High burden of hepatocellular carcinoma and viral hepatitis in Southern and Central Vietnam

Experience of a large tertiary referral center, 2010 to 2016

Song Huy Nguyen-Dinh, Albert Do, Trang Ngoc Doan Pham, Doan Y. Dao, Trinh Nhu Nguy, Moon S Chen

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

AIM To examine the largest tertiary referral center in southern and central Vietnam from 2010 to 2016, evaluating epidemiological trends of hepatocellular carcinoma (HCC) and viral hepatitis B-C in this resource-limited setting. METHODS We extracted data of patients receiving care from Cho Ray Hospital (Ho Chi Minh City), the largest oncology referral center in southern and central Vietnam, from 2010 to 2016. We collected information on patient age, gender, geographic distribution, and disease characteristics including disease stage, tumor biomarker levels [serum alpha-fetoprotein (AFP), AFP-L3 isoform percentage, and prothrombin induced by induced by vitamin K absence-II], and serological testing for hepatitis B virus (HBV) and hepatitis C virus (HCV) infections. RESULTS Data from 24091 HCC patients were extracted, with sample demographics comprising mostly male (81.8%) and older age (however with 8.5% younger than 40 years old). This patient sample included a geographic catchment population of 56 million people (60% of the country's total population of 92.7 million), derived from 38 provinces and municipalities in Vietnam. Chronic HBV infection was found in 62.3% of cases, and chronic HCV infection in 26.0%. HBV and HCV co-infection was seen in 2.7%. Cirrhosis was found in an estimated 30% to 40% of cases. Nine percent of patients were not found to have chronic viral hepatitis. Twenty three point two percent of the patients had a normal AFP level. A total of 2199 patients were tested with AFP-L3 and PIVKA II over two years, with 57.7% having elevated AFP-L3%, and 88.5% with elevated PIVKA II levels. Over this 7-year period, the incidence of HCC increased, with a large proportion of cases (overall 40.8%) presenting initially an advanced stage, not amendable to surgical or locoregional therapy. CONCLUSION HCC contributes significant health care burden in southern and central Vietnam, with increasing case volume over this seven-year period. Viral hepatitis likely explains this high HCC prevalence.

Original languageEnglish (US)
Pages (from-to)116-123
Number of pages8
JournalWorld Journal of Hepatology
Volume10
Issue number1
DOIs
StatePublished - Jan 27 2018

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Vietnam
Tertiary Care Centers
Hepatitis
alpha-Fetoproteins
Hepatocellular Carcinoma
Virus Diseases
Hepatitis B virus
Hepacivirus
Vitamin K
Chronic Hepatitis B
Prothrombin
Chronic Hepatitis C
Chronic Hepatitis
Hepatitis C
Tumor Biomarkers
Hepatitis B
Coinfection
Population
Patient Care
Protein Isoforms

Keywords

  • Alpha-fetoprotein
  • Hepatitis B virus
  • Hepatitis C virus
  • Hepatocellular carcinoma

ASJC Scopus subject areas

  • Hepatology

Cite this

High burden of hepatocellular carcinoma and viral hepatitis in Southern and Central Vietnam : Experience of a large tertiary referral center, 2010 to 2016. / Nguyen-Dinh, Song Huy; Do, Albert; Pham, Trang Ngoc Doan; Dao, Doan Y.; Nguy, Trinh Nhu; Chen, Moon S.

In: World Journal of Hepatology, Vol. 10, No. 1, 27.01.2018, p. 116-123.

Research output: Contribution to journalArticle

Nguyen-Dinh, Song Huy ; Do, Albert ; Pham, Trang Ngoc Doan ; Dao, Doan Y. ; Nguy, Trinh Nhu ; Chen, Moon S. / High burden of hepatocellular carcinoma and viral hepatitis in Southern and Central Vietnam : Experience of a large tertiary referral center, 2010 to 2016. In: World Journal of Hepatology. 2018 ; Vol. 10, No. 1. pp. 116-123.
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T1 - High burden of hepatocellular carcinoma and viral hepatitis in Southern and Central Vietnam

T2 - Experience of a large tertiary referral center, 2010 to 2016

AU - Nguyen-Dinh, Song Huy

AU - Do, Albert

AU - Pham, Trang Ngoc Doan

AU - Dao, Doan Y.

