scholarly journals Structure of Patients with Hepatocellular Cancer (Data Analysis from Two Specialised Centres)

2020 ◽  
Vol 30 (2) ◽  
pp. 58-67
Author(s):  
M. V. Mayevskaya ◽  
M. S. Novruzbekov ◽  
I. M. Borovkov ◽  
D. G. Trofimova ◽  
M. S. Zharkova ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Chronic Hepatitis ◽  
Liver Disease ◽  
Hepatitis C ◽  
Chronic Hepatitis C ◽  
Liver Diseases ◽  
Hepatocellular Cancer ◽  
Number Of Patients ◽  
Before And After ◽  
Twofold Decrease

Aim. To identify trends in the structure of patients with liver diseases, in particular hepatocellular cancer (HCC), by analysing the experience of two specialised medical centres.Materials and methods. A retrospective analysis of the medical records of hepatological patients who sought medical treatment at to the V.Kh. Vasilenko Clinic of Propaedeutics of Internal Diseases, Gastroenterology and Hepatology of the Sechenov University in 2013, 2014 and 2017 (total 2459 patients) was carried out. The number of patients with chronic viral hepatitis (CVH) was 651, with non-alcoholic fatty liver disease (NAFLD) — 590, with alcoholic liver disease (ALD) — 66, with autoimmune liver diseases — 416, with liver cirrhosis (LC) of any etiology 407, other liver diseases — 329. A retrospective analysis of the medical records of patients with HCC who were examined and treated at the N.V. Sklifosovsky Research Institute for Emergency Medicine in the period from 2008 to 2017 (n = 86) was carried out.Results. The ratio of patients with chronic hepatitis C and B in 2013–2017 significantly changed. An almost twofold decrease in the number of patients with chronic hepatitis C (210 patients in 2013 and 141 patients in 2017) and an increase in the number of patients with chronic hepatitis B (20 patients in 2013 and 45 patients in 2017) was observed. An almost twofold increase in the total number of NAFLD patients was detected (163 patients in 2013 and 276 patients in 2017). The number of ALD patients increased from 12 patients in 2013 to 31 patients in 2017. The proportion of patients with autoimmune liver diseases in the overall structure of patients who applied to the department was 20 % in 2013, 13.6 % in 2014 and 10.8 % in 2017. An almost twofold decrease in the number of patients with alcoholic LC and LC associated with HBV was observed (73 patients and 17 patients in 2013 and 38 patients and 6 patients in 2017, respectively) as well as a noticeable increase in the number of patients with alcoholic LC and LC associated with HCV (6 patients and 51 patients in 2013 and 26 patients and 75 patients in 2017, respectively). In the analysis of HCC patients, the ratio of men to women was 3:1 (64 men and 22 women), the median age was 54.5 years (IQR 48–59). The median time from the establishment of chronic liver disease to the detection of HCC was 7.5 years (IQR 3–14.5). In 86 % of cases, the HCC development was preceded by cirrhosis (Child-Pugh A: n = 24; Child-Pugh B: n = 30; Child-Pugh C: n = 20), in 14 % — by chronic hepatitis. Viral liver lesions were the leading cause of HCC in 79 % (n = 68), ALD in 4 % (n = 3), NAFLD in 1 % (n = 1), AIH in 1 % (n = 1). In 10 % (n = 9), a combined liver lesion was observed, in 5 % (n = 4), no previous liver disease was known. The highest five-year survival rate (100 %) was found in the group of patients who received antiviral therapy (AVT) before and after liver transplantation.Conclusions. NAFLD, ALD, and chronic hepatitis B patients began to seek medical help more frequently. An increase in the number of patients with autoimmune LC and LC associated with chronic hepatitis C virus (HCV) infection was observed. The conducted analysis of trends in the structure of HCC patients showed that chronic HCV and HBV infection is the main prerequisite for the development of cancer. Liver transplantation is the most effective treatment for HCC. AVT before and after liver transplantation allows a statistically significant increase in the five-year posttransplant survival of HCC patients with chronic hepatitis C to be achieved.

scholarly journals Hepatitis G virus co-infection in liver transplantation recipients with chronic hepatitis C and nonviral chronic liver disease

Hepatology ◽  
1997 ◽  
Vol 25 (5) ◽  
pp. 1271-1275 ◽  
Author(s):  
M W Fried ◽  
Y E Khudyakov ◽  
G A Smallwood ◽  
M Cong ◽  
B Nichols ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Chronic Hepatitis ◽  
Liver Disease ◽  
Hepatitis C ◽  
Chronic Liver Disease ◽  
Chronic Hepatitis C ◽  
Chronic Liver ◽  
Hepatitis G Virus ◽  
Hepatitis G

Modeling of the epidemiological situation of hepatitis C in the North-Western Federal district and Saint Petersburg until 2030

2020 ◽  
Vol 18 (3) ◽  
pp. 48-54
Author(s):  
E.V. E.V.Esaulenko ◽  
◽  
R.A. R.A.Ganchenko ◽  
◽  
Keyword(s):  
Chronic Hepatitis ◽  
Liver Disease ◽  
Hepatitis C ◽  
Chronic Hepatitis C ◽  
Federal District ◽  
Hcv Infection ◽  
Saint Petersburg ◽  
Number Of Patients ◽  
North Western ◽  
Epidemiological Situation

