{"id":3343,"date":"2023-04-14T13:19:27","date_gmt":"2023-04-14T06:19:27","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=3343"},"modified":"2023-04-17T16:20:49","modified_gmt":"2023-04-17T09:20:49","slug":"viem-gan-b-dien-tien-tu-nhien-cua-benh-va-cac-dau-an","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/14\/viem-gan-b-dien-tien-tu-nhien-cua-benh-va-cac-dau-an\/","title":{"rendered":"Vi\u00eam gan B: di\u1ec5n ti\u1ebfn t\u1ef1 nhi\u00ean c\u1ee7a b\u1ec7nh v\u00e0 c\u00e1c d\u1ea5u \u1ea5n."},"content":{"rendered":"<p><strong>Nhi\u1ec5m virus vi\u00eam gan B (HBV) l\u00e0 m\u1ed9t v\u1ea5n \u0111\u1ec1 y t\u1ebf to\u00e0n c\u1ea7u v\u1edbi h\u01a1n 350 tri\u1ec7u ng\u01b0\u1eddi nhi\u1ec5m m\u1ea1n. HBV c\u00f3 th\u1ec3 g\u00e2y ra c\u00e1c h\u1ed9i ch\u1ee9ng l\u00e2m s\u00e0ng \u0111a d\u1ea1ng g\u1ed3m vi\u00eam gan c\u1ea5p, b\u1ec7nh gan m\u1ea1n t\u00ednh, x\u01a1 gan ho\u1eb7c ung th\u01b0 bi\u1ec3u m\u00f4 t\u1ebf b\u00e0o gan (HCC). K\u1ebft c\u1ee5c c\u1ee7a nhi\u1ec5m HBV ph\u1ee5 thu\u1ed9c v\u00e0o tu\u1ed5i nhi\u1ec5m, m\u1ee9c \u0111\u1ed9 sao ch\u00e9p, t\u00ecnh tr\u1ea1ng mi\u1ec5n d\u1ecbch c\u1ee7a ng\u01b0\u1eddi b\u1ec7nh, s\u1ef1 \u0111\u1ed3ng nhi\u1ec5m virus kh\u00e1c v\u00e0 c\u01a1 \u0111\u1ecba nh\u01b0 l\u1ea1m d\u1ee5ng r\u01b0\u1ee3u bia, b\u00e9o ph\u00ec. \u0110\u00f4ng Nam \u00c1 l\u00e0 v\u00f9ng c\u00f3 t\u1ec9 l\u1ec7 m\u1eafc cao 10 &#8211; 20%.<\/strong><\/p>\n<h2><strong>1. S\u1ef1 l\u00e2y truy\u1ec1n c\u1ee7a virus vi\u00eam gan B.<\/strong><\/h2>\n<p>\u0110\u01b0\u1eddng l\u00e2y c\u1ee7a HBV kh\u00e1c nhau \u1edf c\u00e1c v\u00f9ng \u0111\u1ecba l\u00fd, \u1edf v\u00f9ng c\u00f3 t\u1ec9 l\u1ec7 hi\u1ec7n m\u1eafc cao, l\u00e2y truy\u1ec1n t\u1eeb m\u1eb9 sang con l\u00e0 th\u01b0\u1eddng g\u1eb7p nh\u1ea5t. Truy\u1ec1n ngang giai \u0111o\u1ea1n s\u1edbm th\u1eddi th\u01a1 \u1ea5u g\u1eb7p nhi\u1ec1u \u1edf v\u00f9ng t\u1ec9 l\u1ec7 m\u1eafc trung b\u00ecnh, l\u00e2y qua quan h\u1ec7 t\u00ecnh d\u1ee5c v\u00e0 ti\u00eam ch\u00edch g\u1eb7p nhi\u1ec1u \u1edf v\u00f9ng t\u1ec9 l\u1ec7 m\u1eafc th\u1ea5p.