Phòng Khám Viêm Gan - PGS. TS. Trần Xuân Chương

02/05/2026

Dự phòng các bệnh nhiễm trùng mùa Hè

📌 Gần đây, tại một số địa phương ở Việt Nam đã ghi nhận sự gia tăng các bệnh truyền nhiễm như viêm màng não do não mô cầu, cúm mùa và một số bệnh khác. Các bệnh này có thể lây lan nhanh và gây ra những biến chứng nghiêm trọng cho sức khỏe.

Việc thực hiện các biện pháp phòng ngừa là rất cần thiết để bảo vệ bản thân và những người xung quanh.

Để bảo vệ bạn và những người xung quanh:
👉 Trao đổi với cán bộ y tế về các biện pháp phòng ngừa hiện có, bao gồm tiêm chủng.
👉 Đến cơ sở y tế ngay nếu các triệu chứng trở nặng nhanh chóng.
👉 Ở nhà khi không khỏe. Nếu trẻ em bị ốm, hãy cho trẻ nghỉ ở nhà.
👉 Đeo khẩu trang ở nơi đông người hoặc không gian kín, hoặc khi cảm thấy không khỏe.
👉 Duy trì sức khỏe tốt với chế độ ăn uống cân bằng, vận động thường xuyên và nghỉ ngơi đầy đủ.
👉 Thực hành vệ sinh cá nhân tốt và giữ không gian sống sạch sẽ, thông thoáng.

- - - -
📌 Infectious diseases such as meningococcal meningitis, seasonal influenza, and other illnesses have been increasingly reported recently in some parts of Viet Nam. They can spread quickly and cause serious health complications.

Taking preventive measures is essential to protect yourself and those around you.

How to protect yourself and others:
👉 Consult with your healthcare provider about available preventive options, including vaccination.
👉 Seek immediate medical care if any symptoms worsen rapidly.
👉 Stay home when unwell. If your children are sick, keep them home from school or daycare.
👉 Wear a mask in crowded or enclosed spaces, or when feeling unwell.
👉 Maintain good health with a balanced diet, regular exercise, and adequate rest.
👉 Practice good hygiene and keep living spaces clean and well‑ventilated.

04/04/2026

Hội nghị KH Liver Summit 2026

22/03/2026

Giữ cho gan được khỏe

Gan là cơ quan nội tạng lớn nhất, đóng vai trò như 'nhà máy xử lý' của cơ thể với hàng trăm chức năng quan trọng như chuyển hóa dinh dưỡng, giải độc và dự trữ năng lượng.

21/02/2026

Giới thiệu về bệnh viêm gan B

🦠 HEPATITIS B (HBV) – Complete Medical Overview

🔬 What is Hepatitis B?

Hepatitis B is a viral infection of the liver caused by the Hepatitis B virus (HBV). It can be:
• Acute (short-term, < 6 months)
• Chronic (long-term, > 6 months)

Chronic infection can lead to:
• Liver fibrosis
• Cirrhosis
• Liver failure
• Hepatocellular carcinoma (liver cancer)
• Death if untreated

HBV is one of the most common infectious diseases worldwide.

⸻

🧬 Structure of Hepatitis B Virus

HBV is a DNA virus from the Hepadnaviridae family.

It contains:
• Surface antigen (HBsAg)
• Core antigen (HBcAg)
• “e” antigen (HBeAg)
• Partially double-stranded DNA
• Reverse transcriptase enzyme

⸻

⚙️ Pathophysiology (How HBV Damages the Liver)

Step 1: Entry

HBV enters the body through blood or body fluids.

Step 2: Liver Cell Infection

The virus travels to the liver and binds to hepatocytes (liver cells).

Step 3: Replication

Inside the liver cell:
• HBV DNA enters the nucleus
• Converts into covalently closed circular DNA (cccDNA)
• Uses reverse transcription to replicate

Step 4: Immune Response

The virus itself does NOT directly destroy liver cells.
Damage happens because:
• The immune system (cytotoxic T cells) attacks infected hepatocytes.
• This causes inflammation (hepatitis).

Step 5: Chronic Inflammation

Long-term immune attack leads to:
• Fibrosis (scar tissue formation)
• Cirrhosis (severe scarring)
• Increased risk of liver cancer

⸻

⚠️ Symptoms of Hepatitis B

Many patients (especially children) have no symptoms.

