Interstitial pulmonary disease in hepatitis C virus patients

ABSTRACT

Chronic hepatitis C virus infection has been reported in association with several extrahepatic manifestations. Included in this list is interstitial lung involvement. This study aimed to elucidate the association of HCV infection with interstitial pulmonary involvement and to investigate the relationship of severity of hepatic affection and respiratory functional and radiological changes among involvement. Thirty patients with proved hepatitis C virus [HCV] infection from the outpatient clinic of tropical department of Kasr El-Aini hospital were enrolled in this study. High resolution CT [HRCT] chest was performed to all the patients. Pulmonary changes were detected in HRCT of 14 patients [46.6%]. Lung spirometry was done to all of them. FVC%, and FEV1% were abnormal in 6 patients [20%], FEF25-75% were abnormal in 3 patients [10%]. DLCO was measured in 23 patients and was abnormal in 3 patients [13%]. Liver biopsy results according to the fibrosis stage [METAVIR fibrosis grading scale] revealed to be grade I in 11 patients [36.7%], grade II in 9 patients [30%], grade III in 8 patients [26.7%] and grade IV in 2 patients [6.7%]. The study showed significant inverse correlation between viremia level with DLCO% pred as well as significant direct correlation between liver fibrosis stages with AFP, FEV1/FVClevel and HRCT score in the studied patients. In addition to this AFP was directly correlated with the HRCT score. Otherwise, there was no significant correlation between the following variables HRCT score and pulmonary function tests, Liver fibrosis with FEV1%, FVC%, DLCO% and viremia level, Alphafetoprotein with pulmonary function tests and viremia level in the studied patients and Age with pulmonary function tests, AFP, liver fibrosis, and viremia level and HRCT chest