Azhar Muhammad Junaid, Khalid Noor, Azhar Shanza, Irshad Umer, Ahmed Hassaan, Khan Tayyab Mumtaz, Habib Samat, Ali Zuha, Anwar Yumnah, Bilal Muhammad
Internal Medicine, Rawalpindi Medical University, Rawalpindi, PAK.
Internal Medicine, Foundation University Medical College, Islamabad, PAK.
Cureus. 2020 Aug 31;12(8):e10164. doi: 10.7759/cureus.10164.
Background Several recent studies have shown that the hepatitis C virus (HCV) and its different genotypes are a predominant and leading cause of cirrhosis and splenomegaly in different regions of the world. Advanced stage of cirrhosis leads to portal hypertension that causes splenomegaly. This complication may have many other manifestations such as anemia, infections, and bleeding disorders in severe stages. This study aimed to determine the effect of different HCV genotypes on the development of splenomegaly and to assess which HCV genotypes are more associated with it. Materials and methods A total of 483 conveniently sampled HCV patients were included in this descriptive cross-sectional study. Six genotypes (1, 2a, 2b, 3a, 3b, and mixed) were studied, and 80 patients for each of these genotypes were included. Data were collected from patient medical records regarding patient demographic details, HCV serology and genotyping, and sonographic size of the spleen. Results In total, splenomegaly was present in 14.1% (n=68) patients. The development of splenomegaly was significantly associated with old age, as 25.2% (n=26) of patients above 60 years of age (n=103) developed splenomegaly (P=0.005). Our study determined that splenomegaly was significantly related to HCV genotypes 3a, 3b, and 1 (P<0.001, P=0.017, and P=0.019, respectively). By taking mixed genotype as a reference, the odds of developing splenomegaly with genotype 3a were the highest (OR = 9.481; CI=95%). Conclusions Our study concludes that HCV genotype 3a, 3b, and 1, and age above 60 years have a significant association with splenomegaly. Genotype 3a has the highest risk of developing splenomegaly. Therefore, our study demands screening, early diagnosis, and prompt treatment of these particular HCV genotypes to prevent complications and risk of mortality.
背景 最近的几项研究表明，丙型肝炎病毒（HCV）及其不同基因型是世界不同地区肝硬化和脾肿大的主要和首要原因。肝硬化晚期会导致门静脉高压，进而引起脾肿大。这种并发症在严重阶段可能还有许多其他表现，如贫血、感染和出血性疾病。本研究旨在确定不同HCV基因型对脾肿大发展的影响，并评估哪些HCV基因型与其关联更为密切。材料和方法 本描述性横断面研究共纳入了483例方便抽样的HCV患者。研究了六种基因型（1、2a、2b、3a、3b和混合型），每种基因型纳入80例患者。从患者病历中收集有关患者人口统计学细节、HCV血清学和基因分型以及脾脏超声大小的数据。结果 总共有14.1%（n = 68）的患者出现脾肿大。脾肿大的发生与老年显著相关，60岁以上（n = 103）的患者中有25.2%（n = 26）出现脾肿大（P = 0.005）。我们的研究确定脾肿大与HCV基因型3a、3b和1显著相关（分别为P < 0.001、P = 0.017和P = 0.019）。以混合型为参照，基因型3a发生脾肿大的几率最高（OR = 9.481；CI = 95%）。结论 我们的研究得出结论，HCV基因型3a、3b和1以及60岁以上年龄与脾肿大显著相关。基因型3a发生脾肿大的风险最高。因此，我们的研究要求对这些特定的HCV基因型进行筛查、早期诊断和及时治疗，以预防并发症和死亡风险。