When symptoms occur, they may include:

Early Symptoms:
• Fatigue
• Fever
• Loss of appetite
• Nausea & vomiting
• Joint pain

Liver-Related Symptoms:
• Jaundice (yellow skin & eyes)
• Dark urine
• Pale stools
• Abdominal pain (right upper quadrant)
• Enlarged liver

Chronic hepatitis B may remain silent for years before complications develop.

⸻

🧪 Causes & Transmission

HBV spreads through infected blood and body fluids.

Main Transmission Routes:
1. Unprotected sexual contact
2. Sharing needles (IV drug use)
3. Unsafe medical injections
4. Blood transfusion (unscreened blood)
5. Mother-to-child transmission at birth
6. Sharing razors or toothbrushes

It is NOT spread by:
• Hugging
• Handshakes
• Sharing food
• Coughing or sneezing

⸻

📈 Why Are Cases Increasing?

Several global factors contribute:

1️⃣ Low Vaccination Coverage

Some regions have poor access to HBV vaccine.

2️⃣ Unsafe Injection Practices

Reusing syringes in healthcare settings.

3️⃣ Increased Global Migration

Movement from high-prevalence areas spreads infection.

4️⃣ Lack of Screening

Many people are unaware they are infected.

5️⃣ Mother-to-Child Transmission

Failure to give newborn vaccination within 24 hours.

⸻

🛡️ How to Protect Yourself

✅ Vaccination (Most Important)
• 3-dose vaccine series
• 95% effective
• Safe for infants, children, and adults

✅ Safe S*x
• Use condoms
• Get tested regularly

✅ Avoid Needle Sharing
• Never share syringes
• Use sterile medical equipment

✅ Safe Healthcare Practices
• Screen blood before transfusion
• Proper sterilization

✅ Pregnancy Screening
• All pregnant women should be tested
• Newborn must receive HBV vaccine + HBIG within 12–24 hours if mother is positive

⸻

🧾 Diagnosis

Blood tests detect:
• HBsAg → Current infection
• Anti-HBs → Immunity
• Anti-HBc → Past exposure
• HBeAg → Active replication
• HBV DNA → Viral load

Liver function tests (ALT, AST) show liver damage.

⸻

💊 Treatment

Acute Hepatitis B
• Usually supportive treatment
• Most adults recover completely

Chronic Hepatitis B

Antiviral medications:
• Tenofovir
• Entecavir

Goals:
• Suppress viral replication
• Prevent cirrhosis
• Reduce liver cancer risk

Regular monitoring is essential.

⸻

🚨 Complications

If untreated, chronic HBV can cause:
• Liver cirrhosis
• Portal hypertension
• Ascites
• Liver failure
• Hepatocellular carcinoma (HCC)

HBV is a major global cause of liver cancer.

⸻

🌍 Key Global Facts
• Over 250 million people live with chronic HBV worldwide.
• Many people are unaware they are infected.
• Vaccination has significantly reduced childhood cases.

09/02/2026

Bệnh gan nhiễm mỡ

[PDF] Cập nhật các quan điểm mới về gan nhiễm mỡ
PGS.TS.BS.CKII. Trần Thị Khánh Tường

Tài liệu trong Hội nghị Siêu âm Toàn quốc (VSUM) 2025
Phiên 2A – Gan nhiễm mỡ – Từ lâm sàng đến siêu âm

Link tải: https://drive.google.com/file/d/1Z1UGoA8HzQsquEep5MV54MlKT4uJGg5Y/view

31/01/2026

Các bệnh gan phổ biến

Common Liver Diseases :

🟣 Fatty Liver (Hepatic Steatosis)

→ Excess triglyceride accumulation in hepatocytes
→ Common causes: obesity, type 2 diabetes, alcohol, metabolic syndrome
→ Usually asymptomatic initially
→ May progress to steatohepatitis → fibrosis → cirrhosis

Key labs
→ Mild ↑ ALT/AST (ALT > AST in NAFLD)

🟣 Alcoholic Liver Disease

→ Due to chronic alcohol intake

Progression sequence
→ Fatty liver → Alcoholic hepatitis → Cirrhosis

Histology
→ Ballooned hepatocytes
→ Mallory–Denk bodies
→ Neutrophilic infiltration

Labs
→ AST : ALT > 2:1 (classic)

🟣 Hepatitis (Viral / Inflammatory)