<\/p>\n<p>T\u1ec9 l\u1ec7 chuy\u1ec3n HBV c\u1ea5p sang m\u1ea1n t\u1ec9 l\u1ec7 ngh\u1ecbch v\u1edbi tu\u1ed5i nhi\u1ec5m: 90% \u0111\u1ed1i v\u1edbi nhi\u1ec5m chu sinh, 20 &#8211; 50% \u0111\u1ed1i v\u1edbi tr\u1ebb 1 &#8211; 5 tu\u1ed5i v\u00e0 kho\u1ea3ng 5% \u1edf ng\u01b0\u1eddi tr\u01b0\u1edfng th\u00e0nh<\/p>\n<h2><strong>2. C\u1ea5u tr\u00fac virus vi\u00eam gan B<\/strong>.<\/h2>\n<p>HBV thu\u1ed9c h\u1ecd Hepadnavirus, sao ch\u00e9p nh\u1edd phi\u00ean m\u00e3 ng\u01b0\u1ee3c qua RNA trung gian, n\u00ean d\u1ec5 sinh \u0111\u1ed9t bi\u1ebfn. H\u1ea1t Dane \u0111\u01b0\u1eddng k\u00edch 42nm c\u00f3 v\u1ecf b\u1ecdc, ch\u1ee9a b\u1ed9 gen DNA s\u1ee3i \u0111\u00f4i d\u1ea1ng v\u00f2ng.<\/p>\n<p>HBV \u0111\u01b0\u1ee3c chia th\u00e0nh 8 ki\u1ec3u gen t\u1eeb A &#8211; H, \u00fd ngh\u0129a l\u00e2m s\u00e0ng t\u1eebng ki\u1ec3u gen ch\u01b0a r\u00f5. Ch\u00e2u \u00c1 ch\u1ee7 y\u1ebfu g\u1eb7p ki\u1ec3u gen C.<\/p>\n<p>HBV \u0111\u01b0\u1ee3c chia ra th\u00e0nh 4 ph\u00e2n type v\u00e0 type huy\u1ebft thanh, d\u1ef1a tr\u00ean t\u00ednh kh\u00e1ng nguy\u00ean c\u1ee7a HbsAg.<\/p>\n<h2><strong>3. Sinh b\u1ec7nh h\u1ecdc c\u1ee7a nhi\u1ec5m HBV.<\/strong><\/h2>\n<p>Nhi\u1ec5m HBV m\u1ea1n c\u00f3 th\u1ec3 chia l\u00e0m 2 giai \u0111o\u1ea1n: giai \u0111o\u1ea1n sao ch\u00e9p s\u1edbm k\u00e8m b\u1ec7nh gan ho\u1ea1t \u0111\u1ed9ng v\u00e0 giai \u0111o\u1ea1n sao ch\u00e9p mu\u1ed9n (th\u1ea5p) v\u00e0 b\u1ec7nh gan tho\u00e1i lui. Nhi\u1ec5m chu sinh s\u1ebd c\u00f3 th\u00eam giai \u0111o\u1ea1n dung n\u1ea1p mi\u1ec5n d\u1ecbch.<\/p>\n<p>B\u1ec7nh nh\u00e2n nhi\u1ec5m HBV chu sinh s\u1ebd c\u00f3 \u0111i\u1ec3m \u0111\u1eb7c tr\u01b0ng l\u00e0 HbeAg cao v\u00e0 t\u1ea3i l\u01b0\u1ee3ng DNA cao nh\u01b0ng kh\u00f4ng b\u1eb1ng ch\u1ee9ng b\u1ec7nh gan ho\u1ea1t \u0111\u1ed9ng nh\u01b0: kh\u00f4ng tri\u1ec7u ch\u1ee9ng, ALT b\u00ecnh th\u01b0\u1eddng, thay \u0111\u1ed5i \u00edt tr\u00ean sinh thi\u1ebft gan. Giai \u0111o\u1ea1n n\u00e0y g\u1ecdi l\u00e0 dung n\u1ea1p mi\u1ec5n d\u1ecbch, k\u00e9o d\u00e0i 10 &#8211; 30 n\u0103m, r\u1ea5t \u00edt thanh th\u1ea3i HBeAg.