Incidence and risk factors of extrahepatic manifestations in patients with chronic HCV and HCV/HIV infection

Abstract

Purpose. To study the incidence and risk factors for the development of extrahepatic manifestations like arthralgias, cutaneous manifestations of vasculitis, polyneuropathy, xerophthalmia, Raynaud’s syndrome, chronic kidney disease (CKD) in patients with chronic HCV infection, and HCV/HIV co-infection.Materials and methods. The cohort study included 331 patients: 254 people with HCV, 77 — with HCV/HIV.Results. Extrahepatic manifestations were detected in 50% of HCV patients and 70% of HCV/HIV patients (p=0,002). Among patients with HCV and HCV/HIV the most common were joint lesions (42% vs 46%, p=0,563), skin rashes (20% vs 25%, p=0,345), polyneuropathy (13% vs 17%, p=0,441), CKD (11% vs 35%, p<0,001), less often Raynaud’s syndrome (3% vs 8%, p=0,076) and xerophthalmia (5% vs 4%, p=0,661). The logistic regression model revealed a significant relationship between the development of one or more extrahepatic manifestations in patients with chronic HCV infection with cryoglobulinemia (p<0,001), the presence of HIV infection (p<0,001), and age (p=0,007). However, logistic regression models tested for each of the studied manifestations revealed a significant effect of HIV infection only on the development of CKD (p<0,001), while cryoglobulinemia possessed significant risk factors for each of the manifestations, except xerophthalmia. Conclusion. The data obtained indicate a high incidence of extrahepatic manifestations in patients with chronic HCV and HCV/HIV infection, also a significant role of HIV co-infection for the development of CKD, and the role of cryoglobulinemia in the development of extrahepatic manifestations, except xerophthalmia.