{"id":226,"date":"2025-06-11T12:50:16","date_gmt":"2025-06-11T12:50:16","guid":{"rendered":"https:\/\/analizesanocare.ro\/?post_type=product&#038;p=226"},"modified":"2025-08-08T13:57:26","modified_gmt":"2025-08-08T13:57:26","slug":"ag-hbs-screening","status":"publish","type":"product","link":"https:\/\/analizesanocare.ro\/en\/analiz\u0103\/ag-hbs-screening\/","title":{"rendered":"Ag HBs (screening)"},"content":{"rendered":"<div class=\"info-content content-informatii-generale\">\n<h2><strong>Informa\u0163ii generale \u2013 Ag HBs (screening)<\/strong><\/h2>\n<p>Virusul <a href=\"https:\/\/www.synevo.ro\/hepatita-b-o-infectie-care-poate-fi-prevenita-prin-vaccinare\/\" data-wpel-link=\"internal\">hepatitei B<\/a> este o particul\u0103 alc\u0103tuit\u0103 dintr-un \u00eenveli\u015f \u015fi un nucleu; genomul s\u0103u con\u0163ine un ADN circular, par\u0163ial dublu-catenar.<\/p>\n<p>Virusul se transmite parenteral, prin s\u00e2nge infectat sau contact intim. Perioada de incuba\u0163ie a bolii este \u00een medie 70 zile (40-160 zile)<sup>1<\/sup>.<\/p>\n<p>Antigenul de suprafa\u0163\u0103 al virusului hepatitei B (AgHBs) este un component al \u00eenveli\u015fului extern al virionului B. Persoanele infectate prezint\u0103 \u00een s\u00e2nge, pe l\u00e2ng\u0103 particulele virale infectante, \u015fi alte particule mai mici, neinfec\u0163ioase care con\u0163in de asemenea AgHBs. Determinantul antigenic \u00eempotriva c\u0103ruia se declan\u015feaz\u0103 r\u0103spunsul imun este comun tuturor particulelor de AgHBs<sup>3<\/sup>.<\/p>\n<p>Detectarea AgHBs \u00een ser indic\u0103 prezen\u0163a infec\u0163iei cu virusul hepatitei B. AgHBs este primul marker imunologic al infec\u0163iei, fiind prezent\u00a0\u00een ser cu c\u00e2teva s\u0103pt\u0103m\u00e2ni \u00eenainte de debutul clinic al bolii (al icterului). AgHBs r\u0103m\u00e2ne detectabil o perioad\u0103 de 1-4 luni\u00a0\u00een cursul unei infec\u0163ii acute, dup\u0103 care se negativeaz\u0103.<\/p>\n<p>Dac\u0103 AgHBs persist\u0103 mai mult de 6 luni, se consider\u0103 c\u0103 infec\u0163ia s-a cronicizat<sup>1;3<\/sup>. Aproximativ 5-10% din adul\u0163i \u015fi 90% din nou-n\u0103scu\u0163i nu pot elimina virusul dup\u0103 infec\u0163ie \u015fi devin purt\u0103tori cronici de AgHBs. O treime din pacien\u0163ii purt\u0103tori de AgHBs dezvolt\u0103 hepatita cronic\u0103 care \u00een timp poate evolua spre ciroz\u0103 hepatic\u0103 \u015fi,\u00a0\u00een unele cazuri, spre carcinom hepatocelular<sup>1<\/sup>.<\/p>\n<p>Transmiterea vertical\u0103 a infec\u0163iei, de la mam\u0103 la f\u0103t, se produce la aproximativ 20% din femeile gravide cu AgHBs pozitiv \u015fi la aproximativ 60% din femeile care dob\u00e2ndesc infec\u0163ia primar\u0103 \u00een cursul sarcinii.<\/p>\n<p>Deoarece rata transmiterii verticale a infec\u0163iei cu VHB este diferit\u0103\u00a0\u00een func\u0163ie de zona geografic\u0103 \u015fi tipul popula\u0163iei, se presupune c\u0103 predispozi\u0163ia pentru infec\u0163ia in utero ar fi\u00a0 influen\u0163at\u0103 de tulpina viral\u0103 \u015fi structura genetic\u0103 a popula\u0163iei. Gravidele depistate cu AgHBs pozitiv necesit\u0103 investiga\u0163ii suplimentare. Dintre testele disponibile pentru VHB, \u00eenc\u0103rc\u0103tura viral\u0103 a devenit cel mai bun factor predictiv al infectivit\u0103\u0163ii, \u00een special pentru gravidele aproape de termen.