<\/p>\n<p>\u1ede giai \u0111o\u1ea1n ti\u1ebfp theo, dung n\u1ea1p mi\u1ec5n d\u1ecbch s\u1ebd chuy\u1ec3n th\u00e0nh thanh th\u1ea3i mi\u1ec5n d\u1ecbch. C\u00f3 s\u1ef1 thanh th\u1ea3i t\u1ef1 nhi\u00ean HBeAg t\u1eeb 10 &#8211; 20%\/n\u0103m.<\/p>\n<p>\u1ede ng\u01b0\u1eddi l\u1edbn, giai \u0111o\u1ea1n \u0111\u1ea7u nhi\u1ec5m HBV c\u00f3 s\u1ef1 sao ch\u00e9p m\u1ea1nh (HBeAg d\u01b0\u01a1ng, HBV DNA cao) k\u00e8m b\u1ec7nh gan ho\u1ea1t \u0111\u1ed9ng (t\u0103ng ALT v\u00e0 h\u00ecnh \u1ea3nh vi\u00eam m\u1ea1n tr\u00ean sinh thi\u1ebft gan).<\/p>\n<p>Ng\u01b0\u1eddi b\u1ec7nh mang virus kh\u00f4ng ho\u1ea1t \u0111\u1ed9ng\/sao ch\u00e9p \u00edt th\u00ec HBeAg \u00e2m v\u00e0 anti HBeAg d\u01b0\u01a1ng t\u00ednh. M\u1ed9t s\u1ed1 b\u1ec7nh nh\u00e2n c\u00f3 sao ch\u00e9p v\u1eeba v\u00e0 b\u1ec7nh gan ho\u1ea1t \u0111\u00f4ng nh\u01b0ng HBeAg v\u1eabn \u00e2m. C\u00f3 th\u1ec3 do th\u1ec3 hoang d\u00e3 ho\u1eb7c \u0111\u1ed9t bi\u1ebfn v\u00f9ng kh\u1edfi \u0111\u1ed9ng tr\u01b0\u1edbc trung t\u00e2m\/trung t\u00e2m g\u00e2y kh\u00f4ng s\u1ea3n xu\u1ea5t HBeAg.<\/p>\n<h2><strong>4. <a href=\"https:\/\/www.vinmec.com\/vi\/benh\/viem-gan-b-3116\/\">L\u00e2m s\u00e0ng<\/a><\/strong>.<\/h2>\n<ul>\n<li>Giai \u0111o\u1ea1n \u1ee7 b\u1ec7nh 1 &#8211; 4 th\u00e1ng.<\/li>\n<li>Giai \u0111o\u1ea1n kh\u1edfi ph\u00e1t: c\u00f3 th\u1ec3 c\u00f3 h\u1ed9i ch\u1ee9ng b\u1ec7nh huy\u1ebft thanh (serum sickness-like syndrome) nh\u01b0 s\u1ed1t, ph\u00e1t ban, \u0111au kh\u1edbp, vi\u00eam kh\u1edbp sau \u0111\u00f3 c\u00f3 tri\u1ec7u ch\u1ee9ng c\u1ee7a b\u1ec7nh nh\u01b0 ch\u00e1n \u0103n, bu\u1ed3n n\u00f4n, v\u00e0ng da, \u0111au h\u1ea1 s\u01b0\u1eddn ph\u1ea3i. Nh\u01b0ng ch\u1ec9 30% b\u1ec7nh nh\u00e2n nhi\u1ec5m c\u1ea5p c\u00f3 tri\u1ec7u ch\u1ee9ng (vi\u00eam gan c\u00f3 v\u00e0ng da) c\u00f2n l\u1ea1i vi\u00eam gan d\u01b0\u1edbi l\u00e2m s\u00e0ng\/kh\u00f4ng v\u00e0ng da. B\u1ec7nh th\u01b0\u1eddng n\u1eb7ng khi k\u00e8m nhi\u1ec5m virus vi\u00eam gan kh\u00e1c\/ b\u1ec7nh gan n\u1ec1n. Tri\u1ec7u ch\u1ee9ng v\u00e0 v\u00e0ng da h\u1ebft sau 1 &#8211; 3 th\u00e1ng.