Cheng Zhaojing, Zhou Baotong, Shi Xiaochun, Zhang Yao, Zhang Lifan, Chen Limeng, Liu Xiaoqing
Department of Infectious Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China.
Department of Nephrology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China.
Chin Med J (Engl). 2014;127(7):1206-10.
Chronic hepatitis C virus (HCV) infection can affect multiple organ systems and cause a variety of extrahepatic manifestations (EMs). We sought to assess the constituent ratio of EMs in Chinese patients with chronic HCV infection and identify the clinical and biological factors associated with EM.
The medical records of 297 patients with chronic HCV infection were analyzed and demographic and epidemiological information was collected. The diagnosis of chronic HCV infection was based on positive anti-HCV combined with a positive HCV-RNA or at least two times of elevated aminotransferases attributable to HCV infection. Patients with HBV and/or HIV coinfection, autoimmune hepatitis, and history of alcohol abuse were excluded.
Sixty-two percent (184/297) of the patients had at least one EM, including fatigue (29.4%), type 2 diabetes mellitus (28.2%), renal involvement (12.5%), lymphadenopathy (9.6%), fever (9.4%), thyroid dysfunction (8.1%), and arthralgia (7.4%). Neuropathy, sicca syndrome, B-cell lymphoma, Raynaud's phenomenon, and lichen planus were rare. The mean age of patients with EM was older compared with those without EM.
EMs were common in Chinese patients with chronic HCV infection, particularly fatigue, type 2 diabetes, renal impairment, lymphadenophy, fever, and thyroid dysfunction. Older age was associated with EMs.
慢性丙型肝炎病毒(HCV)感染可累及多个器官系统,并导致多种肝外表现(EMs)。我们旨在评估中国慢性HCV感染患者中EMs的构成比,并确定与EM相关的临床和生物学因素。
分析297例慢性HCV感染患者的病历,并收集人口统计学和流行病学信息。慢性HCV感染的诊断基于抗HCV阳性并伴有HCV-RNA阳性,或至少两次因HCV感染导致转氨酶升高。排除合并HBV和/或HIV感染、自身免疫性肝炎以及有酗酒史的患者。
62%(184/297)的患者至少有一种EM,包括疲劳(29.4%)、2型糖尿病(28.2%)、肾脏受累(12.5%)、淋巴结病(9.6%)、发热(9.4%)、甲状腺功能障碍(8.1%)和关节痛(7.4%)。神经病变、干燥综合征、B细胞淋巴瘤、雷诺现象和扁平苔藓较为罕见。有EM的患者平均年龄比无EM的患者大。
EMs在中国慢性HCV感染患者中很常见,尤其是疲劳、2型糖尿病、肾功能损害、淋巴结肿大、发热和甲状腺功能障碍。年龄较大与EMs相关。