<\/p>\n<p>Introducerea programelor na\u0163ionale de vaccinare \u00eempotriva VHB a redus prevalen\u0163a infec\u0163iei\u00a0\u00een popula\u0163ie<sup>4<\/sup>.<\/p>\n<h2><strong>Recomand\u0103ri pentru determinarea AgHBs<\/strong><\/h2>\n<ul>\n<li>diagnosticul de infec\u0163ie acut\u0103\/cronic\u0103 cu virusul hepatitei B;<\/li>\n<li>monitorizarea evolu\u0163iei infec\u0163iei \u015fi a tratamentului antiviral;<\/li>\n<li>screening-ul produselor de s\u00e2nge \u015fi al donatorilor;<\/li>\n<li>screening-ul prenatal \u00een scopul prevenirii transmiterii infec\u0163iei la f\u0103t<sup>1<\/sup>;<\/li>\n<li>diagnosticul infec\u0163iei neo-natale<sup>4<\/sup>.<\/li>\n<\/ul>\n<p><strong>Preg\u0103tire pacient <\/strong>\u2013 \u00e0 jeun (pe nem\u00e2ncate)<sup>3<\/sup>.<\/p>\n<p><strong>Specimen recoltat <\/strong>\u2013 s\u00e2nge venos<sup>3<\/sup>.<\/p>\n<p><strong>Recipient de recoltare <\/strong>\u2013 vacutainer f\u0103r\u0103 anticoagulant cu\/f\u0103r\u0103 gel separator<sup>3<\/sup>.<\/p>\n<p><strong>Prelucrare necesar\u0103 dup\u0103 recoltare <\/strong>\u2013 se separ\u0103 serul prin centrifugare; se lucreaz\u0103 imediat; dac\u0103 acest lucru nu este posibil, serul se p\u0103streaz\u0103 la 2-8\u00b0C sau la -20\u00b0C<sup>3<\/sup>.<\/p>\n<p><strong>Volum prob\u0103<\/strong> \u2013 minim 0.5 mL ser<sup>3<\/sup><\/p>\n<p><strong>Cauze de respingere a probei <\/strong>\u2013 specimen hemolizat; specimen expus la temperaturi ridicate; specimen contaminat bacterian<sup>3<\/sup>.<\/p>\n<p><strong>Stabilitate prob\u0103 <\/strong>\u2013 serul separat este stabil 5 zile la 2-8\u00b0C; timp \u00eendelungat la -20\u00b0C; evita\u0163i decongelarea\/recongelarea<sup>3<\/sup>.<\/p>\n<p><strong>Metod\u0103 <\/strong>\u2013 imunochimic\u0103 cu detec\u0163ie prin electrochemiluminiscen\u0163\u0103 (ECLIA)<sup>3<\/sup>.<\/p>\n<h2><strong>Valori de referin\u0163\u0103 Ag HBs (screening)<\/strong><\/h2>\n<p>AgHBs negativ<sup>3<\/sup>.<\/p>\n<p><strong>Limite \u015fi interferen\u0163e<\/strong><\/p>\n<p>In aproximativ 5% din cazurile de hepatit\u0103 acut\u0103 B \u015fi \u00eentr-un procent foarte mic din cazurile de hepatit\u0103 cronic\u0103, AgHBs r\u0103mane nedetectabil (hepatita B AgHBs negativ\u0103). In aceste cazuri, diagnosticul se stabile\u015fte prin determinarea <a href=\"https:\/\/www.synevo.ro\/shop\/anti-hbc-igm\/\" target=\"_blank\" rel=\"noopener\" data-wpel-link=\"internal\">anti-HBc-IgM<\/a> sau a ADN viral hepatit\u0103 B<sup>1<\/sup>.<\/p>\n<p>In unele cazuri se poate ob\u0163ine un rezultat slab pozitiv (valoarea indicat\u0103 de analizor &lt;200); \u00een aceste situa\u0163ii se recomand\u0103 efectuarea celorlati markeri de hepatit\u0103 B sau determinarea AgHBs printr-o alt\u0103 metod\u0103<sup>3<\/sup>.