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Updated: Sep 6, 2025
A Protocol for Analyzing Hepatitis C Virus Replication
Published on: June 26, 2014
C-reactive protein to lymphocyte count ratio is a promising novel marker in hepatitis C infection: the clear hep-c
Muhammed Emin Demirkol1, Gulali Aktas1, Satilmiş Bilgin1
1Abant Izzet Baysal University Hospital, Department of Internal Medicine - Bolu, Turkey.
Insights
The C-reactive protein to lymphocyte count ratio (CLR) is significantly elevated in chronic hepatitis C (CHC) patients and indicates liver fibrosis. This inflammatory marker can help identify CHC and its progression.
Area of Science:
- Hepatology and Infectious Diseases
- Inflammatory Biomarkers
- Clinical Diagnostics
Background:
- Chronic hepatitis C (CHC) poses a significant global health burden, potentially leading to cirrhosis and hepatocellular carcinoma.
- The C-reactive protein to lymphocyte count ratio (CLR) is recognized as a marker for estimating inflammatory burden.
Purpose of the Study:
- To compare CLR values between patients with CHC and healthy controls.
- To evaluate the association between CLR and liver fibrosis in CHC patients.
Main Methods:
- A retrospective study involving CHC patients and healthy controls.
- Comparison of CLR values between CHC patients and controls.
- Analysis of CLR in CHC patients with and without liver fibrosis.
Main Results:
- CLR was significantly higher in CHC patients (median 2.61) compared to controls (median 0.31) (p<0.001).
- A significant positive correlation was observed between CLR and APRI score (r=0.15, p=0.04).
- CLR demonstrated high sensitivity (84%) and specificity (82%) in identifying CHC (AUC: 0.884).
- CHC patients with fibrosis exhibited higher CLR (median 3.97) than those without fibrosis (median 1.7) (p=0.001).
Conclusions:
- Elevated CLR is a significant indicator in patients with chronic hepatitis C.
- Increased CLR may serve as a warning sign for the presence of liver fibrosis in CHC patients.
- CLR is associated with both CHC infection and hepatic fibrosis, highlighting its potential diagnostic value.
Objective:
Chronic hepatitis C (CHC) is one of the most important health problems affecting the significant rate of world population and it may lead to cirrhosis and hepatocellular carcinoma. C-reactive protein to lymphocyte count ratio (CLR) is used in estimating inflammatory burden. Therefore, this study aimed to compare CLR values between CHC patients and healthy controls and between CHC patients with and without fibrosis.
Methods:
Patients with CHC infection who visited outpatient and inpatient internal medicine clinics of our institution between January 2021 and December 2021 were enrolled to this retrospective study. CLR of the patients with CHC and healthy controls were compared. We further compared CLR of CHC patients with and without fibrosis.
Results:
Median CLR of CHC and control subjects was 2.61 (5.13%) and 0.31 (0.37%), respectively. CLR of the CHC group was significantly increased compared to the CLR of the controls (p<0.001). There was a significant positive correlation between CLR and APRI score (r=0.15, p=0.04). The sensitivity and specificity of CLR in determining CHC above 0.58% level were 84% and 82%, respectively (AUC: 0.884, p<0.001, 95%CI 0.84-0.93). In subgroup analysis, CLR was 3.97 (6.6%) for CHC patients with fibrosis and 1.7 (4.4%) for CHC subjects without fibrosis (p=0.001).
Conclusion:
Increased CLR in patients with CHC may be an alarming finding of liver fibrosis, as CLR is associated with both CHC and hepatic fibrosis.