<\/li>\n<li><a href=\"https:\/\/www.vinmec.com\/vi\/tieu-hoa-gan-mat\/thong-tin-suc-khoe\/viem-gan-cap-tinh-la-gi-viem-gan-man-tinh-la-gi\/\">Vi\u00eam gan c\u1ea5p<\/a>, x\u00e9t nghi\u1ec7m c\u00f3 th\u1ec3 th\u1ea5y t\u0103ng men gan AST v\u00e0 ALT, c\u00f3 th\u1ec3 \u0111\u1ebfn 1000 &#8211; 2000U\/L. Bilirubin b\u00ecnh th\u01b0\u1eddng n\u1ebfu kh\u00f4ng v\u00e0ng da. X\u00e9t nghi\u1ec7m tr\u1edf v\u1ec1 b\u00ecnh th\u01b0\u1eddng sau 1 &#8211; 4 th\u00e1ng. Khi ALT t\u0103ng k\u00e9o d\u00e0i tr\u00ean 6 th\u00e1ng ch\u1ee9ng t\u1ecf di\u1ec5n ti\u1ebfn \u0111\u1ebfn vi\u00eam gan m\u1ea1n. Tr\u01b0\u1edbc \u0111\u00e2y ng\u01b0\u1eddi ta cho r\u1eb1ng HBV \u0111\u01b0\u1ee3c lo\u1ea1i tr\u1eeb ho\u00e0n to\u00e0n sau kh\u1ecfi nhi\u1ec5m c\u1ea5p, tuy nhi\u00ean t\u1ed5n th\u01b0\u01a1ng m\u00f4 h\u1ecdc c\u00f3 th\u1ec3 k\u00e9o d\u00e0i \u0111\u1ebfn 10 n\u0103m, nhi\u1ec5m ti\u1ec1m t\u00e0ng \u0111\u01b0\u1ee3c ki\u1ec3m so\u00e1t b\u1edfi h\u1ec7 mi\u1ec5n d\u1ecbch v\u00e0 c\u00f3 th\u1ec3 t\u00e1i ho\u1ea1t khi mi\u1ec5n d\u1ecbch suy gi\u1ea3m.<\/li>\n<li>V\u1edbi vi\u00eam gan B m\u1ea1n, c\u00f3 th\u1ec3 kh\u00f4ng tri\u1ec7u ch\u1ee9ng ho\u1eb7c tri\u1ec7u ch\u1ee9ng kh\u00f4ng \u0111\u1eb7c hi\u1ec7u nh\u01b0 m\u1ec7t m\u1ecfi. M\u1ed9t s\u1ed1 ng\u01b0\u1eddi b\u1ec7nh c\u00f3 th\u1ec3 c\u00f3 \u0111\u1ee3t b\u00f9ng ph\u00e1t kh\u00f4ng tri\u1ec7u ch\u1ee9ng ho\u1eb7c tri\u1ec7u ch\u1ee9ng gi\u1ed1ng vi\u00eam c\u1ea5p. Kh\u00e1m c\u00f3 th\u1ec3 kh\u00f4ng tri\u1ec7u ch\u1ee9ng r\u00f5 r\u00e0ng, c\u00f3 th\u1ec3 c\u00f3 d\u1ea5u hi\u1ec7u g\u1ee3i \u00fd b\u1ec7nh gan m\u1ea1n, l\u00e1ch to. B\u1ec7nh nh\u00e2n x\u01a1 gan m\u1ea5t b\u00f9 s\u1ebd c\u00f3 v\u00e0ng da, c\u1ed5 tr\u01b0\u1edbng, ph\u00f9 ngo\u1ea1i vi v\u00e0 b\u1ec7nh n\u00e3o gan. D\u1ea5u hi\u1ec7u g\u1ee3i \u00fd x\u01a1 gan nh\u01b0 c\u01b0\u1eddng l\u00e1ch (gi\u1ea3m b\u1ea1ch c\u1ea7u v\u00e0 ti\u1ec3u c\u1ea7u), gi\u1ea3m ch\u1ee9c n\u0103ng t\u1ed5ng h\u1ee3p c\u1ee7a gan (gi\u1ea3m albumin, t\u0103ng prothrombine time, t\u0103ng bilirubin gi\u00e1n ti\u1ebfp).