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[Hepatocellular carcinoma (CHC) in patients chronically infected with HBV]
W Zielińska1, H Kiszkis, J Dybicki
1Klinika Chorób Zakaźnych Akademii Medycznej, Gdańsku.
Insights
Hepatocellular carcinoma (HCC) in patients with chronic Hepatitis B virus (HBV) infection presents challenges. Early diagnosis and treatment, particularly for patients with liver cirrhosis, may improve survival and quality of life.
Area of Science:
- Hepatology
- Oncology
- Virology
Context:
- Hepatocellular carcinoma (HCC) is a significant complication of chronic Hepatitis B virus (HBV) infection.
- Many patients present with advanced disease, often complicated by liver cirrhosis.
- Diagnosis can be delayed due to non-specific symptoms overlapping with underlying liver disease.
Purpose:
- To analyze the clinical characteristics, treatment outcomes, and survival of HCC patients with chronic HBV infection.
- To evaluate the efficacy of different treatment modalities including cytostatic therapy, embolization, and surgery.
- To assess the impact of treatment on patient survival and quality of life.
Summary:
- This study presents 42 cases of HCC in patients with chronic HBV infection, predominantly men, with liver cirrhosis as a common underlying condition.
- Viral markers confirmed HBV infection, with a high percentage of patients showing subclinical disease progression before HCC diagnosis.
- Treatment approaches included cytostatic therapy, liver artery embolization, and surgery, with survival rates varying across treatment groups. Improvement in quality of life was noted in certain patient cohorts.
Impact:
- The findings support the consideration of treatment interventions for specific patient groups (Groups 1 and 2) with HCC and chronic HBV infection.
- Highlights the need for improved diagnostic strategies for early detection of HCC in HBV-infected individuals.
- Provides data on treatment outcomes, informing clinical decision-making for managing this complex patient population.
Abstract:
42 cases of hepatocellular carcinoma (CHC) in patients chronically infected with HBV are presented. These are 37 men and 5 women, aged 12 to 78 years. The underlying disease was liver cirrhosis in 38 cases and chronic active hepatitis in 4. HBV infection was confirmed by the detection of viral markers in serum or/and in liver tissue. 52 percent of patients were HBsAg positive and 92 HBcAg positive. In 64 percent of cases the course of HBV infection had been subclinical before the CHC was revealed. The first signs of neoplasm are not characteristic, as the concomitant liver cirrhosis may well justify them. In all patients the diagnosis of CHC was established with presence when manifest clinical symptoms were present according to advanced lesions in most of cases. For the estimation of the stage of disease, the OKUDA system was used. In 24 patients cytostatic treatment was applied. The liver artery embolisation was performed in two cases. The surgical treatment took place in 2 cases of monolobular tumours. The survival period of the non-treated and treated patients was: in the 1st group 2.5 and 7.7 mths, in the 2nd group 1.5 and 5.2 mths, in 3rd group 1.2 and 1.1 mths, and in the 4th group 1.0 and 2.5 mths, respectively. In the groups 1 and 2 improvement of live comfort, due to Zubrod scale, was obtained. The results presented are the argument for attempts of treatment in patients from the 1st and 2nd groups.