Background: Approximately 3% of the world population is infected with Hepatitis C virus, with the highest prevalence noted in Africa and Asia. In India, the prevalence of Hepatitis C virus infection ranges from 0.3% to 0.4% of the general population in different parts of the country, where it accounts for 0-12.8% of acute hepatitis, 10-20% of chronic liver disease and 10-15% of Hepatocellular Carcinoma. Several extra hepatic manifestations have been reported in hepatitis C infection. According to different studies, 40-74% of patients infected with the virus develop atleast one of the extrahepatic manifestations during the course of the disease. Extrahepatic manifestations may be the only and the first signal of an HCV infection, as many patients may not show any hepatic symptoms. Hence, detection of extrahepatic manifestation may help in easly diagnosis and initiation of treatment. So this study was undertaken to find out the prevalence and the common extrahepatic manifestations of Hepatitis C infection in a teritiary care centre in south Kerala, Government T D Medical College Alappuzha.

Materials and Methods: This study included a total of 95 patients diagnosed as HCV infected, attending the medical/ Gastroenterology wards/ OPD of the institution. It was a cross sectional study carried out over a period of 1 year regarding the clinical charecteristics of Hepatitis C infected patients.

Results: Extrahepatic Manifestations were seen in around 47.37% of the total sample population. They included neurological, renal, rheumatological and skin manifestations. Skin manifestations were the commonest. However Essential mixed cryoglobulinemia could not be detected due to the absence of a well set up laboratory facility.

Conclusion: Beyond the liver, HCV is a multifaceted disease. Some of the extrahepatic manifestations are due to immune reaction and some are due to chronic inflammation. Recognition of the extrahepatic manifestation is of paramount importance in early diagnosis of the disease.

Keywords: Hepatitis C, extrahepatic manifestations.

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Suresh Raghavan MD

Professor, Department of Medicine, Government T D Medical College, Alappuzha