Evaluation of bone marrow examination in patients with hepatitis C virus infection

Background:Over 170 million individuals are infected with hepatitis C virus (HCV) worldwide. The report published by the Egyptian Demographic Health Survey stated that in Egypt, there is an overall anti-HCV antibody prevalence of 14.7% and the number of Egyptians estimated to be chronically infected was 9.8%. Hematological manifestations are among the most common extrahepatic manifestations of HCV infection. Patients with HCV infection can develop peripheral blood cell count abnormalities that are commonly attributed to hypersplenism, antiviral therapy, decreased thrombopoietin levels, and/or autoimmune mechanisms.Aim of the work: Evaluation of bone marrow findings in patients infected with HCV presenting with peripheral blood cytopenias.Material and Methods: This study was carried out on 35 patients with chronic HCV infection presenting with cytopenias. Patients were subjected to history taking, physical examination, and routine laboratory investigations together with bone marrow aspiration and trephine biopsy. Flow cytometry and cytogenetics analysis were carried out in selected patients.Results: Among the patients studied, B-cell non-Hodgkin lymphoma was the most commonly encountered disorder (31%), followed by idiopathic thrombocytopenic purpura (11%), acute lymphoblastic leukemia, acute myeloid leukemia, myelodysplastic syndrome, and hypersplenism (9% each), and autoimmune hemolytic leukemia (6%), and the least encountered disorders were anemia of chronic disease, aplastic anemia, CLL, myelofibrosis, Evan’s syndrome, and sideroblastic anemia (3% each).Conclusion: B-cell non-Hodgkin lymphoma was the most frequently detected problem among the patients recruited (31%). There were significant data regarding relation of bone marrow dysplasia and fibrosis with age of patients.