Osteoporosis in Chronic Hepatitis C Virus with Advanced Liver Fibrosis

Abstract

AIM: The incidence of osteoporosis in chronic liver diseases varies widely, and is dependent on the severity of the underlying liver disease. The aim of this work was to evaluate the bone mineral density (BMD) in chronic hepatitis C virus (HCV) patients and explore the association between the degree of liver disease and BMD. Methods: Patients (n=88) were recruited from the Hepatology Department, National Hepatology and Tropical Medicine Research Institute, Egypt and dual-energy X-ray absorptiometry (DXA) was used for the determination of the BMD. Liver biopsy was performed to evaluate fibrosis staging. Results: The extent of osteoporosis was greater in patients with advanced fibrosis as compared to patients with early stage of fibrosis. There was also significant correlation between fibrosis stage and BMD. Smoking significantly associated with osteoporosis. When smoking was added as a cofactor, univariate analysis by logistic regression found that the presence of advanced fibrosis was associated with decreased BMD. Conclusions: Our study showed an association between advanced stage of liver fibrosis, the level of viremia and decreased BMD in chronic HCV patients. Replacement therapy for osteoporosis in advanced liver fibrosis caused by HCV is recommended.