Pathomorphosis of viral hepatitis (according to the data of Pathology Department of Clinical infectious diseases hospital n.a. S.P. Botkin)

Abstract

Патоморфоз вирусных гепатитов(по данным ПАО КИБ имени Боткина) Вирусные гепатиты широко распространены и представляют собой одну из нерешенных проблем для здравоохранения. Вирусные гепатиты могут приводить к циррозу печени, гепатоцеллюлярной карциноме и в конечном итоге-к летальному исходу. За последние 20 лет фенотип вирусных гепатитов претерпел существенные изменения.

Pathomorphosis of Viral Hepatitis (according to the data of Pahtology Department of Botkin Clinical Hospital) BACKGROUND & AIMS: The global burden of viral hepatitis is profound, and represents a public health threat as chronic infection can lead to liver cirrhosis, hepatocellular carcinoma, and death. The phenotype of viral hepatitis has drastically changed during 20 last years. The major cases of that change are anti-viral therapy and coinfections. Clinical Infectious Hospital n. a. S.P.Botkin is the biggest infectious hospital of Saint-Petersburg. The autopsy material of Pathology Department of Botkin Hospital gives us quite a representative picture of mortality rate caused by infections including hepatitis. METHODS: It is a descriptive retrospective study. We analised autopsy reports of years 1997, 2007, and 2017. Firstly, we investigated the demography of patients- age and gender. Then we evaluated the species of viral hepatitis and it’s activity (acute or chronical). Then we analysed the main cause of death of patient. Then we investigated the patients’ comorbidity. RESULTS: in 1997 257 patients died in Botkin Hospital. 52 of them had viral hepatitis. The mean age was 49,6 years. Men were significantly prevalent- they were 33 and women were 18. 6 of the patients with hepatitis died from acute virus hepatitis (4-B, 1- B+C and 1- B+C+A+E+D), the main cause of death was acute liver failure and coma (3 cases). 28 patients died of chronic viral hepatitis ( 15- hepatitis B, 3- B+C, 3-C, 5 –non-verified). Gastroesophgeal hemorrhage was the main cause of death in 17 cases. 6 patients died from gut phlegmon. 4 patients died of hepatocellular carcinoma, which is associated with chronic viral hepatitis. 1 patient died from AIDS. 352 patients died in 2007. 278 of them died of viral hepatitis. Their mean age was 43,75. 159 of them were male, 115 –female. 43 patients died from AIDS. 3 patients died from acute viral hepatitis, in all that cases the hepatitis was not verified. 8 patients died from cancer of liver. 2 patients died from subacute viral hepatitis B. 159 patients died from chronic viral hepatitis.40 of them died from hepatitis B, 22- from hepatitis B+C, 27-from hepatitis C, 69- from non-verified chronic viral hepatitis. 64 of that 159 patients died from gastroesophageal hemorrhage, 64- from phlegmon of gut. In 2017 there were 603 lethal cases in Botkin hospital. In 403 of that cases there was viral hepatitis. 226 patients were male, 177- female.The mean age was 44,5 years. 228 patients died from AIDS. 20 patients died from cancer of liver. 1 patient died from acute hepatitis B. 131 patient died from chronic viral hepatitis. 10 of that cases were caused by non-verified viral hepatitis, 46-hepatitis C, 80-hepatitis B, 11-B+C. 71 patients died from gut phlegmon, 42 from gastroesophageal hemorrhage. CONCLUSIONS: The morbidity and mortality caused by viral hepatitis is growing. There are only sporadic cases of death caused by acute viral hepatitis. The mean age of patients keeps on being between 40 and 50 years. Male patients are prevalent. The mortality of hepatitis patients caused by AIDS has drastically grown during last 20 years. The main causes of death in patient with chronic viral hepatitis are gastroesophageal hemorrhage and gut phlegmon.