Prevention of virus-induced liver cancer in Uzbekistan: Tashkent-Hanover Liver Network (PLUTHO)\r
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Long-term reduction of morbidity and mortality caused by virus-induced hepatocellular carcinoma (HCC) in Uzbekistan is the joint goal of the Department of Gastroenterology, Hepatology, Infectious Diseases and Endocrinology of the MHH Hospital in Hanover, Germany, and the Clinic of the Scientific Research Institute of Virology in Uzbekistan. To achieve this goal, they are establishing an ultrasonography training programme for early detection of HCC. In addition, they are improving methods for diagnosing viral hepatitis and are establishing new biomarkers for individual risk assessment.\r
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Background information\r
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Infections of the liver with viral hepatitis are a huge health issue in Uzbekistan. Depending on the region, up to 10 per cent of the population is affected by chronic hepatitis B, C or D. Liver cirrhosis and HCC are the leading causes of death in these areas. Curative treatments are available for early-stage HCC. The favourable cost-benefit ratio of high-resolution ultrasonography means that it is recommended as the screening method of choice for detecting HCC in national and international guidelines. Knowledge and experience on the part of the attending physicians is crucial for successful early detection.\r
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Activities\r
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•\tStructured ultrasonography training programme for early detection of liver cancer: \r
o\tFour continuing professional development courses on diagnosing liver cancer with a focus on risk findings and use of an ultrasound simulator\r
o\tTraining for 10 fellows from Uzbekistan in ultrasonography diagnosis of liver masses in Hanover\r
•\tClinical virology – diagnostics, evaluation of biomarkers and biobanking:\r
o\tEvaluating the sensitivity of established tests for quantifying hepatitis D RNA\r
o\tEstablishing transient elastography thresholds for confirming or ruling out liver cirrhosis\r
o\tEstablishing a biobanking structure at the Clinic of the Scientific Research Institute of Virology\r
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Results \r
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Early detection of liver cancer is increasing at the Clinic of the Scientific Research Institute of Virology, which means that patients have better chances of cure or survival thanks to timely therapy. Physicians acquire new expertise through the training that they disseminate to colleagues. \r