-HCV nu permite \u00eens\u0103 diferen\u0163ierea infec\u0163iei acute\/ cronice de o infec\u0163ie \u00een antecedente<\/strong>; pentru aceasta se utilizeaz\u0103 determinarea HCV-ARN.<\/p>\n<ul>\n<li style=\"text-align: justify;\">\u00cen infec\u0163ia recent\u0103 HVC, HCV-RNA se detecteaz\u0103 de obicei, la pu\u0163ine s\u0103pt\u0103m\u00e2ni de la invazia viral\u0103 (primul marker serologic al infec\u0163iei HVC) \u015fi precede cu s\u0103pt\u0103m\u00e2ni, luni, seroconversia imunologic\u0103 (apari\u0163ia anti-VHC).<\/li>\n<li style=\"text-align: justify;\">\u00cen remisiunea spontan\u0103 a infec\u0163iei HCV recente (acut\u0103), HCV-RNA se negativeaz\u0103 de obicei, dup\u0103 4-6 luni.<\/li>\n<li style=\"text-align: justify;\">Infec\u0163ia cronic\u0103 HCV se consider\u0103 prezent\u0103 dac\u0103 HVC-RNA r\u0103m\u00e2ne detectabil pentru o perioad\u0103 de cel pu\u0163in 12 luni. Concentra\u0163ia HCV-RNA fluctueaz\u0103 pe parcursul evolu\u0163iei infec\u0163iei cronice; temporar, concentra\u0163ia poate sc\u0103dea sub nivelul de detec\u0163ie. De aceea, un rezultat negativ HCV-RNA nu exclude prezen\u0163a infec\u0163iei cronice sau a infectivit\u0103\u0163ii serului. Numai dac\u0103 detectarea HCV-RNA r\u0103m\u00e2ne negativ\u0103 la 3 determin\u0103ri consecutive, la interval de 1 an, se poate presupune vindecarea infec\u0163iei HCV.<\/li>\n<\/ul>\n<p style=\"text-align: justify;\"><strong>Detectarea HVC-RNA <\/strong>este esen\u0163ial\u0103 nu numai <strong>\u00een diagnosticul infec\u0163iei acute sau cronice HCV<\/strong>, dar \u015fi <strong>\u00een stabilirea indica\u0163iei de tratament cu interferon <\/strong>a hepatitei cronice HVC<strong>, <\/strong>precum \u015fi <strong>\u00een monitorizarea r\u0103spunsului la tratament<\/strong>.<sup>2<\/sup><\/p>\n<p style=\"text-align: justify;\">\u201c\u0162inta\u201d terapiei este r\u0103spunsul virusologic sus\u0163inut, considerat atunci c\u00e2nd HCV-RNA r\u0103m\u00e2ne nedetectabil 6-12 luni dup\u0103 terminarea tratamentului. <strong>Un indicator al r\u0103spunsului favorabil <\/strong>este ob\u0163inerea la 3 luni de la ini\u0163ierea terapiei antivirale a r\u0103spunsului virusologic precoce \u2013 HCV-RNA nedetectabil sau sc\u0103zut cu 2 log.10 (ex. de la 2 milioane la 20000 ui) din nivelul viremiei de baz\u0103.<sup>4<\/sup><\/p><div class=\"wp-block-columns is-layout-flex wp-container-core-columns-is-layout-1 wp-block-columns-is-layout-flex\"><div class=\"wp-block-column is-vertically-aligned-center is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:33.33%\"><p><strong>Analize medicale disponibile \u00een laboratoarele Synevo:<\/strong><\/p><\/div>\n\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:66.66%\"><div class=\"synevo-shop-products\">\r\n    <div class=\"sysprod\">\r\n        \r\n        <div class=\"sysprod-products\">\r\n                            <div class=\"sysprod-product\">\r\n                    <a class=\"sysprod-product-title\" href=\"https:\/\/old.synevo.md\/ru\/shop\/anti-hcv\/\">Anti-HCV<\/a>\r\n                    <div class=\"sysprod-product-price\">\r\n                        <span>Pre\u021b:<\/span>\r\n                        <span>235 lei<\/span>\r\n                    <\/div>\r\n                                            <div class=\"sysprod-product-addcart\">\r\n                            <a\r\n                                href=\"?add-to-cart=9135\"\r\n                                data-quantity=\"1\"\r\n                                class=\"addToCart button product_type_simple add_to_cart_button ajax_add_to_cart \"\r\n                                data-product_id=\"9135\"\r\n                                data-product_sku=\"MV09\"\r\n                                rel=\"nofollow\"\r\n                            ><div><\/div><\/a>\r\n                        <\/div>\r\n                                    <\/div>\r\n                            <div class=\"sysprod-product\">\r\n                    <a class=\"sysprod-product-title\" href=\"https:\/\/old.synevo.md\/ru\/shop\/arn-viral-hepatita-c-cantitativ\/\">ARN viral hepatita C (cantitativ)<\/a>\r\n                    <div class=\"sysprod-product-price\">\r\n                        <span>Pre\u021b:<\/span>\r\n                        <span>1790.00 lei<\/span>\r\n                    <\/div>\r\n                                            <div class=\"sysprod-product-addcart\">\r\n                            <a\r\n                                href=\"?add-to-cart=9168\"\r\n                                data-quantity=\"1\"\r\n                                class=\"addToCart button product_type_simple add_to_cart_button ajax_add_to_cart \"\r\n                                data-product_id=\"9168\"\r\n                                data-product_sku=\"BM03\"\r\n                                rel=\"nofollow\"\r\n                            ><div><\/div><\/a>\r\n                        <\/div>\r\n                                    <\/div>\r\n                    <\/div>\r\n        \r\n    <\/div>\r\n<\/div>\r\n\r\n<style>\r\n.synevo-shop-products {\r\n    padding: 24px 0;\r\n    margin: 24px 0;\r\n    border-radius: 10px;\r\n    background: #F6F7F9;\r\n}\r\n.synevo-shop-products .sysprod-product {\r\n    position: relative;\r\n    margin: 0 24px;\r\n    margin-bottom: 24px;\r\n    border-radius: 10px;\r\n    background: #fff;\r\n    display: flex;\r\n    flex-direction: row;\r\n    align-items: center;\r\n}\r\n.synevo-shop-products .sysprod-product:last-child {\r\n    margin-bottom: 0;\r\n}\r\n.synevo-shop-products .sysprod-product-title {\r\n    flex-grow: 1;\r\n    padding: 15px;\r\n    margin-left: 14px;\r\n    font-family: Poppins,sans-serif;\r\n    font-weight: 600;\r\n    font-size: 16px;\r\n    color: #29263F;\r\n}\r\n.synevo-shop-products .sysprod-product-price {\r\n    flex-shrink: 0;\r\n    font-family: Poppins,sans-serif;\r\n    font-weight: 600;\r\n    font-size: 18px;\r\n    color: #FDB813;\r\n}\r\n.synevo-shop-products .sysprod-product-addcart {\r\n    flex-shrink: 0;\r\n    position: relative;\r\n    width: 38px;\r\n    height: 38px;\r\n    margin-left: 24px;\r\n    margin-right: 24px;\r\n}\r\n.synevo-shop-products .sysprod-product-addcart .button {\r\n    top: unset;\r\n    right: unset;\r\n}\r\n<\/style><\/div><\/div><p><strong><small>Bibliografie:<\/small><\/strong><small>1. Hepatita acut\u0103 viral\u0103, Manualul Merck de Diagnostic \u015fi Tratament, Ed.XVII, versiunea \u00een limba rom\u00e2n\u0103, 2002, pg.377-384<\/small><small>2. Gert Frosner, Viral hepatitis, In Lothar Thomas\u2019 Clinical Laboratory Diagnostics- Use and Assessment of Clinical Laboratory Results. TH- Books Verlagsgesellschaft mbH, Frankfurt \/Main, Germany,1 Ed., 1998, 1273-1277<br>3. Ana Ionit\u0103, Al. Oproiu, Hepatitele cronice, \u00een Medicina intern\u0103, Bolile digestive hepatice \u015fi pancreatice, Vol.3, sub redac\u0163ia L. Gherasim, Editura medical\u0103, 1999, pg.765-831.<br>4. Dumitru Matei, Actualit\u0103\u0163i \u00een diagnosticul \u015fi tratamentul hepatitelor cronice, www.ecmb.ro, 2007<\/small><\/p><p>___________________________________________<\/p><p>Mai multe informa\u021bii despre teste:<\/p><ul class=\"wp-block-list\"><li><a href=\"\/shop\/anti-hcv\/\" class=\"rank-math-link\">Anti-HCV<\/a><\/li><li><a href=\"\/shop\/arn-viral-hepatita-c-cantitativ\/\" class=\"rank-math-link\">ARN viral hepatit\u0103 C<\/a><\/li><\/ul><p><\/p>","protected":false},"featured_media":0,"template":"","synevo_diseases_category":[890,895],"class_list":["post-10428","synevo_diseases","type-synevo_diseases","status-publish","hentry","synevo_diseases_category-boli-infectioase","synevo_diseases_category-gastroenterologie"],"_links":{"self":[{"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/synevo_diseases\/10428","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/synevo_diseases"}],"about":[{"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/types\/synevo_diseases"}],"wp:attachment":[{"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/media?parent=10428"}],"wp:term":[{"taxonomy":"synevo_diseases_category","embeddable":true,"href":"https:\/\/old.synevo.md\/ru\/wp-json\/wp\/v2\/synevo_diseases_category?post=10428"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}