Sonographic Patterns and Findings Within the Liver Among Hepatitis B and C Patients: A Cross-Sectional Study

Objective: Hepatitis B virus (HBV) and hepatitis C virus (HCV) infections remain major global health challenges. Rwanda faces a disproportionately high HCV burden, with a prevalence of 6.7%, nearly ten times the global average of 0.7%, while HBV prevalence stands at 2.1%. Therefore, the aim was to identify sonographic liver patterns among hepatitis B and C patients and assess their association with sociodemographic factors. Materials and Methods: A cross-sectional study was conducted among 240 patients with viral hepatitis (120 HBV and 120 HCV). Sonographic findings were analyzed for associations with type of hepatitis and demographic variables using Fisher’s exact test and chi-square analysis. Results: The 240 participants had a mean age of 52.7 ± 17.9 years, and 57.1% were male. The most frequent liver sonographic findings were patterns of chronic liver alteration, which was suggestive of fibrosis (21.7%), fatty liver (8.8%), liver size abnormalities (14.6%), and suspicious nodules (5.0%). Fibrotic patterns were more commonly associated with HCV compared with HBV (14.2% vs 7.5%, p = .010), with HCV showing nearly double the cirrhosis rate (6.7 vs 3.3%). Fibrotic patterns were strongly associated with older age ( p < .001) and being female ( p = .014). Conclusion: Sonography revealed distinct liver morphological changes among hepatitis B and C patients, more frequent in HCV, older participants, and females, suggesting differences in infection duration or health care-seeking behavior. Sonography can be a practical diagnostic tool for identifying and monitoring liver changes in resource-limited practice setting.