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Evolution of chronic viral delta infection – from chronic hepatitis delta to hepatocelullar carcinoma


Author: Țurcanu Adela
Degree:doctor habilitat of medicine
Speciality: 14.00.05 - Internal Diseases (with specification: Pulmonology, Gastroenterology, Hepatology, Nephrology, Functional Diagnostics and Endoscopy)
Year:2021
Scientific consultant: Eugen Tcaciuc
doctor habilitat, associate professor (docent), Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova
Institution: Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova

Status

The thesis was presented on the 22 April, 2021
Approved by NCAA on the 25 June, 2021

Abstract

Adobe PDF document – 1.46 Mb / in romanian

Thesis

CZU 616.36-002.2:578.891-06:616.36-006.6(043.2)

Adobe PDF document 4.44 Mb / in romanian
209 pages

Keywords

Delta, HDV, hepatocellular carcinoma, delta liver cirrhosis, GDNT

Summary

Structure of dissertation: introduction, seven chapters, conclusions, bibliography, 184 pages of basic text, 37 figures, 23 tables. The results were published in 60 scientific papers.

Field of study: Internal Diseases (hepatology and gastroenterology).

Aim of the research: highlighting the peculiarities of liver disease progression in patients with chronic delta hepatopathy by identifying aggravating clinical-evolutionary risk factors, as well as estimating noninvasive scores predictive for advanced stages of chronic delta viral liver disease (liver cirrhosis and carcinoma). Research objectives: 1. Evaluation and identification of the clinical- virological profile of the patient with chronic viral HDV. 2. Establishment of the biological model of liver disease progression in patients with chronic HDV. 3. Characterization of the fibrotic pattern of patients with chronic delta viral liver disease. 4. Assessment of the sensitivity and specificity of the noninvasive score of patients with chronic HDV. 5. Identification of the distinctive features of the evolution of liver disease in patients with chronic HDV compared to patients with chronic HBV. 6. Research of clinical-biological features in patients with hepatocellular carcinoma associated with chronic delta viral infection. 7. Determining the influencing factors in the progression of liver disease in patients with chronic delta viral liver disease monitored over a period of time. 8. Analysis of the influence of the therapeutic factor in the evolutionary dynamics of chronic delta viral hepatitis. 9. Stratification of patients with chronic delta viral liver disease through the prism of the clinical- biological evolutionary process in order to more personalized evaluation of these patients.

Scientific novelty and originality: based on a complex study, the applicative value of the stratified approach of the patient with chronic delta viral liver disease, and the identification of risk factors with a role of progression in delta viral liver disease was assessed.

The importance of this study: the scientific substantiation of the profiling evaluation of the patient with HDV was performed, which led to the elaboration of the noninvasive liver decompensation score and the detection of valid biological parameters with prognostic role in HDV evolution.

Theoretical significance and applicative value of the thesis: The research results demonstrated the usefulness and informativeness of the HDVnoninvasive and individualizeted evaluation.

Implementation of scientific results: The methodological recommendations were implemented in the hepatology department of the ISMP of the Republican Clinical Hospital Timofei Moșneaga, in the didactic process of training medical staff at the gastroenterology discipline of SUMP N.Testemițanu