Risk of progression and the cause of mortality at chronic viral mixed-hepatitis

Abstract

Aim of investigation. To estimate risk of development of liver function decompensation, hepatocellular carcinoma (HCC) development and prognostic factors of liver-related mortality in patients with chronic viral mixed-hepatitis.Material and methods. 82 patients with hepatitis D, 56 – with hepatitis B+C and 20 – with hepatitis B+C+D, followed-up from Jan 2002 to Dec 2011, were included in the study. Results. During follow-up, decompensation occurred in 45.1, 8.9 and 62.5% of patients with compensated liver cirrhosis in groups D, BC and BCD, respectively. The 5-year risk of decompensation was 62%, 27% and 60%. HCC developed in 5.7% of patients, high AFP being the only predictor of HCC. The 5-year risk of HCC was 3.8%, 3.5% and 0%, respectively. 17.1%, 1.8% and 20% of patients died in groups D, BC and BCD, respectively, 5-year survival rate was 90%, 97% and 82%.Conclusions. In patients with chronic viral mixed hepatitis it is decompensation with liver failure development that determines prognosis and is principal cause of liver-related mortality in the most cases, not HCC development.

Keywords

• mixed-hepatitis
• combined hepatitis
• liver cirrhosis
• hepatocellular carcinoma
• decompensation
• hepatitis b
• hepatitis c
• hepatitis delta