CLINICAL AND LABORATORY FEATURES OF THE DEVELOPMENT OF LIVER CIRRHOSIS WITH HDV-INFECTION IN THE REPUBLIC OF SAKHA (YAKUTIA)

The aim of the research: to study the clinical and laboratory features of the formation of liver cirrhosis in HDV infection among the population of Yakutia.

Materials and methods of the study: An analysis was made of 120 case histories of patients with chronic hepatitis D who underwent inpatient treatment from 2020 to 2021. The analyzed patients were divided into 2 groups: with the formation of liver cirrhosis (n=76), which was divided according to the severity of the course (3 classes according to Child-Pugh) and without liver cirrhosis (n=44). Epidemiological factors, the duration of infection and the formation of complications, clinical and laboratory markers of the severity of the course were assessed. Data processing was carried out using statistical criteria using the IBM SPSS Statistics 26.0 software package.

Results: It was found that people of indigenous nationality are more susceptible to hepatitis D, while HDV-cirrhosis is formed on average 15 years from the moment of infection. Of 120 patients, 37% had chronic HDV infection without severe fibrosis, and 63% of patients were diagnosed with liver cirrhosis, including hepatocellular carcinoma in 18% of patients. Reliably significant changes in the form of anemia (44,1; p<0,000), thrombocytopenia (38,5; p<0,000), hypoalbuminemia (69,5; p<0,000), a decrease in the prothrombin index (72,6; p<0,000), increased activity of AST (24,0; p<0,000), bilirubinemia (50,3; p<0,000) were observed in the advanced stage of liver fibrosis. Mixed replication of HBV/HDV was observed significantly more often (11,6; р<0,007) in patients with liver cirrhosis and HCC. The overall mortality was 6.6%. The proportion of deaths with liver cirrhosis was 7.3%, with confirmed hepatocellular carcinoma - 19%.

Conclusion: The Republic of Sakha (Yakutia) is a region with a high prevalence of HDV infection, especially among the working population, which requires strengthening measures to prevent the development of cirrhosis and liver cancer. The performed analysis confirmed the importance of further search for predictors of fibrosis formation, including genetic markers of severe course in persons with HDV infection.

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