Correlation between HCV viraemia and splenic volume in chronic HCV infected patients: an Egyptian study

As HCV lymphotropism was ascertained, this study was carried out to verify the possible involvement of the spleen in HCV-related chronic hepatitis.

A cross-sectional study was conducted on 97 HCV infected patients attending for treatment with interferon, categorised as follows; before treatment (group I, n=49), non-responders (group II, n=18), responders (group III, n=18) and group IV (n=12) including patients with HCV RNA below detection limit after 24 weeks of treatment. A control group of healthy blood donors (n=19) was enrolled in our study. Conventional ultrasonography was carried out on all participants. Splenic volume was measured and compared between the groups, and its relationship to HCV RNA concentration was investigated.

It was found that the splenic volume of patients of both groups I and II is significantly greater than that of the control group (p-values : 0.004 and 0.009, respectively) and, of patients of both groups III and IV. The latter are not significantly greater than that of the control group (p-value: 0.8 and 0.6, respectively). A significant positive relationship was detected between the splenic volume and the HCV RNA concentration in group I (r=0.56, p-value=0.00) but this is insignificant in group II. There is no significant relationship between the splenic longitudinal diameter and the HCV RNA concentration in any of the studied groups.

The splenic volume positively correlated with HCV RNA concentration in HCV positive patients, but this become insignificant in non-responders to interferon therapy. The successful response to interferon therapy matches with near normal splenic volume whilst non-responders to Interferon therapy matches with increased splenic volume. The change in the viral load leads to a corresponding change in the splenic volume and does not affect the splenic longitudinal diameter.