AU - Nguy, Trinh Nhu

AU - Chen, Moon S

PY - 2018/1/27

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N2 - AIM To examine the largest tertiary referral center in southern and central Vietnam from 2010 to 2016, evaluating epidemiological trends of hepatocellular carcinoma (HCC) and viral hepatitis B-C in this resource-limited setting. METHODS We extracted data of patients receiving care from Cho Ray Hospital (Ho Chi Minh City), the largest oncology referral center in southern and central Vietnam, from 2010 to 2016. We collected information on patient age, gender, geographic distribution, and disease characteristics including disease stage, tumor biomarker levels [serum alpha-fetoprotein (AFP), AFP-L3 isoform percentage, and prothrombin induced by induced by vitamin K absence-II], and serological testing for hepatitis B virus (HBV) and hepatitis C virus (HCV) infections. RESULTS Data from 24091 HCC patients were extracted, with sample demographics comprising mostly male (81.8%) and older age (however with 8.5% younger than 40 years old). This patient sample included a geographic catchment population of 56 million people (60% of the country's total population of 92.7 million), derived from 38 provinces and municipalities in Vietnam. Chronic HBV infection was found in 62.3% of cases, and chronic HCV infection in 26.0%. HBV and HCV co-infection was seen in 2.7%. Cirrhosis was found in an estimated 30% to 40% of cases. Nine percent of patients were not found to have chronic viral hepatitis. Twenty three point two percent of the patients had a normal AFP level. A total of 2199 patients were tested with AFP-L3 and PIVKA II over two years, with 57.7% having elevated AFP-L3%, and 88.5% with elevated PIVKA II levels. Over this 7-year period, the incidence of HCC increased, with a large proportion of cases (overall 40.8%) presenting initially an advanced stage, not amendable to surgical or locoregional therapy. CONCLUSION HCC contributes significant health care burden in southern and central Vietnam, with increasing case volume over this seven-year period. Viral hepatitis likely explains this high HCC prevalence.

AB - AIM To examine the largest tertiary referral center in southern and central Vietnam from 2010 to 2016, evaluating epidemiological trends of hepatocellular carcinoma (HCC) and viral hepatitis B-C in this resource-limited setting. METHODS We extracted data of patients receiving care from Cho Ray Hospital (Ho Chi Minh City), the largest oncology referral center in southern and central Vietnam, from 2010 to 2016. We collected information on patient age, gender, geographic distribution, and disease characteristics including disease stage, tumor biomarker levels [serum alpha-fetoprotein (AFP), AFP-L3 isoform percentage, and prothrombin induced by induced by vitamin K absence-II], and serological testing for hepatitis B virus (HBV) and hepatitis C virus (HCV) infections. RESULTS Data from 24091 HCC patients were extracted, with sample demographics comprising mostly male (81.8%) and older age (however with 8.5% younger than 40 years old). This patient sample included a geographic catchment population of 56 million people (60% of the country's total population of 92.7 million), derived from 38 provinces and municipalities in Vietnam. Chronic HBV infection was found in 62.3% of cases, and chronic HCV infection in 26.0%. HBV and HCV co-infection was seen in 2.7%. Cirrhosis was found in an estimated 30% to 40% of cases. Nine percent of patients were not found to have chronic viral hepatitis. Twenty three point two percent of the patients had a normal AFP level. A total of 2199 patients were tested with AFP-L3 and PIVKA II over two years, with 57.7% having elevated AFP-L3%, and 88.5% with elevated PIVKA II levels. Over this 7-year period, the incidence of HCC increased, with a large proportion of cases (overall 40.8%) presenting initially an advanced stage, not amendable to surgical or locoregional therapy. CONCLUSION HCC contributes significant health care burden in southern and central Vietnam, with increasing case volume over this seven-year period. Viral hepatitis likely explains this high HCC prevalence.

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KW - Hepatitis C virus

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