<\/p>\n<p>Interferen\u0163e analitice<\/p>\n<p>Pot produce interferen\u0163e cu unele componente ale kit-ului \u015fi conduce la rezultate neconcludente urm\u0103toarele:<\/p>\n<ul>\n<li>tratamentul cu biotin\u0103 \u00een doze mari (&gt;5 mg\/zi); de aceea se recomand\u0103 ca recoltarea de s\u00e2nge s\u0103 se fac\u0103 dup\u0103 minimum 8 ore de la ultima administrare;<\/li>\n<li>titrurile foarte crescute de anticorpi anti-streptavidina \u015fi anti-ruteniu;<\/li>\n<li>anticorpii monoclonali proveni\u0163i de la \u015foarece administra\u0163i la unii pacien\u0163i \u00een scop diagnostic sau terapeutic<sup>3<\/sup>.<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<h2><strong>Bibliografie<\/strong><\/h2>\n<div>1. Gert Frosner. Hepatitis B surface antigen (HBsAg). In Lothar Thomas\u2019 Clinical Laboratory Diagnostics. Use and Assessment of Clinical Laboratory Results. TH-Books Verlagsgesellschaft mbH, Frankfurt \/Main, Germany,1 Ed. 1998, 1264-1266.<\/div>\n<div>2. Jacques Wallach. Hepatita B (AgHBs). In Interpretarea testelor de diagnostic. Editura Stiin\u0163elor Medicale, Rom\u00e2nia, Ed.7 2001, 310-312.<\/div>\n<div>3. Laborator Synevo. Referin\u0163ele specifice tehnologiei de lucru utilizate 2023. Ref Type: Catalog.<\/div>\n<div>4. Lynn Bry. Prenatal Screening and Diagnosis of Congenital Infections. In Handbook of Clinical Laboratory Testing During Pregnancy. Ann M. Gronowski. Humana Press, USA, 2004, 255-257. <a href=\"https:\/\/link.springer.com\/chapter\/10.1007\/978-1-59259-787-1_12\" target=\"_blank\" rel=\"noopener nofollow external noreferrer\" data-wpel-link=\"external\">https:\/\/link.springer.com\/chapter\/10.1007\/978-1-59259-787-1_12<\/a><\/div>\n<\/div>","protected":false},"excerpt":{"rendered":"<p>Informa\u0163ii generale \u2013 Ag HBs (screening) Virusul hepatitei B este o particul\u0103 alc\u0103tuit\u0103 dintr-un \u00eenveli\u015f \u015fi un nucleu; genomul s\u0103u con\u0163ine un ADN circular, par\u0163ial dublu-catenar. Virusul se transmite parenteral, prin s\u00e2nge infectat sau contact intim. Perioada de incuba\u0163ie a bolii este \u00een medie 70 zile (40-160 zile)1. Antigenul de suprafa\u0163\u0103 al virusului hepatitei B [&hellip;]<\/p>\n","protected":false},"featured_media":0,"template":"","meta":{"_acf_changed":false},"product_brand":[],"product_cat":[38],"product_tag":[],"class_list":["post-226","product","type-product","status-publish","product_cat-markeri-virlai","first","instock","shipping-taxable","purchasable","product-type-simple"],"acf":[],"_links":{"self":[{"href":"https:\/\/analizesanocare.ro\/en\/wp-json\/wp\/v2\/product\/226","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/analizesanocare.ro\/en\/wp-json\/wp\/v2\/product"}],"about":[{"href":"https:\/\/analizesanocare.ro\/en\/wp-json\/wp\/v2\/types\/product"}],"wp:attachment":[{"href":"https:\/\/analizesanocare.ro\/en\/wp-json\/wp\/v2\/media?parent=226"}],"wp:term":[{"taxonomy":"product_brand","embeddable":true,"href":"https:\/\/analizesanocare.ro\/en\/wp-json\/wp\/v2\/product_brand?post=226"},{"taxonomy":"product_cat","embeddable":true,"href":"https:\/\/analizesanocare.ro\/en\/wp-json\/wp\/v2\/product_cat?post=226"},{"taxonomy":"product_tag","embeddable":true,"href":"https:\/\/analizesanocare.ro\/en\/wp-json\/wp\/v2\/product_tag?post=226"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}