Abstract
BackgroundFor patients with chronic hepatitis B and cirrhosis in less developed western regions in China, due to constraints of local economic conditions, the choice of treatment measures is often limited. However if patients recieved valid management and effective treatment, they were able to maintain their health and benign prognosis.Case presentationThis study narrates the long-term treatment and careful follow-up of a patient with chronic hepatitis B and cirrhosis in a less developed western region in China, and analyzes the prognosis of the disease and countermeasures.ConclusionsThis would partly reflect the development of antiviral therapy for chronic hepatitis B and multidisciplinary comprehensive treatment for cirrhosis-related complications in remote region with limited resources in the past 20 years.
Highlights
For patients with chronic hepatitis B and cirrhosis in less developed western regions in China, due to constraints of local economic conditions, the choice of treatment measures is often limited
Medical history characteristics: (1) The patient had an onset of the disease at youth, denied any family history of hepatitis B, and was a hepatitis B patient without mother-to-infant vertical transmission
(2) Since the primarily diagnosis in June 1996, the diagnosis and treatment lasted for 22 years, the patient developed from chronic hepatitis to decompensated cirrhosis, and successively had esophageal varices bleeding, ascites, hypersplenism and other complications [5]. (3) Based on the treatment of nucleoside antiviral drugs, endoscopic variceal ligation (EVL) and partial splenic artery embolization (PSE) and other treatments were performed for a number of times, preventing complications such as upper gastrointestinal bleeding, ascites, hepatic encephalopathy, and hypersplenism in the past 10 years, and achieving the goal of “inhibiting viral replication, delaying the progression of the disease, prolonging survival time, and improving quality of life” [6]
Summary
The widespread inoculation of hepatitis B vaccine has reduced the infection rate of hepatitis B virus from 9.75%, 20 years ago, to 7.18%, 10 years ago in China [1, 2]. For patients with chronic hepatitis B and cirrhosis in less developed western regions in China, due to constraints of local economic conditions, the choice of treatment measures is often limited. The patient is a resident of Lanzhou, Gansu Province, and is a worker He denies any family history of hepatitis B. Primary diagnosis: In June 1996, the patient was hospitalized due to fatigue and yellow staining of the skin and mucosa for 10 days. Clinical diagnosis: (1) chronic active hepatitis; (2) early cirrhosis. Examination results of liver function in July 2002: TBIL, 265.1 μmol/L; ALT, 352 U/L; AST, 233 U/L; HBVDNA, 3.6 × 104 cps/ml. Clinical diagnosis: decompensated hepatitis and cirrhosis, esophageal varices bleeding, and ascites.
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