Predictors development of hepatocellular carcinoma of patients with chronic viral hepatitis in the Republic of Sakha (Yakutia)

• Snezhana S. Sleptsovа
• Bilukina Iraida F.

Abstract

High incidence of chronic viral hepatitis observing in the Republic of Sakha (Yakutia), which is significantly higher than in the Russian Federation. Severe presentation of parenteral viral hepatitis and their further chronicity are associated with the presence of immunodeficiency states, the frequency of which increases significantly in unfavorable environmental conditions.

According to the Register "Chronic viral hepatitis in the Republic of Sakha (Yakutia)", 15 145 people are registered in total, 6417 with chronic hepatitis B (CHB), 6781 with chronic hepatitis C (CHC), 1101 with chronic hepatitis D (CHD), hepatitis of combined etiology - 641, hepatitis of unspecified etiology - 4, and 385 patients with liver cirrhosis (LC) and 27 people with primary liver cancer (PLC).

Aim of the work is to identify the main predictors of primary liver cancer development in patients with chronic viral hepatitis in the Republic of Sakha (Yakutia) and to improve the management algorithm for patients.

Material and methods. 116 case histories of patients with viral etiology (B, C, D) LC who were treated in the department of viral hepatitis Yakut City Clinical Hospital in 2017 had been analyzed. There were 56 (48.3%) men, 60 (51.7%) women, the age of patients ranged from 24 to 82 years, the average age was 57.4±2.1 years. The patients are divided into 2 groups: CH-LC - 58 (50%) people, CH-PLC - 58 (50%).

Results and discussion. Hepatocellular carcinoma (HCC) developed on the background of chronic viral hepatitis in the CP stage caused by HCV (41.38%) in majority of cases. The highest incidence of liver cirrhosis was observed with HDV infection (51.72%). A high incidence of cirrhosis (70.7%) and primary liver cancer (79.3%) in people of indigenous nationality has been established. Primary liver cancer most often developed in CGD with mixed replication (75%) compared with the mono-replicative form of HDV (p<0.05). HCV genotyping showed that genotype 1b was isolated in 100% of cases of liver cancer. The level of alpha-fetoprotein in patients with HCC was significantly higher (504.4±102 ng/ml, p<0.05) than in liver cirrhosis, which is also a predictor of the progression of chronic viral hepatitis to hepatocellular carcinoma.

Keywords:chronic viral hepatitis, liver cirrhosis, primary liver cancer, predictors

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