Uncorrected Proof
Hepat Mon. In Press(In Press):e136164.
Published online 2023 August 2.
https://doi.org/10.5812/hepatmon-136164.
Research Article
Predictors for Liver Cirrhosis in Patients with Hepatitis C Virus: A
Cross-Sectional Study
Abolfazl Namazi
1
, Arash Sarveazad
1
, Mohsen Khaleghian
2
, Mansour Bahardoost
3, *
, Marjan
Mokhtare
1
and Shahram Agah
1, **
1
Colorectal Research Center, Iran University of Medical Sciences, Tehran, Iran
2
Department of General Surgery, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
3
Department of Epidemiology, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
*
Corresponding author: Department of Epidemiology, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Email:
mansourbahari93@gmail.com
**
Corresponding author: Colorectal Research Center, Rasoul-e-Akram Hospital, Nyaiesh Ave., Tehran, Iran. Email: shahramagah@gmail.com
Received 2023 March 12; Revised 2023 June 14; Accepted 2023 June 18.
Abstract
Background: Cirrhosis is one of the most critical health problems with a great economic burden on the health system.
Objectives: This study evaluated cirrhosis predictors in patients with hepatitis C virus (HCV).
Methods: A total of 608 patients with HCV were included in the present study within 2011 and 2017 and divided into two groups
based on the presence and absence of cirrhosis. Demographic and laboratory data (e.g., blood group, aspartate transaminase (AST),
alanine transaminase (ALT), prothrombin time (PT), platelet count, anti-HCV antibodies, and virus level count) were collected by
referring to patients’ files and compared between the two groups. Predictive factors were determined using the regression model.
Results: In this study, 85 patients (13.9%) had liver cirrhosis. Univariate analysis showed that hepatic enzymes AST, ALT, platelet
count, PT, partial thromboplastin time, international normalized ratio, and HCV ribonucleic acid levels in cirrhosis patients were
significantly higher than in non-cirrhosis patients (P < 0.05). Adjusted logistic regression analysis showed age < 45 years (adjusted
odds ratio (ORAdj ): 1.11, P = 0.028), male gender (ORAdj : 2.08, P = 0.023), co-infection with hepatitis B virus (HBV) infection (ORAdj : 2.58,
P = 0.001), and alcohol consumption (ORAdj : 1.87, P = 0.001) were predictive factors for cirrhosis in patients with HCV
Conclusions: This study showed that in patients with hepatitis C, age > 45 years, male gender, alcohol consumption, and
co-infection with HBV significantly increased the risk of liver cirrhosis.
Keywords: Liver Cirrhosis, Hepatitis C Virus, Predictors, Iran
1. Background
Hepatitis C is one of the liver infections spread
by contact with blood and through needles or other
equipment from infected persons (1, 2). Hepatitis C usually
is a short-term illness; however, in some cases, it can
become a long-term chronic infection and, consequently,
serious diseases, such as cancer and liver cirrhosis (3-5).
According to a World Health Organization report, it
has been estimated that 58 million individuals suffer from
chronic hepatitis C virus (HCV) infection. About 1.5 million
new cases occur annually, and 3.2 million individuals
(adolescents and children) live with chronic hepatitis C
infection. Additionally, it has been estimated that about
290,000 individuals died from hepatitis C in 2019, most of
which were due to cirrhosis and hepatocellular carcinoma
(HCC) (6). According to studies, the overall seroprevalence
of HCV in the general population in Iran was 0.6%, which
ranged from 0.08% to 1.6% based on different provinces
(7). In a study in 2014, the number of individuals suffering
from HCV infection was estimated to be around 186,500 in
Iran (8). The modeling results showed that assuming the
current settings of diagnosis/treatment, it is expected that
by 2030, the number of HCV cases will increase to 213,700,
and the number of decompensated cirrhosis, HCC, and
liver disease mortalities will increase threefold to fourfold
in Iran (8).
Cirrhosis is characterized histologically by the
formation of diffuse nodules surrounded by dense fibrotic
lamina, along with hepatic tissue disruption, collapse,
and rupture of the vessels around these laminae (9, 10).
In addition to hepatitis C, the leading causes of cirrhosis
Copyright © 2023, Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License
(http://creativecommons.org/licenses/by-nc/4.0/) which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly
cited.