Viral hepatitis and interstitial lung diseases: can HRCT assess their relation and characterize its pattern?

Abstract

Background: Clinical and pathological studies suggested the presence of a relation between active viral hepatitis and interstitial lung diseases (ILD) ranging from mild to moderate relation. Most studies attribute this relation to viral geno-physiological characteristics. The purpose of the study is first to assess the role of high-resolution computed tomography (HRCT) in evaluating the relation between viral hepatitis and ILDs, then to characterize the predominant pattern of ILD that affects patient management and prognosis. Results: This prospective study was conducted on 300 patients with viral hepatitis. They were divided into three groups of patients according to blood viremia assessed by polymerase chain reaction (PCR) as well as the diffusing capacity of carbon monoxide (DL CO) in examined pulmonary function tests (PFT). Group [A] included 100 patients with low or moderate viremia and showing normal or low to moderate DL CO decline (> 50%). Group [B] included 100 patients with high viremia and showing normal or low to moderate DL CO decline (> 50%). Group [C] included 100 patients with high viremia and showing a restrictive DL CO decline pattern (< 50%). The study included 182 males and 118 females with a ratio of 3:2, while the age ranged between 40 and 70 years (mean age of 55 years). No ILD was found among the group [A] patient. Meanwhile, 27% of patients in the group [B] showed a non-fibrotic pattern of ILD and 50% of patients in the group [C] showed a fibrotic pattern of ILD. Among patients in group [B] and group [C] together, 77 patients showed ILD accounting for 38.5%. Conclusion: In concordance with the results of the previous clinicopathological and geno-physiological studies, our HRCT results further established a mild to moderate relation between active hepatitis and ILD regardless of the pulmonary functions. The fibrotic pattern of ILD with poor response to therapy and poor prognosis was found in those patients with concomitant restrictive PFT and rapidly progressive symptoms.

Assess Restricted Pulmonary Function in Chronic Hepatitis C Patients at Various Phases

“…Because of lung inflammation, the presence of viremia is also linked to an aberrant spirometric reading. [14] In our study 17 (18.1%) cases had severe HCV, 45 (47.9%) cases had moderate and 32 (34.04%) patients had mild HCV.…”

“…These findings were comparable to the previous studies. [13,14] There appears to be a plethora of extrahepatic symptoms of chronic HCV infection, including those in the lung. Symptoms of increasing liver disease and the use of HCV drugs can have secondary consequences on lung function.…”

The Crucial Role of NLRP3 Inflammasome in Viral Infection-Associated Fibrosing Interstitial Lung Diseases

“…Some studies found the pathogenetic link between pulmonary fibrosis and Hepatitis C virus (HCV) infection [ 91 , 92 ]. More recently, Samir et al, by using a high-resolution CT scan (HRCT), detected a fibrotic pattern of ILD in patients with high HCV viremia and showed a restrictive diffusing capacity of carbon monoxide (DLCO) decline pattern [ 93 ].…”