Hematological indices as predictors of disease stage and antiviral-treatment response in patients with hepatitis C virus infection

Background Hepatitis C virus (HCV) infection is still a major cause of chronic liver disease, cirrhosis, and hepatocellular carcinoma (HCC) globally. Direct-acting antivirals have increased cure rates. The total blood count’s neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and mean platelet volume (MPV) indicate systemic inflammation and may be noninvasive indicators of hepatic disease development. Aim To evaluate the clinical significance of NLR, PLR, and MPV in differentiating between various stages of HCV-associated liver disease and to assess their predictive value for antiviral-treatment response in noncirrhotic HCV patients. Patients and methods A case–control research included 120 patients. Participants were divided into four groups: HCV-related cirrhosis ( n =30), HCV-related HCC ( n =30), noncirrhotic HCV patients receiving antiviral medication ( n =30), and age-matched and sex-matched healthy controls. Hematological indicators (NLR, PLR, MPV) were computed and compared across groups. The antiviral group investigated these variables at baseline, week 12, and week 24. The statistical analyses included analysis of variance, correlation, receiver operating characteristic curve, and logistic regression. Results There were substantial differences in NLR and PLR between the groups ( P <0.001). The NLR was higher in HCC patients. MPV efficiently differentiated between healthy and diseased groups (area under the curve=0.84–0.91, P <0.001). The PLR did not change during 24 weeks, whereas antiviral therapy decreased the NLR by 0.045. Regression demonstrated that no hematological variables individually predicted antiviral responses. Conclusion Hematological parameters, especially MPV and NLR, can distinguish HCV-related liver illness and inflammation at low cost. The clinical use of these indicators may improve illness monitoring.