Abstract
Background and Objectives: Hepatitis C virus (HCV) remains a significant cause of chronic liver disease worldwide. While direct-acting antivirals achieve high cure rates, the interplay between viral load, gender, and routine laboratory parameters remains unclear. This study aimed to investigate hematological, biochemical, and coagulation profiles, as well as derived non-invasive indices, in HCV-infected patients, stratified by gender and viremia levels. Materials and Methods: This retrospective study included 367 patients with HCV infection (223 males and 144 females). Patients were divided into four groups: high viremia males (hiVM), high viremia females (hiVF), low viremia males (loVM), and low viremia females (loVF), using 800,000 IU/mL as the threshold. Routine hematological, biochemical, and coagulation tests were conducted, and derived indices (FIB-4, APRI, AST/ALT ratio, PLR, NLR, SII, AISI, PNI, HALP, PAR, NAR) were calculated. Results: Significant gender- and viremia-specific differences were observed. hiVM showed higher erythrocyte indices and altered coagulation parameters, whereas hiVF had increased lymphocyte counts and AST/ALT ratio elevation. loVM displayed reduced hemoglobin and hematocrit, along with worse coagulation results. Biochemical analysis revealed gender differences in GGT, bilirubin, and albumin levels. Among derived indices, FIB-4 and APRI were higher in loVM, while SII and PLR were elevated in loVF. At the second visit after 17±4 weeks, when patients had no detectable HCV DNA in the peripheral blood, most indices improved significantly across groups. Conclusions: HCV infection affects laboratory profiles depending on gender and viremia levels. Non-invasive indices from routine tests offer valuable insights into inflammatory and nutritional status. Using these indices alongside traditional markers may aid hypothesis generation or clinical assessment and help prioritize further assessment for HCV patients.