Comparative Analysis of Demographic and Clinical Profiles in Chronic Hepatitis B, Chronic Hepatitis C, and Healthy Populations

Abstract

Chronic hepatitis B (HBV) and hepatitis C (HCV) infections remain leading causes of progressive liver disease, cirrhosis and hepatocellular carcinoma, and Pakistan carries a disproportionate share of this burden. Although the virological determinants of outcome are well characterised, comparative data describing the demographic profile and symptomatic presentation of the two infections in rural South Asian populations remain limited. In this comparative cross-sectional study, 360 participants were enrolled in three equal groups () patients with chronic HBV infection, patients with chronic HCV infection, and apparently healthy controls recruited from the same catchment population. Gender, occupation, literacy, body mass index and socioeconomic status were documented for all participants, and six presenting symptoms were compared between the two infected groups. Categorical variables were analysed by Pearson's chi-square test, with odds ratios and 95% confidence intervals calculated for the symptom comparison. Men predominated in all three groups (56.7%, 53.3% and 54.2% of controls, HBV and HCV patients respectively), and roughly half of each group was illiterate. Housewives and manual labourers together accounted for approximately two-thirds of every group, and more than half of all participants belonged to the lower socioeconomic stratum. None of these distributions differed significantly between groups (all p > 0.5), nor did body mass index, which was normal in 82.5–89.2% of participants. Fatigue was the leading complaint in both infections (75.0% in HBV versus 65.0% in HCV; p = 0.121). All six symptoms were more frequent in chronic HBV, but the difference reached significance only for fever (30.8% versus 16.7%; OR 2.23, 95% CI 1.20–4.13; p = 0.015) and joint pain (25.0% versus 10.0%; OR 3.00, 95% CI 1.45–6.20; p = 0.004). Chronic HBV and HCV patients were demographically indistinguishable from healthy controls drawn from the same community, indicating that the illiteracy and socioeconomic disadvantage observed characterise the population at risk rather than differentiating infected individuals. Symptom-based case detection is therefore unreliable for HCV, and serological screening independent of clinical presentation is required for timely diagnosis in high-prevalence rural districts.