Репозиторий Университета

© 2018, Dynasty Publishing House. All rights reserved. The objective. To evaluate the incidence and prevalence of hepatitis C in Russia and estimate the impact of hepatitis C virus on liver cirrhosis, hepatocellular carcinoma and liver-related mortality before the implementation of the national program for the elimination of viral hepatitis. Materials and methods. We analyzed statistical data on the incidence of hepatitis C in Russia in 2001–2017, the incidence, prevalence and mortality rates from liver cirrhosis and malignant liver tumors in 2011–2015. An analysis of the incidence and prevalence of HCV was carried out in various age-sex groups. The structure of genotypes of the hepatitis C virus was determined in patients at different stages of liver fibrosis and with different levels of viral load. Results. In 2017, 50 798 cases of HCV were registered in Russia (34.6 per 100 thousand of the population). As of January 1, 2017, the total number of patients with chronic hepatitis C under medical observation was 591 830 (405 per 100 thousand population). The incidence rate of fibrosis and cirrhosis in Russia in 2015 was 12.7 per 100000 population (18640 cases), the total number of registered patients – 75.9 per 100 thousand population (110951 people). The incidence rate of malignant liver tumors in 2015 was 5.5 per 100 thousand population (8083 cases), the total number of patients on dispensary observation was 5.0 per 100 thousand population (7360 people). In 2015, the estimated number of deaths from liver cirrhosis and hepatocellular carcinoma in the outcome of chronic hepatitis C was 14 792 and 1635, respectively. Conclusion. Hepatitis C is the main cause of liver cirrhosis (excluding alcoholic etiology), hepatocellular carcinoma and liver-related mortality in Russia. To reduce the prevalence of HCV and mortality from liver cirrhosis and primary liver cancer, it is necessary to provide all patients with HCV with antiviral drugs.

© 2018 Dynasty Publishing House. All rights reserved. Hepatocellular carcinoma (HCC) is rarely diagnosed during pregnancy, its fibrolamellar variant (FHCC) is a specific form that is more often diagnosed in young women and is rarely associated with cirrhosis or chronic infection with hepatitis B or C viruses. Making a diagnosis at early stages is complicated by the fact that the α-fetoprotein (AFP) level is usually not enhanced, and symptoms develop only at advanced stages of disease. A clinical case of FHCC in a 27-year-old woman is presented, diagnosed at the 30th week of pregnancy after persistent dragging and spastic pains in the epigastric region. US detected a tumour with sizes 110 × 81 × 89 mm and foci in the lungs. Variants of treating such patients depending on tumour characteristics, pregnancy period and family preferences are discussed.