HEPATOCELLULAR CARCINOMA IN THE COHORT OF VIETNAMESE PATIENTS WITH CHRONIC HEPATITIS C

Abstract

Objectives. To describe the clinical and laboratory characteristics of chronic hepatitis C patients with hepatocellular carcinoma (HCC) and to evaluate the effectiveness of antiviral therapy in these patients. Materials and methods. This is a prospective and retrospective study. Data from 1870 patients with CHC observed in the hepatology clinic in Ho Chi Minh City (Vietnam) for the years 2010–2015 were analyzed. Results. The average age of detection of HCV infection in patients with hepatocellular carcinoma was 63,1±10,0 years, men — 62,3%. HCC was detected in 9% of patients with chronic hepatitis C (159 people). In 58% of cases, HCC and HCV infection were diagnosed at the same time. In 91,8% patients with HCC, HCV infection was first detected at the age of over 50 years. However, in 46,1% of patients, HCC was diagnosed at stages of the disease, when the possibilities of therapy were limited. Analyzing the effectiveness of antiviral therapy, including sofosbuvir and ribavirin (in 24 weeks), showed that of 75 patients with chronic hepatitis C (genotype 6) without a history of HCC, SVR-24 was registered in 98,7% people; of 11 patients with HCC, only 5 patients (45,5%) achieved SVR-24. Conclusion. Presence of HCC, including after chemotherapy or surgical treatment, is a negative predictor of response to therapy, including sofosbuvir and ribavirin. It is necessary to introduce in Vietnam screening programs for HCV infection to identify patients in the early stages of the disease and to expand access to antiviral drugs for HCV therapy.