An Evaluation of Frequency and Distribution of Cutaneous Manifestation in Patients of Hepatitis C Virus and its Correlation with Cardiac Manifestations
AbstractBackground: Hepatitis C virus infection is a major health care concern worldwide but more so in develop-ing countries like Pakistan, 170 million people have chronic hepatitis C virus infection. Which represents the 3% of global prevalence rate. Most patients with acute and chronic hepatitis C virus infection are asym-ptomatic and may remain oblivious of their disease for long time due to its indolent and silent course. Chronic hepatitis C virus infection may be associated with numerous extra hepatic manifestation and after liver skin could be the 2nd main target organ for many der-matologic manifestations and may be the 1st clue to the underlying HCV infection and may served as early marker of potentially fetal chronic liver disease and its complications.
To determine the frequency and distribution of various dermatologic manifestation in patients with H and its consequent impact on development of heart disease.
Material and Methods: In this cross – sectional stu-dy conducted at Mayo Hospital, Lahore, the data was collected through consecutive sampling over a period of three years from 402 patients. These were found HCV positive during routine investigation. All patients gave a complete history regarding clinical features, cardiovascular risk factors profile and special history regarding dermatologic manifestation associated with HCV infection was inquired into. Detailed examina-tion was done to see any evidence of skin manifesta-tion. SPSS 15 was used for data management and analysis. Tabulation and Chi-square test were consti-tuents of analysis.
Results: Out of 402 patients who were diagnosed to have Hepatitis C, 218 (54.2%) were males and 184 female the highest percentage (269; 66.9%) patients were more than 40 years of age with mean age 47.6 ± 13 years. 371 (92.3%) patients belonged to poor socio-economic class, 164 (40.8%) patients were hyper-tensive, 129 (32.1%) were diabetic, 45 (11.2%) had a family history of Ischemia and 84 (20.9%) patients were smokers. 107 (26.6%) patients had various cuta-neous manifestations (pruritis 10.69%, prirutus plus purpuric eruption 13.6%, isolated purpura was found in 1.7% and Eczema in 0.71%). Cutaneous manifesta-tions were most common among, smokers, hyperten-sive, obese and patients having low socioeconomic status and suffering from Ischemic heart disease.
Conclusion: Overall higher frequency of cutaneous manifestation was observed in patients with positive serology for Hepatitis C virus infection and suffering from Ischemic heart disease, Hypertension and obesity along with low socioeconomic group and were habi-tual of smoking as compared with those who were HCV positive but not having associated these co-mor-bidities. Hepatitis C virus is suggested and must be considered in the differential diagnosis of these pati-ents to avoid missing dis-important but occult factor in the clinical diagnosis of the skin diseases in appro-priate setting.
Key words: HCV, IHD, CLD.
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