RISK FACTORS FOR LOW MINERAL BONE DENSITY IN PATIENT WITH CHRONIC VIRAL C INFECTION
Journal Title: Analele Universitatii Dunarea de Jos din Galati, Fascicula XVII, Medicina - Year 2014, Vol 1, Issue 1
Abstract
Hepatitis C viral infection is one of the major public health problems, with a global prevalence of 2.35%.It is estimated that approximately 160 million people have been infected with HCV. Metabolic bone disease (often known as hepatic osteodystrophy) is a common complication of long-standing liver disease (affects 12- 55% of patients), and has an important effect on life as it causes fractures with immobilization. 85 patients with chronic HCV infection and 120 healthy controls were included in the study. Subgroups were defined on the basis of age, gender, menopausal status, alcohol intake, hormonal therapy, Metavir score, and serum viral load. Bone mineral density at the level of lumbar spine was evaluated using DEXA equipment: the WHO classification of osteoporosis was used. Diagnosis of chronic HCV liver disease was based on clinical, laboratory, imaging and invasive (liver biopsy) evidence. Student’s t, chi-square, Mann-Whitney tests, and logistic regression were used to assess the risk factors for osteoporosis in these patients. Prevalence of osteoporosis in patients versus controls was higher both in women (48.9% versus 37.2%) (p=0.003) and men (13% versus 8%) (p=0,645). Low BMD was significantly associated with patients’ age (p<0.001) and gender (p<0.001), and was more frequently present in patients with viral liver disease diagnosed for >5 years, as compared with those recently diagnosed (78.18% versus 11.36%, p<0.001). Patients with higher degrees of liver fibrosis had more frequently a low BMD (F3 or F4: 66.67%; F2: 41.2%; F1: 12.5%) (p<0.001). We found no association between BMD level and the activity score A (p=0.09). Evaluated by logistic regression, from the six predictor variables for a low BMD (duration since diagnosis, histological scores A and F, initial viremia, gender, age), only age at diagnosis (p<0.001) and high viremia (p=0.002) appeared to be independent risk factors for osteoporosis. Our results suggest that chronic viral C infection represents a risk factor for osteoporosis especially for patients with advanced liver disease, diagnosed for more than 5 years, and with a high viral load.
Authors and Affiliations
C. Lucaci, Monica Lencu
Keywords
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