Potential utility of hemogram indices in hepatitis C virus-related vasculitis: a case–control study

Abstract

BackgroundHemogram indices are simple, economic indicators of the systemic inflammation characteristic of autoimmune diseases including vasculitides. The clinical utility of hemogram indices in hepatitis C virus-related vasculitis (HCV-V) has not been established. This study aimed to evaluate neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), neutrophil/hemoglobin ratio (NHR), platelet/hemoglobin ratio (PHR), and systemic immune-inflammation index (SII) as potential biomarkers of HCV-V, and their relationship with disease activity. This cross-sectional case–control study was conducted in the departments of Rheumatology and Rehabilitation and Hepatogastroenterology, at Cairo University Hospital. Patients with HCV-V, patients with HCV infection free from extrahepatic manifestations (HCV sine vasculitis), and healthy control subjects were recruited. HCV-V activity was assessed using the Birmingham Vasculitis Activity Score (BVAS).ResultsTwenty-four HCV-V patients, 21 HCV sine vasculitis patients, and 40 healthy controls were recruited. Age and sex distribution was similar across groups. In HCV-V patients, NLR, PLR, NHR, and SII were higher than healthy controls, with NLR (area under curve (AUC) 0.94, p = 0.002), PLR (AUC 0.72, p = 0.007), NHR (AUC 0.89, p < 0.001) and SII (AUC 0.92, p < 0.001) discriminating both groups. PHR correlated with BVAS (r = 0.53, p = 0.007) while NHR correlated with ESR (r = 0.55, p = 0.007). NLR, NHR, and SII were higher in HCV-V than HCV sine vasculitis patients, with NHR (AUC 0.74, p = 0.022) and SII (AUC 0.75, p = 0.038) discriminating in both groups.ConclusionHemogram indices are useful biomarkers of HCV-V. Longitudinal studies are recommended to explore the predictive power of HCV-infected patients developing vasculitis and their potential relationship with therapeutic response and disease relapse.