Association of the degree of liver fibrosis evaluated by elastography with carotid intima media thickening in hepatitis C patients

Abstract

Objective: To evaluate the degree of liver fibrosis and carotid intima-media thickness in patients with hepatitis C virus, and to assess the correlation between the degree of fibrosis and carotid intima-media thickness.

Method: The cross-sectional study was conducted at the Dow University of Health Sciences, Karachi, from August 2018 to August 2020, and comprised healthy volunteers as controls in group A, and diagnosed chronic hepatitis C virus patients in group B. Those in group B were further divided based on Metavir fibrosis staging into group B1 comprising those with stages 1 and 2, and group B2 comprising those with stages 3 and 4. Liver fibrosis was quantitatively measured as liver stiffness via elastography, and carotid atherosclerosis was evaluated using B-mode carotid ultrasonography. The relationship between liver fibrosis and carotid intima-media thickness was assessed. Data was analysed using SPSS 22.

Results: Of the 90 subjects, 30(33.3%) were in group A; 16(53.3%) females and 14(46.7%) males with overall mean age 45.8±8.2 years. There were 29(32.2%) patients in group B1; 15(51.7%) females and 14(48.3%) males with overall mean age 45.7±11.0 years. There were 31(34.4%) patients in group B2; 19(61.3%) males and 12(48.3%) females with overall mean age 50.4±7.0 years (p>0.05). Liver stiffness was significantly higher in group B2 compared to groups A and B1 (p=0.000). Carotid intima-media thickness was significantly increased in group B compared to group A (p=0.001), but no significant difference was noted between groups B1 and B2 (p=0.227). Carotid intima-media thickness showed a weak, non-significant positive correlation with fibrosis severity (r=0.021; p=0.178).

Conclusion: Hepatitis C virus infection was found to be significantly associated with increased carotid intima-media thickness, but no significant correlation was observed between liver fibrosis severity and carotid intima-media thickness.

Key Words: HCV, Elastography, Carotid intima and media thickening.