Interstitial pulmonary changes in patients with hepatitis C-related chronic liver disease

Abstract 

Background and study aims

Several extrahepatic manifestations (EHMs) have been reported in the natural history of hepatitis C virus (HCV) infection. Some studies had demonstrated a higher frequency of HCV in patients with idiopathic interstitial pulmonary fibrosis (IPF). The aim of this study is to investigate interstitial pulmonary changes via high-resolution computed tomography (HRCT) and pulmonary function tests (PFTs) in patients with HCV infection.

Patients and methods

Forty patients with HCV infection without diagnosis of any pulmonary diseases (group I) and 10 healthy persons (group II) were enrolled in the study. PFT and HRCT were performed in all cases.

Results

Findings of interstitial pulmonary involvement were detected in the HRCT of 19 out of 40 patients (47.5%). A decrease lower than 80% of the predicted value was detected in forced vital capacity (FVC) with restrictive pattern together with post-exercise hypoxia, in 21 (52.5%) patients. There was a significant difference between both groups in the findings of HRCT (x²=7.66, df=1, p=0.004) and PFTs (x²=9.05, df=3, p=0.002).

According to the Child–Pugh classification, in group I, 15 patients were of class A, 16 were of class B and nine of class C, with no significant difference between classes as regards HRCT findings and PFT values. Six patients were positive for serum cryoglobulins. In these patients, all the parameters were not related to age.

Conclusion

Pulmonary interstitial changes are prevalent in HCV-infected patients, irrespective of the severity of their liver condition. It may also occur without respiratory symptoms.

Keywords: Hepatitis C virus, Interstitial pulmonary fibrosis, High-resolution computed tomography, Pulmonary function tests, Extrahepatic manifestations