<\/li>\n<\/ul>\n<h2><strong>5. <a href=\"https:\/\/www.vinmec.com\/vi\/tieu-hoa-gan-mat\/thong-tin-suc-khoe\/xet-nghiem-mau-chan-doan-viem-gan-b\/#:~:text=X%C3%A9t%20nghi%E1%BB%87m%20Anti%2DHBs,mi%E1%BB%85n%20d%E1%BB%8Bch%20v%E1%BB%9Bi%20virus%20n%C3%A0y.\">C\u00e1c d\u1ea5n \u1ea5n mi\u1ec5n d\u1ecbch ch\u1ea9n \u0111o\u00e1n nhi\u1ec5m vi\u00eam gan B<\/a>.<\/strong><\/h2>\n<p><em><strong>HBsAg<\/strong><\/em>. L\u00e0 kh\u00e1ng nguy\u00ean b\u1ec1 m\u1eb7t c\u1ee7a HBV, t\u0103ng cao trong nhi\u1ec5m c\u1ea5p v\u00e0 m\u1ea1n. HBsAg d\u01b0\u01a1ng c\u00f3 ngh\u0129a \u0111ang nhi\u1ec5m, tr\u1eeb tr\u01b0\u1eddng h\u1ee3p d\u01b0\u01a1ng tho\u00e1ng qua trong v\u00f2ng 30 ng\u00e0y sau ti\u00eam vaccin HBV.<\/p>\n<p><em><strong>Anti HBs<\/strong><\/em>. C\u00f3 anti HBs ch\u1ee9ng t\u1ecf \u0111\u00e3 kh\u1ecfi ho\u1eb7c c\u00f3 mi\u1ec5n d\u1ecbch.<\/p>\n<p><em><strong>Anti HBc total<\/strong><\/em>. G\u1ed3m IgM v\u00e0 IgG. D\u01b0\u01a1ng t\u00ednh ch\u1ee9ng t\u1ecf \u0111\u00e3 nhi\u1ec5m ho\u1eb7c \u0111ang nhi\u1ec5m, kh\u00f4ng x\u00e1c \u0111\u1ecbnh th\u1eddi gian. C\u1ea7n k\u1ebft h\u1ee3p th\u00eam anti HBc IgM \u0111\u1ec3 x\u00e1c \u0111\u1ecbnh.<\/p>\n<p><em><strong>Anti HBc IgM<\/strong><\/em>. D\u01b0\u01a1ng t\u00ednh ch\u1ee9ng t\u1ecf m\u1edbi nhi\u1ec5m (&lt;6 th\u00e1ng). N\u00f3 hi\u1ec7n di\u1ec7n ch\u1ee9ng t\u1ecf nhi\u1ec5m c\u1ea5p. Nh\u01b0ng \u00e2m t\u00ednh c\u0169ng kh\u00f4ng lo\u1ea1i tr\u1eeb m\u1edbi nhi\u1ec5m c\u1ea5p khi x\u00e9t nghi\u1ec7m s\u1edbm c\u00f3 th\u1ec3 ch\u01b0a k\u1ecbp t\u1ea1o kh\u00e1ng th\u1ec3.<\/p>\n<p><em><strong>HBeAg<\/strong><\/em>: d\u01b0\u01a1ng ch\u1ee9ng t\u1ecf virus \u0111ang sao ch\u00e9p g\u1eb7p trong nhi\u1ec5m c\u1ea5p ho\u1eb7c \u0111\u1ee3t b\u00f9ng ph\u00e1t c\u1ee7a nhi\u1ec5m m\u1ea1n, vi\u00eam gan m\u1ea1n.<\/p>\n<p><strong>M\u1ed9t s\u1ed1 t\u00ecnh hu\u1ed1ng v\u00e0 ch\u1ea9n \u0111o\u00e1n<\/strong>.<\/p>\n<ul>\n<li>HBsAg d\u01b0\u01a1ng + antiHBc total d\u01b0\u01a1ng + anti HBc IgM d\u01b0\u01a1ng + anti HBs d\u01b0\u01a1ng: nhi\u1ec5m HBV c\u1ea5p.