Vietnam with a population of larger than 97.46 million has a prevalence of 9.05% and 1.49% of hepatitis B and C respectively [1]. Coupled with lifestyle needs for alcohol consumption, this presents challenges in overall liver disease management. Liver disease can be grouped into four main categories, namely,
1. no liver scarring or mild liver scarring (F0-1);
2. moderate liver scarring (F2);
3. severe liver scarring (F3) and
4. cirrhosis (F4)

 

Cirrhosis is common among the population, which is a worrying trend and a potential healthcare burden. It is also a well-established risk factor for hepatocellular carcinoma (HCC) that usually results in poor patient survival outcomes [1,2]. Liver cirrhosis incidence in Southeast Asian countries is on the rise, as highlighted in the Global Burden of Disease statistics [3,4]. In particular, Vietnam and Thailand have significant number of cases per 100,000 people from the data gathered in 2015. The rate of increase is also a worrying trend as that underscore the critical need for more healthcare resources to tackle the disease. Recent studies conducted in major hospitals in Vietnam highlights the cirrhotic patient demographics. It remains dominated by lifestyle and viral hepatitis infections [5].

 

Cirrhosis induced complications are worrying and difficult to manage [2]. Gastro-intestinal bleeding as a result of esophageal varices rupture is among the most common complication seen in these patients. A significant group of patients further develop HCC. In a study from 2010-2016 from 38 provinces in Southern and Central Vietnam, a high burden of HCC and viral hepatitis was observed [5]. Of the 24,091 HCC patients in this study group, 81.8% were male and 62.3% had hepatitis B infection. Of note, alphafeto protein (AFP) used in diagnosis of HCC cases were elevated for only half of the cases. More biomarkers related to HCC detection or risk stratification will be desired [6].

 

 

A P Bui Huu Hoang

 

A/Prof. BUI HUU HOANG, MD, PhD

Head of Gastroenterology
University Medical Center, Ho Chi Minh city,
Vice President of HASLD

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