Analysis Of Clinical Features Of Cases With Hepatitis C Virus Complicated With Liver Fluke Infection

Objective:Fuyu area of Jilin Province in China was an area with high incidence of hepatitis C and clonorchiasis.The main cause of hepatitis C virus infection in these patients was the sharing of syringe injections in the late 1970 s and early 1980 s.The main causes of clonorchiasis infection were the regional characteristics of the area,that is,located in the Songhuajiang River and eating habits caused by raw freshwater fish and shrimp.In this study,the clinical characteristics of patients with hepatitis C complicated with clonorchiasis infection were analyzed by collecting and sorting out the case data of epidemiological investigation in Fuyu area in August 2017.In order to strengthen the understanding of those patients,clarifying whether the co-infection will affect the development of the disease,and further guide clinical decision-making.Strengthen the health publicity and education of high-risk groups in the region,reduce the predisposing factors from the level of primary prevention.At the same time,early diagnosis and early treatment of infected people,and actively prevent the occurrence and development of end-stage liver disease and cholangiocarcinoma.Methods:In August 2017,a cross-sectional survey of liver flukes was conducted in the Fuyu area of Jilin Province.Excluding patients with incomplete clinical data and patients with hepatitis B virus infection,196 patients of hepatitis C complicated with clonorchiasis infection were collected.Based on the epidemiological survey data,1:1 pairing method was used.The corresponding control group(matching factors were age,sex,alcohol consumption,treatment),that is,190 cases of hepatitis C virus infection alone.169 cases of clonorchiasis infection alone.The general data such as age,sex,alcohol consumption,diabetes mellitus and the clinical data such as laboratory examination and imaging examination of those patients were collected and sorted.And the statistics were analyzed by SPSS 24.0 software.Results:1.Basic situation:Of the 196 patients with hepatitis C virus and liver fluke infection,152(77.6%)were male and 44(22.4%)were female.The male to female ratio was 3.45:1,the minimum age was 33,and the maximum age was 76.The average age was 57.35 ± 7.84 years old.Among them,89(45.4%)drunk alcohol,118(60.2%)were smokers,and 15(7.7%)were diabetic.The BMI of those patient were generally high,and there were 97 cases(50.3%)higher than the normal range(> 24).The number of smokers in the co-infected group was significantly higher than that in the liver fluke alone infection group(P<0.001),and the BMI value in the liver fluke alone infection group was higher than that in the co-infected group(P = 0.02).2.Clinical performance analysis:In 196 patients with hepatitis C and liver fluke infection,symptoms mainly appeared as thirst,dry eyes,itchy skin,pain in the liver area,fullness of the upper abdomen,fatigue and weakness.49 cases of thirst(30.2%),78 cases of dry eyes(44.6%),30 cases of skin itching(19.0%),31 cases of pain in the liver area(19.0%),34 cases of upper abdominal fullness(21.0%),fatigue of 50 cases(29.4%)respectively.In the co-infected group,the pain in the liver area(P=0.03)and fatigue(P=0.02)were more severe than those in the liver fluke alone infection group.3.Laboratory results analysis:In the hepatitis C alone infection group,WBC(P=0.02)and EO(P<0.001)were lower than the co-infected group.The ALT(P<0.001),AST(P<0.001),?-GT(P=0.01)and ALP(P=0.003)in the liver fluke alone infection group were significantly lower than those in the co-infected group.The PTL(P<0.001),UREA(P=0.03),TG(P=0.02)and CHO(P<0.001)were higher than the co-infected group.4.Analysis of abdominal ultrasound results:The complication of the biliary system was significantly more severe in the co-infected group than in the hepatitis C alone infection group(P=0.001).Liver steatosis of liver fluke alone infection group was heavier than co-infection group(P=0.004).Co-infected group compared with liver fluke alone infection group spleen enlarged(P=0.03),the extent of diffuse changes in the liver parenchyma(P<0.001)were more severe(the diffuse change of liver parenchyma in the abdominal ultrasound results in this study was removed of diffuse changes of liver parenchyma in patients with steatosis and liver fibrosis).5.Analysis of liver fibrosis related results:APRI,FIB-4 and Fibroscan of the coinfected group were significantly higher than the liver fluke alone infection group(P<0.001).Conclusions:1.In this study,there were more middle-aged men with hepatitis C and liver fluke infection,which were consistent with the distribution of high-risk groups of HCV and liver fluke infection in the region.2 The laboratory results of patients with hepatitis C and liver fluke infection increased with ALT,AST,?-GT and DBIL mainly.3.Compared with the group infected with liver fluke alone,the degree of liver damage and liver fibrosis were more serious in the hepatitis C combined with liver fluke infection group.Compared with the hepatitis C virus alone infection group,the biliary tract lesions were more severe in the hepatitis C combined with liver fluke infection group.4.Compared with the patients of hepatitis C complicated with liver fluke infection,elevated serum TG,CHO and BMI were more common in patients with liver fluke alone infection.