→ Inflammation of liver parenchyma

Causes
→ Viral (A, B, C, D, E)
→ Autoimmune
→ Drugs / toxins

Symptoms
→ Fatigue, jaundice, RUQ pain, nausea

Chronic hepatitis may lead to
→ Fibrosis
→ Cirrhosis
→ Hepatocellular carcinoma

🟣 Liver Cirrhosis

→ Irreversible fibrosis with regenerative nodules

Major consequences
→ Portal hypertension
→ Ascites
→ Varices
→ Hepatic encephalopathy
→ Coagulopathy

Common causes
→ Alcohol
→ Chronic hepatitis B/C
→ NAFLD

🟣 Hepatocellular Carcinoma (HCC)

→ Primary liver malignancy
→ Usually develops on cirrhotic liver

Risk factors
→ Chronic HBV/HCV
→ Alcohol
→ NAFLD

Features
→ Weight loss
→ RUQ pain
→ Rising AFP (alpha-fetoprotein)
→ Vascular invasion common

🟣 Cholestasis / Bile Duct Obstruction

→ Impaired bile flow

Clinical features
→ Pruritus
→ Pale stools
→ Dark urine
→ Jaundice

Labs
→ ↑ ALP
→ ↑ GGT
→ ↑ Direct bilirubin

Causes
→ Gallstones
→ Tumors
→ Strictures
→ Primary biliary cholangitis

🟣 Acute Liver Failure

→ Rapid loss of liver function

Defined by
→ Encephalopathy
→ Coagulopathy (↑ INR)

Causes
→ Acetaminophen toxicity (most common)
→ Viral hepatitis
→ Drugs / toxins

Histology
→ Massive hepatocyte necrosis

Medical emergency.

🟣 Primary Biliary Cholangitis (PBC)

→ Autoimmune destruction of intrahepatic bile ducts

Typical patient
→ Middle-aged woman

Labs
→ ↑ ALP
→ Positive antimitochondrial antibodies (AMA)

Leads to
→ Progressive cholestasis
→ Cirrhosis

🟣 Portal Hypertension

→ Increased pressure in portal venous system (usually due to cirrhosis)

Consequences
→ Splenomegaly
→ Ascites
→ Esophageal varices
→ Caput medusae

Mechanism
→ Increased intrahepatic resistance + collateral formation

28/01/2026

Phân biệt viêm gan B cấp và mạn tính

Acute vs Chronic Hepatitis B

27/01/2026

Between 1 January and 29 August 2025, the International Health Regulations National Focal Point (IHR NFP) for Bangladesh notified WHO of four confirmed fatal Nipah virus (NiV) infection cases, temporally unrelated, reported from four different districts across three separated geographical divisions....

25/01/2026

Các dấu hiệu ngoài da của bn xơ gan

Skin Signs of Liver Cirrhosis (What Your Skin Is Trying to Tell You)

When the liver starts failing, it doesn’t stay silent. One of the earliest and most visible warning systems is your skin. As toxins build up and hormones fall out of balance, the body often shows distress on the surface—sometimes long before serious internal symptoms are diagnosed.

Jaundice is usually the first red flag. The skin and the whites of the eyes take on a yellow tone because bilirubin isn’t being cleared properly. It’s not just a color change—it’s a sign the liver is overwhelmed.

Spider angiomas appear as tiny red, spider-like blood vessels, most commonly on the face, neck, or chest. These form due to altered estrogen metabolism and weakened blood vessel regulation.

Palmar erythema causes unusual redness on the palms, especially near the base of the thumb and little finger. The palms may feel warm but are usually painless—yet they signal serious internal imbalance.

Easy bruising and petechiae happen because a damaged liver produces fewer clotting proteins. Even light bumps can leave deep bruises or small red dots under the skin.

Caput medusae—swollen, visible veins spreading from the navel—occur due to increased pressure in the portal vein system. This is often seen in advanced cirrhosis.

Paper money skin describes thin, fragile skin crisscrossed with fine blood vessels, resembling old currency notes. It reflects chronic vascular and collagen damage.

Pruritus marks come from relentless itching caused by bile salt buildup under the skin. The itching can be intense, leading to visible scratch lines and skin damage.

⚠️ Important: These signs are not cosmetic issues. They are distress signals from the liver. Early recognition and medical evaluation can be life-saving.