<\/li>\n<li>HBsAg d\u01b0\u01a1ng + antiHBc total d\u01b0\u01a1ng + anti HBc IgM \u00e2m: nhi\u1ec5m m\u1ea1n.<\/li>\n<li>HBsAg \u00e2m + antiHBc total d\u01b0\u01a1ng + anti HBs d\u01b0\u01a1ng: \u0111\u00e3 kh\u1ecfi.<\/li>\n<li>HBsAg \u00e2m + anti HBc total d\u01b0\u01a1ng + antiHbs \u00e2m: nhi\u1ec5m \u0111\u00e3 kh\u1ecfi, ch\u01b0a c\u00f3 mi\u1ec5n d\u1ecbch; nhi\u1ec5m ti\u1ec1m \u1ea9n; d\u01b0\u01a1ng t\u00ednh gi\u1ea3; nhi\u1ec5m ch\u1ee7ng \u0111\u1ed9t bi\u1ebfn HBsAg.<\/li>\n<\/ul>\n<h2><strong>6. C\u00e1c giai \u0111o\u1ea1n nhi\u1ec5m HBV m\u1ea1n theo H\u1ed9i nghi\u00ean c\u1ee9u b\u1ec7nh gan Ch\u00e2u \u00c2u EASL 2017<\/strong>.<\/h2>\n<p>Nhi\u1ec5m HBV m\u1ea1n l\u00e0 m\u1ed9t qu\u00e1 tr\u00ecnh \u0111\u1ed9ng ph\u1ea3n \u1ee9ng t\u01b0\u01a1ng t\u00e1c gi\u1eefa s\u1ef1 sao ch\u00e9p HBV v\u00e0 \u0111\u00e1p \u1ee9ng mi\u1ec5n d\u1ecbch c\u1ee7a ng\u01b0\u1eddi nhi\u1ec5m v\u00e0 kh\u00f4ng ph\u1ea3i t\u1ea5t c\u1ea3 ng\u01b0\u1eddi nhi\u1ec5m m\u1ea1n \u0111\u1ec1u c\u00f3 vi\u00eam gan m\u1ea1n. Di\u1ec5n ti\u1ebfn t\u1ef1 nhi\u00ean c\u1ee7a nhi\u1ec5m HBV m\u1ea1n c\u00f3 th\u1ec3 ph\u00e2n th\u00e0nh 5 giai \u0111o\u1ea1n, d\u1ef1a tr\u00ean s\u1ef1 hi\u1ec7n di\u1ec7n HBeAg, HBV DNA, ALT v\u00e0 vi\u00eam gan<\/p>\n<p><em>Pha 1:<\/em> nhi\u1ec5m HBV m\u1ea1n HBeAg d\u01b0\u01a1ng t\u00ednh. HBeAg d\u01b0\u01a1ng t\u00ednh, t\u1ea3i l\u01b0\u1ee3ng HBV DNA cao, ALT trong ng\u01b0\u1ee1ng b\u00ecnh th\u01b0\u1eddng (40U\/L). \u00cdt thanh th\u1ea3i HBeAg, l\u00e2y nhi\u1ec5m m\u1ea1nh.<\/p>\n<p><em>Pha 2.<\/em> Vi\u00eam gan B m\u1ea1n HBeAg d\u01b0\u01a1ng t\u00ednh. C\u00f3 HBeAg, HBV DNA cao v\u00e0 t\u0103ng ALT; tr\u00ean m\u00f4 h\u1ecdc vi\u00eam v\u1eeba &#8211; n\u1eb7ng v\u00e0 x\u01a1 h\u00f3a ti\u1ebfn tri\u1ec3n. Ph\u1ea7n l\u1edbn c\u00f3 chuy\u1ec3n \u0111\u1ed5i huy\u1ebft thanh HBeAg, gi\u1ea3m HBV DN.<\/p>\n<p><em>Pha 3<\/em>. Nhi\u1ec5m HBV m\u1ea1n HBeAg \u00e2m. C\u00f3 antiHBe d\u01b0\u01a1ng, HBV DNA th\u1ea5p (&lt;2000 IU\/mL) v\u00e0 ALT b\u00ecnh th\u01b0\u1eddng.