Prediction of Outcome of Newly Onset Cerebrovascular Stroke in HCV Infected Patients

Abstract

Chronic Vascular Diseases (CVD) is a major health burden. Hepatitis C Virus (HCV) infection has been implicated in the development of carotid artery atherosclerosis and has recently been associated with poor prognosis in stroke patients. The purpose of this study is to predict the result of de novo cerebrovascular accidents in HCV-infected patients and to look for variables that may predict it. Case control, prospective study had been carried out on two groups, Group (A) of 32 HCV infected patients presented with newly onset cerebrovascular stroke and Group (B) of 32 patients with cerebrovascular stroke without HCV infection. After meticulous history taking and neurological examination for all patients, those presenting with cerebrovascular stroke confirmed by computerized tomography (CT) or Magnetic resonance imaging (MRI) of brain were included in this study. These patients were followed up for 2 weeks and then extended follow up for 3 months was done. The outcome and predictors of prognosis had been documented and estimated statistically. Hb, platelets, albumin, cholesterol, and Na showed significant decreases in the HCV patients than in the free group. However, direct bilirubin, total bilirubin, international normalized ratio (INR), and HbA1C showed significant increases in the case group. Age, National institute of health stroke scale (NIHSS), and Diabetes Mellitus (DM) showed significant increases in poor prognosis in HCV cases, whereas HDL showed a significant decrease. NIHSS, abnormal carotid intima thickness (CIT), and abnormal pulse showed significant increases in control group with poor prognosis. Regarding fate, no significant difference was found between HCV patients and the control group. Regarding prognosis by three-month Modified rankin score (MRS) a significant decrease in the HCV patient group in comparison to the free group. We found there is a significant association between chronic HCV infections and Ischemic Stroke severity and bad prognosis.