Abstract
Background and study aim: Interstitial lung disease (ILD) includes a variety group of about 200 conditions that insult the lung parenchyma with different patterns of inflammation and fibrosis. Hepatitis C virus (HCV)is Flavivirus with diverse hepatic and extrahepatic diseases. Its direct and indirect pathogenic association with many pulmonary manifestations-including interstitial lung disease-has been suggested yet needs more elucidation. Patients and Methods: A case control study was conducted with a total of 50 chronic hepatic patients. They were equally divided into two groups, HCV positive group (group 1= 25 patients) and HCV negative group (group 2= 25 patients). Group 1 was subdivided into two subgroups, without-idiopathic interstitial pneumonias patients (without IIPs subgroup A= 13 patients) and with idiopathic interstitial pneumonias patients (IIPs subgroup B = 12 patients). Both groups were subjected to thorough history taking, clinical examination, and routine investigations. The diagnosis of HCV was confirmed by viral markers including HCV antibodies and PCR. Other chronic hepatic liver diseases were confirmed by abdominal ultrasound and ultrasound- guided liver biopsy. Arterial blood gases, auto antibodies, Computerized pulmonary function tests and radiological studies including plain X ray chest and heart and HRCT scanning were also done. All patients with idiopathic pulmonary fibrosis (IPF) had fulfilled the ATS/ ERS diagnostic guidelines. Both groups were matched according to age, sex and body mass index. Results: The HCV positive group was found to have a significantly higher frequency of ILD than the HCV negative group with also more restrictive pattern hypoxemia and higher scores of IPF (by computed tomography). Conclusion: ILD is more frequent in patients with chronic HCV infection with higher grades of fibrosis and hypoxemia. HCV infection may be predisposing factor for IPF.
Highlights
Hepatitis C virus (HCV) is a hepatotropic and lymphotropic virus that belongs to the Flaviviridae family
Group 1 was subdivided into two subgroups, without-idiopathic interstitial pneumonias patients and with idiopathic interstitial pneumonias patients
Fifty hepatic patients were included in this study. They were divided into two groups, HCV positive group and HCV negative group, HCV negative group were (HBV 12 patients, non-alcoholic steatohepatitis (NASH) 6 patients, Autoimmune hepatitis 5 patients, unidentified cause 2patients)
Summary
Hepatitis C virus (HCV) is a hepatotropic and lymphotropic virus that belongs to the Flaviviridae family. Chronic HCV infection is associated with a wide spectrum of clinical hepatic and extrahepatic disease including nonHodgkin's lymphoma, mixed cryoglobulinemia, nephrological, dermatological, cardiovascular, neurological and pulmonary disorders [1,2,3]. Multiple direct and indirect pulmonary manifestations were associated with chronic HCV infection. Interstitial lung disease (diffuse parenchymal lung disease) is a group of multiple conditions insulting the lung parenchyma [15]. These conditions present with different grades of interstitial inflammation and fibrosis and different clinical, radiological and histopathological. Interstitial lung disease (ILD) includes a variety group of about 200 conditions that insult the lung parenchyma with different patterns of inflammation and fibrosis. Its direct and indirect pathogenic association with many pulmonary manifestations-including interstitial lung disease-has been suggested yet needs more elucidation
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