<\/p>\n<p><em>Pha 4<\/em>: vi\u00eam gan B m\u1ea1n HBeAg \u00e2m. HBeAg th\u1ea5p, HBV DNA t\u0103ng v\u1eeba, ALT t\u0103ng v\u1eeba. M\u00f4 h\u1ecdc th\u1ea5y vi\u00eam ho\u1ea1i t\u1eed v\u00e0 x\u01a1 h\u00f3a.<\/p>\n<p><em>Pha 5:<\/em> HbsAg \u00e2m t\u00ednh. HBsAg \u00e2m, antiHBc d\u01b0\u01a1ng, ALT b\u00ecnh th\u01b0\u1eddng, HBV DNA kh\u00f4ng ph\u00e1t hi\u1ec7n \u0111\u01b0\u1ee3c.<\/p>\n<p>T\u00e0i li\u1ec7u tham kh\u1ea3o:<\/p>\n<p>EASL 2017 Clinical Practice Guidelines on the management of hepatitis B virus infection<\/p>\n<p>Manson&#8217;s tropical medicine.<\/p>\n<p>CDC Hoa K\u1ef3.<\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Nhi\u1ec5m virus vi\u00eam gan B (HBV) l\u00e0 m\u1ed9t v\u1ea5n \u0111\u1ec1 y t\u1ebf to\u00e0n c\u1ea7u v\u1edbi h\u01a1n 350 tri\u1ec7u ng\u01b0\u1eddi nhi\u1ec5m m\u1ea1n. HBV c\u00f3 th\u1ec3 g\u00e2y ra c\u00e1c h\u1ed9i ch\u1ee9ng l\u00e2m s\u00e0ng \u0111a d\u1ea1ng g\u1ed3m vi\u00eam gan c\u1ea5p, b\u1ec7nh gan m\u1ea1n t\u00ednh, x\u01a1 gan ho\u1eb7c ung th\u01b0 bi\u1ec3u m\u00f4 t\u1ebf b\u00e0o gan (HCC). K\u1ebft c\u1ee5c c\u1ee7a [&hellip;]<\/p>\n","protected":false},"author":69,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[5,33],"tags":[3],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v20.4 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Vi\u00eam gan B: di\u1ec5n ti\u1ebfn t\u1ef1 nhi\u00ean c\u1ee7a b\u1ec7nh v\u00e0 c\u00e1c d\u1ea5u \u1ea5n. - Vinmec<\/title>\n<meta name=\"description\" content=\"Virus vi\u00eam gan B c\u00f3 th\u1ec3 g\u00e2y ra c\u00e1c h\u1ed9i ch\u1ee9ng l\u00e2m s\u00e0ng \u0111a d\u1ea1ng g\u1ed3m vi\u00eam gan c\u1ea5p, b\u1ec7nh gan m\u1ea1n t\u00ednh, x\u01a1 gan ho\u1eb7c ung th\u01b0 bi\u1ec3u m\u00f4 t\u1ebf b\u00e0o gan\" \/>\n<meta name=\"robots\" content=\"noindex, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Vi\u00eam gan B: di\u1ec5n ti\u1ebfn t\u1ef1 nhi\u00ean c\u1ee7a b\u1ec7nh v\u00e0 c\u00e1c d\u1ea5u \u1ea5n. - 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