Hepatitis C virus (HCV), which is previously known as a non-A, non-B hepatitis, HCV is a linear, single-strand, positive-sense, 9600-nucleotide RNA virus[1]. Hepatitis C infection is usually acquired through infected syringes and needles, and transfusion of infected blood, Sexual transmission of HCV occurs infrequently in heterosexual couples, it‘s estimated overall prevalence of nearly 3%. Approximately 80% patients with hepatitis C virus develop chronic infection, and progression to cirrhosis occurs in nearly 20% of these subjects[2].

Moreover, patients with HCV-related cirrhosis are at an increased risk of developing hepatocellular carcinoma, which is estimated to occur at the rate of 1.5% to 4% per year. In most individuals, liver disease progresses slowly over several decades, but the rate of progression is highly variable. Whereas some patients develop cirrhosis and end-stage liver disease within one to two years of exposure, others may die of old age or an entirely unrelated cause[3].

Although it is mostly unclear why some patients progress more rapidly than others, several factors have been identified as having a role in disease severity. HCV patients co-infected with hepatitis B virus (HBV) have an increased risk of developing cirrhosis and decompensated liver disease as well as hepatocellular carcinoma. Several researches have noted more severe clinical and histological abnormalities in HCV infected chronic alcoholics compared to non-alcoholics with HCV infection[4-5]. Other factors associated with a more rapid course of liver disease include age at acquisition of HCV infection, gender of the patient and presence of immunodeficiency states[6].

Several studies have assessed the correlation between serum HCV viral titers and different clinical and laboratory parameters. Several studies demonstrate a statistically significant correlation of aminotransferase values with the histological parameters, and even stronger correlation with AST values with liver damage. Hence the biochemical markers and HCV RNA LOAD are the important predictor for acute and chronic infection also development of liver cirrhosis[7].

This was a Cross section observational study conducted over 10 months duration between March 2022 to December 2022 in SSG HOSPITAL, Vadodara, Gujarat, India. Ethical committee approval was obtained from The Institutional Ethics Committee for Human Research- PG Research (IECHR-PGR) to carry out this study on 28 February 2022. Once patient met the inclusion criteria, Informed written consent were taken before the enrolment of the patients.

Inclusion Criteria:

1. The patients with HCV antigen positive aged 18 -60 years attending medicine in and out patient department
2. The patients with HCV RNA viral load detection
3. Subject who is willing to give consent for the study

Exclusion Criteria:

1. Subjects less than 18 years and more than 60 years of age.
2. Subjects with liver cirrhosis due to any other cause like non-alcoholic fatty liver disease, auto immune liver cirrhosis, Hepatitis B.

Table 1: Socio demographic Details of Patients

The age group and gender wise distribution of patients. The age and gender wise distribution of patients are calculated in frequency and percentage. Majority of the patients belong to age group of 51-60 years. Number of patients is same in age group of 18-30 and 41-50 years.

Table 2: Symptoms of Patients

Different symptoms in patients with Hepatitis C infection. Frequency and percent are calculated for each symptoms. Almost 95% percent patients present with anorexia followed by nausea (65%), yellowish discoloration skin (52.50%), vomiting (40.00%). Other symptoms like pedal edema (20%), abdominal distention (15%), Hematemesis (12.50%) present in some patients. Very few patients present with the symptoms like decrease urine output (10%) and altered sensorium (5%).

Table 3: Correlation Coefficient of HB and HCV RNA Load

Correlation between HB and HCV titer. There is no statistically significant correlation found between HB and HCV titer. (correlation coefficient r =-0.1078, p= 0.50220)

Table 4: Correlation Coefficient of TC and HCV RNA Load

Correlation between TC and HCV titer. It is not showing statistically significant correlation between TC and HCV titer. (correlation coefficient r =0.3950, p= 0.0106)

Table 5: Correlation Coefficient of PC and HCV RNA Load

Correlation between PC and HCV titer. There is no statistically significant correlation found between PC and HCV titer. (correlation coefficient r =-0.1082, p= 0.5009)

Hepatitis C virus (HCV) is a blood borne pathogen that is endemic in most parts of the world, with an estimated overall prevalence of nearly 3%. Approximately 80% patients with hepatitis C virus develop chronic infection, and progression to cirrhosis occurs in nearly 20% of these subjects. Several studies have assessed the correlation between serum HCV viral titres and different clinical and laboratory parameters[8].

Majority of the patients belong to age group of 51-60 years. Number of patients is same in age group of 18-30 and 41-50 years. We have 53% female and 47% male patients. Percentage of female patients is slightly more than male patients[9].

A study was done by Cohen JM et al with aim of finding risk factor for hepatitis C. He found out that Hepatitis was more common in the age group of 40-59 year of age group. Our study findings are also similar to the findings of this study and we have more patients in the age group of 51-60 years and 41-50 years of age group[10]. The same study did not find any association between gender and disease occurrence.

A study done by Meda N et al aimed to find out the seroprevalence of hepatitis C virus had revealed that maximum Hepatitis C virus prevalence was present in the age group of 41-49 years of age group.

Almost 95% percent patients present with anorexia followed by nausea (65%), yellowish discoloration of skin (52.50%), vomiting (40%). Other symptoms like pedal edema (20%), abdominal distention (15%), Hematemesis (12.50%) present in some patients. Very few patients present with the symptoms like decrease urine output (10%) and altered sensorium (5%). Signs of Hepatitis pallor and icterus were also present in some patients in this study[11]. The symptoms observed in the study were similar to that of standard clinical presentation of Hepatitis C available in literature.

In a study done by Alsaran KA et al they had found out that mean Haemoglobin is more among patients diagnosed with Hepatitis C. On the other hand, we were not able to correlate Haemoglobin with the HCV RNA virus[12]. Therefore, it is difficult to comment upon correlation of HCV RNA virus and Haemoglobin

In our study most of the patients with HCV RNA detected level has no statistically significant correlation with Patient Clinical Profile and Biochemical Profile. Clinical and Biochemical profile has more predictive value than HCV RNA level. So Early Detection and Early treatment with Directly Acting Antiviral agents can improve the patient and prevent it from the further complication.

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