Complications associated with HCV-related liver cirrhosis and their relationship with diabetic control. A tertiary care center study in Peshawar, Pakistan.

Abstract

Objective: To determine the frequencies of liver cirrhosis-associated complications in patients with HCV+ diabetic patients and its association with HbA1C. Study Design: Observational Cross-sectional study. Setting: Medical Wards of Khyber Teaching Hospital. Period: October 2019 to November 2020. Methods: After approval from the hospital ethical committee, all HCV positive diabetic patients were enrolled in the study. Informed consent was obtained and relevant examination was performed. Hematemesis was diagnosed clinically, while venous blood was sent for all routine and relevant specialized investigations. Twenty-four-hour urinary output was calculated. Abdominal ultrasounds and Triphasic CT abdomen were done where required. Data were collected on structurally designed proforma. All data were entered into SPSS version 22. Results: A total of 62 patients were enrolled. The mean age was 49. 23 years ± 11.72 SD. Twenty-three patients (37.1%) were males, while 39 patients (62.9%) were females. Forty-nine patients (79%) were PCR-positive for HCV. Most patients (58.1%) had less than five years duration of HCV. Frequency of SBP was 16.1%, hepatic encephalopathy was 22.6%, ascites was 40.3%, hematemesis was 11.3%, portal vein hypertension was 45.2%, and HCC 3.2%. On post-stratification, significant associations emerged with age, where SBP (p <0.01), hepatic encephalopathy (p<0.001), and ascites (p<0.0001), increased with advancing age, while hematemesis (p<0.04) and portal vein hypertension (p<0.04) were more pronounced in younger patients. Conclusion: In conclusion, individuals with both chronic HCV and diabetes mellitus exhibit an increased risk of cirrhosis-related complications. The most common complication was portal vein hypertension followed by ascites and hepatic encephalopathy. The complications like SBP, Hepatic encephalopathy and ascites associated with increasing age.