Deep Amar, Kumari Shweta, Malakar Sayan, Swaroop Suchit, Rungta Sumit
Medical Gastroenterology, King George's Medical University, Lucknow, IND.
Biochemistry, King George's Medical University, Lucknow, IND.
Cureus. 2024 Jul 15;16(7):e64550. doi: 10.7759/cureus.64550. eCollection 2024 Jul.
Background Liver cirrhosis (LC) caused by chronic hepatitis C (CHC) infection is a major global public health concern. This study will look at the risk factors for progressive fibrosis and cirrhosis in patients with persistent hepatitis C virus (HCV) infection. Methods In this cohort study, a total of 300 patients were included. We collected comprehensive diagnostic records for the entire study group of 200 people with chronic hepatitis C infection. For the comparison, 100 healthy people were recruited and assessed. FibroScan (Echosens, Paris, France) scores were used to categorize liver fibrosis stages: F0-F1 (no or mild fibrosis, <7 kPa), F2 (moderate fibrosis, 7-8.99 kPa), F3 (significant fibrosis, 9-12.49 kPa), and F4 (cirrhosis, ≥12.5 kPa). Their demographic, biochemical, and serological data were evaluated and compared. Results Most patients were males (47% females and 53% males). In the CHC group, the mean age of diagnosis was 37.68±11.57 years, whereas in the chronic hepatitis C-related liver cirrhosis (CHC-LC) group, the mean age was 48.89±12.30 years (p=0.01). Compared to normal individuals, CHC patients had higher body mass index (BMI) (22.37±1.89 versus 21.72±1.95, p=0.01), alanine aminotransferase (ALT) (36.70±7.13 versus 82.78±82.53, p=0.01), and aspartate aminotransferase (AST) (34.96±6.04 versus 80.82±91.77, p=0.01). However, compared to the patients with CHC, the patients with LC have lower platelet (PLT) count (1.51±0.78 versus 1.7±0.41, p=0.01) and higher liver enzymes (AST: 117.7±186.9 versus 80.8±91.7, p=0.01; ALT: 86.71±80.24 versus 82.78±82.53, p=0.01). On regression analysis, higher BMI, older age, low hemoglobin (Hb), and higher bilirubin, ALT, AST, and prothrombin time (PT) were associated with LC. Conclusion It is imperative to shift toward prevention and early intervention as the new approach to managing patients with HCV-related cirrhosis. Cirrhosis should be suspected in older patients with CHC who are obese and have low platelet counts with higher liver enzymes.
背景 慢性丙型肝炎（CHC）感染所致肝硬化（LC）是全球主要的公共卫生问题。本研究将探讨持续性丙型肝炎病毒（HCV）感染患者发生进行性肝纤维化和肝硬化的危险因素。方法 在这项队列研究中，共纳入300例患者。我们收集了200例慢性丙型肝炎感染患者整个研究组的综合诊断记录。作为对照，招募并评估了100名健康人。采用FibroScan（法国巴黎Echosens公司）评分对肝纤维化阶段进行分类：F0-F1（无或轻度纤维化，<7 kPa）、F2（中度纤维化，7-8.99 kPa）、F3（显著纤维化，9-12.49 kPa）和F4（肝硬化，≥12.5 kPa）。对他们的人口统计学、生化和血清学数据进行了评估和比较。结果 大多数患者为男性（女性占47%，男性占53%）。在CHC组，诊断时的平均年龄为37.68±11.57岁，而在慢性丙型肝炎相关肝硬化（CHC-LC）组，平均年龄为48.89±12.30岁（p=0.01）。与正常个体相比，CHC患者的体重指数（BMI）更高（22.37±1.89 vs 21.72±1.95，p=0.01）、丙氨酸氨基转移酶（ALT）更高（36.70±7.13 vs 82.78±82.53，p=0.01）和天冬氨酸氨基转移酶（AST）更高（34.96±6.04 vs 80.82±91.77，p=0.01）。然而，与CHC患者相比，LC患者的血小板（PLT）计数更低（1.51±0.78 vs 1.7±0.41，p=0.01）且肝酶更高（AST：117.7±186.9 vs 80.8±91.7，p=0.01；ALT：86.71±80.24 vs 82.78±82.53，p=0.01）。回归分析显示，较高的BMI、年龄较大、血红蛋白（Hb）水平较低以及胆红素、ALT、AST和凝血酶原时间（PT）较高与LC相关。结论 必须转向预防和早期干预，作为管理HCV相关肝硬化患者的新方法。对于肥胖且血小板计数低、肝酶高的老年CHC患者，应怀疑有肝硬化。
