Ascites And Hepatic Encephalopathy Conspicous Features of Hepatitis-C Epidemiology: A Case Series Study In Services Hospital, Lahore

Abstract

Objective: To study the epidemiological profile in patients infected with Hepatitis C Virus
admitted in Medical wards of Services Hospital, Lahore (SHL).
Methods: It was a case series study in which total 115 HCV positive patients were interviewed
after taking informed consent with a pretested questionnaire.
Results: Among 115 patients, 53(46.1%) were females and 62(53.9%) were males. Mean age
was 54 years with standard deviation of 13.1. Age was stratified into three age groups. Patients
belonging to age group 40 years and below were 12.2% ,whereas maximum number of patients
fall into age group 41-60 years i.e. 64.3% and only 23.5% belonged to age group 61 years and
above. Majority of the patients belonged to rural areas i.e. 34.8%, whereas 33.9% came from periurban areas and 31.3% were from urban areas. Considering the educational status, most of the
lot were illiterate i.e. 60.9%, whereas 16.5% had primary education, 20% had secondary
education and only 2.6% were educated above secondary school. As far as family history of HCV
is concerned, 64.3% had no family history of hepatitis C whereas rest had HCV positive parents,
siblings, spouse or children. Talking about the presentation of the patients, 56(48.7%) patients
presented with fatigue and fever, 33(28.7%) patients presented with hematemesis, 15(13%)
patients had melena whereas 11(9.6%) patients had pain epigastrium, 32.2 % were in hepatic
encephalopathy and 31.3 % of patients had ascites. Regarding the potential risk factors, 36.5%
had no history of surgeries, 27% had major surgeries, 23.5% underwent dental procedures
whereas 13% had minor surgical procedures. Among males, 77% were habitual of getting shaved
from local barber shop. 13% of females underwent ear/nose piercing whereas 16% of males had
tattooing.
Conclusions: It was concluded from our study that HCV is common in age group 41-60 years
with great burden on males, majority of whom were illiterate, residing in rural areas with history of
surgical procedures and getting shaved from local barber shop. Ascites and hepatic
encephalopathy were the two conspicuous presentations in these patients. Cosmetic procedures
and HCV positive family history had also minor contributions. It is the need of time to educate
people and organize campaigns spreading awareness among high risk population and general
public.