Adrenal Insufficiency Is A Common Finding In Chronic Hepatitis C Patients Regardless Of Cirrhosis

EA and YZ were concerned with the design of the study; ME and HM were responsible about statistical analysis; HM performed the PCR and laboratory parameters; NM was responsible for radiological examination and EA, MF and AH analyzed the data and drafted the manuscript. All authors critically revised the manuscript, approved the final version to be published, and agree to be accountable for all aspects of the work. Background: Chronic hepatitis C virus (HCV) infection is a real public health issue and a major contributor to liver-related morbidity and death because of its propensity for liver fibrosis, cirrhosis, and cancer. Several extra-hepatic illnesses that affect the kidneys, skin, salivary glands, eyes, thyroid, joints, neurological system, and immune system have also been linked to HCV infection. Adrenal insufficiency (AI) was demonstrated in patients with cirrhosis and liver failure. Objective: We aimed to detect serum cortisol levels and ACTH levels in patients with HCV and liver cirrhosis and study the relationship between liver function and adrenal insufficiency. Methods: Our study included 240 HCV patients subdivided into four groups: Group 1: Included 60 with chronic HCV without cirrhosis. Group 2: It included 60 patients with HCV-related compensated cirrhosis. Group3: included 60 patients with HCV decompensated cirrhosis, and Group 4 included 60 healthy volunteers. Results: ACTH level was significantly higher in all HCV groups than in the control group (p<0.001), also, delta cortisol was significantly lower in all HCV groups than in the control group groups (p=0.021). The prevalence of AI among patients with decompensated cirrhosis, compensated, and chronic hepatitis was 25%, 15%, and 11.7%, respectively. Conclusion: AI could be encountered in patients with chronic HCV without liver cirrhosis and is typical in cirrhotic individuals without signs of sepsis or hemodynamic disturbance. Keywords : Adrenal cortex hormones, Hepatitis C virus, liver cirrhosis, liver failure, ACTH