Currently, there is an urgent need to monitor the epidemiological situation of the infection caused by hepatitis C virus (HCV) and control its early diagnosis. Objective. To determine the public health burden of HCV infection in Saint Petersburg (SPb) and North-Western Federal district (NWFD), to predict the epidemiological situation, and to identify measures that should be taken to achieve the goals mentioned in the WHO strategy by 2030. Materials and methods. We have developed a dynamic model of disease progression for quantitative assessment of HCV burden by stages of liver disease for 1950–2030 in collaboration with the Center for Disease Analysis, USA. Results. With the existing approach to HCV diagnosis and treatment, the number of patients with chronic hepatitis C in SPb and NWFD will continue to grow and reach 332,000 and 193,000 cases respectively. We expect at least a two-fold increase in the number of deaths associated with liver disease and in the number of patients with decompensated cirrhosis and hepatocellular carcinoma in both SPb and NWFD. Changes in the approaches currently used for HCV treatment and implementation of additional measures will help to achieve main WHO goals by 2030. Conclusion. Implementation of the WHO strategy in the NWFD and SPb has obvious advantages, but requires significant resources and optimization of existing approaches to the diagnosis and treatment of HCV infection in the region. Keywords: HCV infection, chronic hepatitis C, WHO strategy to eliminate hepatitis C

scholarly journals Treatment of anicteric acute hepatitis C with peginterferon alpha-2a plus ribavirin

2005 ◽  
Vol 62 (11) ◽  
pp. 865-868
Author(s):  
Dragan Delic ◽  
Zorica Nesic ◽  
Milica Prostran ◽  
Jasmina Simonovic ◽  
Neda Svirtlih
Keyword(s):  
Chronic Hepatitis ◽  
Liver Disease ◽  
Hepatitis C ◽  
Acute Hepatitis ◽  
Chronic Hepatitis C ◽  
Combined Therapy ◽  
Acute Infection ◽  
Hcv Infection ◽  
Acute Hepatitis C ◽  
Number Of Patients

Background. Hepatitis C virus (HCV) infection is the most frequent cause of chronic hepatitis, cirrhosis, and hepatocellular carcinoma in the world. Acute hepatitis C is the most commonly asymptomatic liver disease with the development of chronic HCV infection in the majority of infected patients. Studies of the natural history of HCV infection suggest that only 15-30% of patients with acute infection recover spontaneously. Others, up to 85% of the infected patients develop chronic hepatitis C. Acute hepatitis C is so uncommon and with the unpredictable occurrence, and of the low frequency, that it is difficult to determine the optimal treatment of this disease. There have been many randomized, controlled trials of the therapy in patients with chronic hepatitis C, but none of an adequate size or rigor in patients with acute hepatitis C. Therefore, the causal treatment of patients with acute hepatitis C aimed at the prevention of chronic liver disease is necessary. Case report. We have treated a patient with anicteric form of acute hepatitis C after a three-month outpatient follow-up using a combined therapy: pegylated interferon-alpha 2a, 180 ?g, subcutaneously, once a week plus ribavirin 1000 mg orally once a day. The treatment lasted 24 weeks. Stable biochemical and virological response was achieved both at the end of the treatment and 6 months after the completion of the therapy. Conclusion. We believe that the above mentioned might be one of the approaches to the treatment of acute hepatitis C. However, further prospective studies with significantly larges number of patients are necessary for the definite conclusions about the treatment of HCV infections.

scholarly journals Antiviral Treatment for Hepatitis C Virus Infection after Liver Transplantation

2010 ◽  
Vol 2010 ◽  
pp. 1-9
Author(s):  
Yasuhiko Sugawara ◽  
Sumihito Tamura ◽  
Norihiro Kokudo
Keyword(s):  
Liver Transplantation ◽  
Chronic Hepatitis ◽  
Hepatitis C Virus ◽  
Liver Disease ◽  
Hepatitis C ◽  
Chronic Hepatitis C ◽  
Antiviral Treatment ◽  
Significant Proportion ◽  
Sustained Viral Response ◽  
Preemptive Therapy

A significant proportion of patients with chronic hepatitis C virus (HCV) infection develop liver cirrhosis and complications of end-stage liver disease over two to three decades and require liver transplantation, however, reinfection is common and leads to further adverse events under immunosuppression. Pretransplant antiviral or preemptive therapy is limited to mildly decompensated patients due to poor tolerance. The mainstay of management represents directed antiviral therapy after evidence of recurrence of chronic hepatitis C. Combined pegylated interferon and ribavirin therapy is the current standard treatment with sustained viral response rates of 25% to 45%. The rate is lower than that in the immunocompetent population, partly due to the high prevalence of intolerability. To date, there is no general consensus regarding the antiviral treatment modality, timing, or dosing for HCV in patients with advanced liver disease and after liver transplantation. New anti-HCV drugs to delay disease progression or to enhance viral clearance are necessary.

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