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It is accepted that bacterial infection induces sepsis via the production of endotoxins and the process is maintained by the inflammatory cascade and oxidative mechanisms that, once activated, operate independently from the presence of pathogens 103

The prevalence of pruritus varies depending on the underlying cause, with reports indicating rates of up to 70% in primary biliary cholangitis, 2.530% in chronic hepatitis C virus-related liver disease, and roughly 8% in cirrhosis attributed to hepatitis B virus infection ( Numerous hypotheses have been posited to elucidate the genesis of pruritus, albeit none deemed definitive

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The age of onset is earlier in men than in women and men are more prone to spinal involvement, whereas bulbar involvement is more common in women (McCombe and Henderson, 2010)