In Albanian patients with chronic liver disease, we have found that: (i) HBV remained the most important aetiologic factor of chronic liver disease; HDV and HCV prevalences were still low, (ii) in HBsAg-positive patients, HBeAg-negative chronic hepatitis prevailed, (iii) in HBsAg-negative patients, HBV DNA prevalence was high, (iv) during the last decade, an increased prevalence of alcohol intake in the aetiology of chronic liver disease was observed.
Alveolar echinococcosis (AE) is caused by the larval form of the tapeworm Echinococcus multilocularis. In humans, E. alveolaris metacestode cells proliferate in the liver inducing a hepatic disorder that mimics liver cancer and can spread to other organs. From 1960 to 1972 mortality was at 70% and 94% after 5 and 10 years of follow-up, respectively. Since then, studies have shown an increasing trend towards improving survival rates [1]. As AE is also spreading to new areas of Eastern Europe, researchers seek to better understand the clinical presentation of pathology, including asymptomatic forms. Clinical case; One 36-year-old woman from Peshkopia has been admitted to the Gastrohephatology department on 20.07.2011 with fatigue, anorexia, dull pain in right hypochondrium, mild epigastric pain, bloating, and weight loss. The epidemiological anamnesis showed that the patient lived in the village and had pets. On physical examination, the patient appeared severely ill with jaundice, massive hepatomegaly, massive mass in the mesogastric area, and anxiety. Laboratory examinations were as follows: Hb 11.1 g/dl, sediment 25 mm/h; leukocytes 6700/mm3; platelets 127000/mm3; prothrombin level 60%, uremia 12.7 mmol/l; creatinine 0.78 mmol /l; ALP 127 U/I; AST 15 U/I; ALT 37 U/I; GGT 131 U/I; bilirubin 3.7 mg/l, albumin 2.8 gr / l, total protein 8.1 gr / l, HbsAg negative, anti-HCV negative. Regarding serology, the titer of anti-echinococcal antibodies was positive (22, n = 11) Conclusions: Clinical presentation and radiologic imaging findings of disseminated alveolar echinococcosis can mimic metastatic malignancy, and diagnosis can be challenging in atypically advanced cases. As the incidence of human alveolar echinococcosis appears to be increasing and, physicians should be aware of alveolar echinococcosis, its epidemiology, and its clinical features.
Background Treating chronic hepatitis C (CHC) with direct-acting antiviral (DAA) is very effective at clearing the infection. In Albania treatment with DAA is limited to patients with liver stiffness F3-F4, and with other co-infections. The objective of this study was to evaluate the efficacy of DAA in Albanian patients with genotypes 1-5, who mostly suffer from advanced liver fibrosis. Material and Methods This is a retrospective study carried out at the University Hospital Center “Mother Teresa”, Tirana, during 2014-2019, including treatment-naïve and treatment-experienced patients with genotypes 1-5. All patients were evaluated with elastography and most of them were F3-F4. The primary endpoint involved the patients achieving SVR-12, or undetectable hepatitis C virus/ribonucleic acid (HCV RNA) 12 weeks after the end of treatment. In patients without a genotype, we have used a pangenotypic regimen. Results This study included 207 patients with a mean age of 48.9 ± 13.1 years, 56% male and 44% female; 152 (73%) were genotype 1, 24 were (11.5%) genotype 2, nine were (4.3%) genotype 3, 14 were (6.7%) genotype 4, one was (0.4%) genotype 5, and seven (3.8%) unassigned genotypes. The sustained virologic response (SVR) percentage according to genotype is discussed in the article. The overall SVR score of all the patients in our study was >93%. According to elastography, 127 (66%) were F3-F4, and 80 (38.6%) were F1-F2. Conclusion Treatment with DAA proved to be very effective in our patients; most of them had advanced liver fibrosis as well as compensated or decompensated liver cirrhosis. The overall SVR score of the patients in our study was >93%. Our country needs to treat all patients with chronic hepatitis C without limitations to attain the WHO objective of eradicating this disease by 2030.
Background: Spontaneous bacterial peritonitis (SBP) is one of the most common complications in cirrhosis with ascites, which is associated with a high mortality. Various studies have shown that the prevalence of PBS ranges from 20-30% in patients with cirrhosis and ascites. Not in all cases it is accompanied by obvious symptoms, which makes early diagnosis difficult. Aim: The aims of this study were to assess the prevalence and the risk factors of PBS in alcohoolic liver cirrhosis. Methodology: This is a retrospective study, which considers all cases diagnosed with PBS admitted to our hospital during 2018-2021. Diagnosis is based on the European Association for the Study of Liver (EASL) guidelines. The patients were divided into two groups, alcohoolic cirrhosis with PBS, and without PBS. Data collection consists of filling out a standard form for each patient,which contained information about the diagnosis, the degree of liver function damage evaluated by Child-Pough score and MELD score, clinical and laboratory indicators and complications associated with cirrhosis with PBS, ascitic fluid analyses. All categorical variables were analised by using SPSS version 25, and t-test were used for continuous date. Results: The average age of the patients included in the study was 54.15 ± 12.5 years, while according to gender, there were 112 males (97.3%) and 3 females (2.7%). According to the evaluation of MELD, it was seen to be higher in the group with PBS than those without PBS (p < 0.05). The most frequent complications accompanying PBS were Encephalopathy (p < 0.004), hepatorenal syndrome (p < 0.004), gastro\intestinal hemorrhage (p < 0.004). From laboratory data, platelets (p < 0.015), creatinine (p < 0.006), bilirubin (p < 0.002), INR (p < 0.049) and prothrombin level (p < 0.002) were seen as predictive factors. Conclusions: The most probable predictive factors in the case of PBS in alcoholic cirrhosis were found the low level of platelets, prolonged level of INR and prothrombin, increased level of creatinine. While the most frequent associated complications were hepatic encephalopathy, HRS, G\I hemorrhage, jaundice.
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