Development of hepatocellular carcinoma in a patient with chronic hepatitis C and cirrhosis. Сlinical case

Background. Chronic hepatitis C is currently an urgent problem worldwide. According to the World Health Organization, there are currently more than 50 million people living with chronic hepatitis C virus infection, with approximately 1 million new cases of hepatitis C virus infection reported each year. In Russia, according to the State Report "On the State of Sanitary and Epidemiological Well-being of the Population in the Russian Federation in 2023", there has been an increase in the number of registered cases of chronic hepatitis C virus infection since 2021, despite the previous long-term trend toward a decrease in the incidence of chronic hepatitis C. For a patient with chronic hepatitis C, the prognosis is determined primarily by the stage of liver fibrosis. Despite the new possibilities of antiviral therapy, mortality from cirrhosis of the liver and hepatocellular carcinoma remains at a high level, due to both medical and socio-economic factors. The probability of hepatocellular carcinoma formation persists even after hepatitis C virus eradication.

Materials and methods. The article describes a clinical case of liver cirrhosis and hepatocellular carcinoma in the outcome of chronic hepatitis C virus infection. The main errors in the management of a patient with chronic hepatitis C virus infection were analyzed, and risk factors for late diagnosis of the oncological process were identified, which caused the fatal outcome. The pathoanatomic conclusion is presented. This clinical observation draws the attention of doctors of various specialties to the need for caution in the examination and treatment of patients with chronic hepatitis C virus infection regarding the development of hepatocellular carcinoma.

Conclusions. The clinical case demonstrates the importance of dynamic follow-up of patients with chronic hepatitis C virus infection to identify risk factors for liver cirrhosis and hepatocellular carcinoma (stage F-2 and higher, co-infection with other hepatotropic viruses, alcohol consumption, male gender and some genetic factors), as well as for the timely appointment of antiviral treatment. Only such an approach can provide a favorable prognosis for patients at the stage of liver cirrhosis and reduce the risks of transformation into primary liver cancer with subsequent death.

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