An Evaluation of Frequency and Distribution of Cutaneous Manifestation in Patients of Hepatitis C Virus and its Correlation with Cardiac Manifestations

Abstract

Background:  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 2^nd main target organ for many der-matologic manifestations and may be the 1^st clue to the underlying HCV infection and may served as early marker of potentially fetal chronic liver disease and its complications.

Objectives:

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.