{"id":9899,"date":"2019-05-19T21:20:20","date_gmt":"2019-05-19T14:20:20","guid":{"rendered":"https:\/\/www.hmm88i.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:\/\/hmm88i.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 106<\/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