Comparative study on risk factors and clinical correlation of certain extrahepatic manifestations in patients with chronic hepatitis B and C virus infections

Abstract

Background: Chronic infection with hepatitis B virus (HBV) and hepatitis C virus (HCV) is a major cause of liver cirrhosis and hepatocellular carcinoma worldwide, and is also associated with a wide range of extrahepatic manifestations affecting multiple organ systems. However, comparative studies on the prevalence, risk factors, and clinical associations of these extrahepatic manifestations in Mongolia remain limited. Aim: To comparatively evaluate the risk factors and clinical associations of selected extrahepatic manifestations in patients with chronic HBV and HCV infections. Materials and Methods: This retrospective cohort study included a total of 1.040 participants matched by age and sex. Extrahepatic manifestations were assessed, including hypertension, hyperglycemia, dyslipidemia, and impaired renal function. Results: Extrahepatic manifestations such as hypertension, hyperglycemia, dyslipidemia, and renal dysfunction were significantly more prevalent in the chronic HCV group (p<0.05). In contrast, obesity was more common in the chronic HBV group, particularly among males aged 50-59 years. Increasing age (OR=1.04, 95% CI: 1.02-1.06) and chronic HCV infection (OR=1.65, 95% CI: 1.20-2.26) were associated with a higher risk of extrahepatic manifestations. Liver fibrosis showed similarly high prevalence in both groups (71-72%), with the highest occurrence in the 50-59 age group. A moderate positive correlation was observed between fibrosis stage and renal function impairment (r=0.45). Conclusion: Chronic HCV infection is more strongly associated with the presence and risk of extrahepatic manifestations compared to HBV. Age, sex, and metabolic abnormalities are important contributing risk factors. Therefore, regular monitoring of metabolic and renal function, in addition to liver disease, is essential in patients with chronic viral hepatitis to prevent complications.