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TITLE:

RELATIONSHIP OF DERANGEMENTS IN VARIOUS BLOOD INDICES AND COAGULOPATHY WITH LIVER STIFFNESS INDEX (LSI) IN VARIOUS STAGES OF FIBROSIS IN HEPATITIS C

AUTHORS:

Azhar Hussain, Ijaz Khalid, Rameen Fatima and, Dr. Muhammad Asif Gull

ABSTRACT:

Background: Liver performs a lot of functions of liver and damage to hepatocytes leads to dysfunction; multiple chemicals are released from it due to structural cell damage like ALT, AST and many others and cause functional loss leading to changes in albumin, bilirubin and clotting factors. Methods: The prospective cross sectional study was conducted in medicine wards and hepatitis clinic of LGH/AMC, Lahore from February 22, 2018 to January 21, 2019. We studied 251 HCV infected patients which were got CBC, LFTs, ELISA and PCR done to perfectly diagnose ongoing hepatitis C infection and then, fibro scan were performed for staging of fibrosis. In order to differentiate HCV fibrosis progression, we compared the relationship of derangements in various blood indices and coagulopathy with liver stiffness index (LSI) in various stages of fibrosis in hepatitis C. Results: The independent t test result of variables like Patient Age, Baseline Viral Load, TLC, Neutrophil Count, Platelet Count, MCV, MCH, MCHC, Hb, Hct, ALT, AST, ALP, Albumin, PT, APTT for fibrosis stages F0 –F1 and F2 have statistically significant result with fibro scan score or liver stiffness index with p values < 0.05 except TLC, Neutrophil Count, Platelet Count, MCV, MCH, MCHC, Hct, ALT, AST, ALP, Albumin, PT, APTT while for F3 and F4, all of these variables found to be significant except TLC, MCV, MCH, MCHC and Hct. They were able correlate to stage of liver fibrosis with correlation coefficient indexes or R squared values of 0.827,0.822, 0.798, 0.902, 0.878, 0.735, 0.981, 0.952, 0.86 and 0.846 respectively. Conclusions: Various blood indices (TLC, Neutrophil Count, Platelet Count, MCV, MCH, MCHC, Hband Hct) and coagulopathy ( prolonged PT and aPTT) showed a positive association with liver stiffness index (LSI) in various stages of fibrosis in hepatitis C.

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