Clinical Significance of Perihepatic Lymphadenopathy in Patients with Chronic Hepatitis C Infection
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Patients with chronic hepatitis C (HCV) infection commonly have perihepatic lymph node enlargement (PLNE). We investigated the prognostic value of PLNE in the development of complicated cirrhosis and death, as well as the clinical and laboratory factors associated with the presence of PLNE in a cohort of HCV-infected veterans.
Using a retrospective cohort design, we compared the rate of development of decompensated cirrhosis and/or death in a group of HCV-infected patients who did not have evidence of decompensated cirrhosis stratified by the presence or absence of PLNE. We used Kaplan–Meier survival curves. We then evaluated which factors were predictive of detection of PLNE using logistic regression.
A total of 131 patients were included in the study. Fifty-nine patients had PLNE and 72 patients did not. After a mean follow-up of 42 months, survival in the absence of progression to decompensated cirrhosis and/or death was not significantly different between the two groups (log-rank test, p = 0.27). The only factor predictive of progression to decompensated cirrhosis and/or death was the presence of cirrhosis at baseline (HR 13.13, 95% CI 2.21–79.41). In addition, cirrhosis was the only factor predictive of the detection of PLNE on CT scan (OR 3.09: CI 2.1–25.9).
Presence of PLNE in patients with chronic HCV infection is strongly associated with subclinical cirrhosis. However, PLNE does not independently predict the progression of liver disease to decompensated cirrhosis and/or death in HCV-infected patients.
- Armstrong GL, Wasley A, Simard EP, McQuillan GM, Kuhhert WL, Alter MJ. The prevalence of hepatitis C virus infection in the United States. Ann Intern Med. 2006;144:705–714.
- Fattovich G, Stroffolini T, Zagni I, Donato F. Hepatocellular carcinoma in cirrhosis: incidence and risk factors. Gastroenterology. 2004;127:S35–S50. CrossRef
- Thomas DL, Seeff LB. Natural history of hepatitis C. Clin Liver Dis. 2005;9:383–398. CrossRef
- Bruix J, Sherman M. Management of hepatocellular carcinoma. Hepatology. 2005;42:1208–1236. CrossRef
- Bruix J, Sherman M, Llovet JM, et al. Clinical management of hepatocellular carcinoma: conclusions of the Barcelona-2000 EASL conference. J Hepatol. 2001;35:421–430. CrossRef
- Moore KL, Dalley AF, Agur AMR. Clinically oriented anatomy. 5th ed. Philadelphia, PA: Lippincott, Williams, & Wilkins; 2006:298–299.
- Cassani F, Valentini P, Cataleta M, et al. Ultrasound-detected abdominal lymphadenopathy in chronic hepatitis C: high frequency and relationship with viremia. J Hepatol. 1997;26:479–483. CrossRef
- Spinetti A, Matricardi L, Puoti M, et al. Ultrasound evaluation of hepatic lymph nodes in patients with anti-hepatitis C virus antibody reactivity. Ital J Gastroenterol Hepatol. 1999;31:295–330.
- Maeda T, Hori Y, Yamaguchi N, et al. Clinical significance of lymphadenopathy in the upper abdomen: ultrasound demonstration. Nippon Acta Radiogica. 1995;55:228–232.
- Choi MS, Lee JH, Koh KC, et al. Clinical significance of enlarged perihepatic lymph nodes in chronic hepatitis B. J Clin Gastroenterol. 2001;32:329–332. CrossRef
- Dietrich CF, Zeuzem S, Caspary WF, Wehrmann T. Ultrasound lymph node imaging in the abdomen and retroperitoneum of healthy probands. Ultraschall Med. 1998;19:265–269. CrossRef
- Kuo H, Lin C, Chen J, Tsai S. Enlarged lymph nodes in porta hepatis: sonographic sign of chronic hepatitis B and C infections. J Clin Ultrasound. 2006;34:211–216. CrossRef
- Watanabe T, Sassa T, Hiratsuka H, Hattori S, Abe A. Clinical significance of enlarged perihepatic lymph node on ultrasonography. Eur J Gastroenterol Hepatol. 2005;17:185–190. CrossRef
- Dietrich CF, Lee J, Herrmann G, et al. Enlargement of perihepatic lymph nodes in relation to liver histology and viremia in patients with chronic hepatitis C. Hepatology. 1997;26:467–472. CrossRef
- Soresi M, Bonfissuto G, Magliarisi C, et al. Ultrasound detection of abdominal lymph nodes in chronic liver diseases: a retrospective analysis. Clin Radiol. 2003;58:372–377. CrossRef
- Dietrich CF, Stryjek-Kaminska D, Teuber G, Lee J, Caspary WF, Zeuzem S. Perihepatic lymph nodes as a marker of antiviral response in patients with chronic hepatitis C infection. Am J Roentgenol. 2000;174:699–704.
- Soresi M, Bonfissuto G, Sesti R, et al. Perihepatic lymph nodes and antiviral response in chronic HCV-associated hepatitis. Ultrasound Med Biol. 2004;30:711–717. CrossRef
- Dofman RE, Alpern MB, Gross BH, Sandler MA. Upper abdominal lymph node: criteria for normal size determined with CT. Radiology. 1991;180:319–322.
- Armstrong GL, Wasley A, Simard EP, McQuillan GM, Kuhner WL, Alter MJ. The prevalence of hepatitis C virus infection in the United States, 1999 through 2002. Ann Intern Med. 2006;144:705–714.
- Richardson D, Fisher M, Sabin CA. Sexual transmission of hepatitis C in MSM may not be confined to those with HIV infection. J Infect Dis. 2008;197:1213–1214. CrossRef
- Van de Laar TJW, Van Der Bij AK, Prins M, et al. Increase in HCV incidence among men who have sex with men in Amsterdam most likely caused by sexual transmission. J Infect Dis. 2007;196:230–238. CrossRef
- Ferenci P, Laferl H, Scherzer TM, Gschwantler M, Maieron A, Brunner H, et al. Peginterferon alfa-2a and ribavirin for 24 weeks in hepatitis C type 1 and 4 patients with rapid virological response. Gastroenterology. 2008; 135:451–458. 2008 May 27.
- Kudo M, Zheng RQ, Kim SR, et al. Diagnostic accuracy of imaging for liver cirrhosis compared to histologically proven liver cirrhosis: a multicenter collaborative study. Intervirology. 2008;51:17–25. CrossRef
- Di Bisceglie AM, Sterling RK, Chung RT. Serum alpha-fetoprotein levels in patients with advanced hepatitis C: results from the HALT-C trial. J Hepatol. 2005;43:434–441. CrossRef
- Wai C, Greenson JK, Fontana RJ, Kalbfleisch JD. A simple noninvasive index can predict both significant fibrosis and cirrhosis in patients with chronic hepatitis C. Hepatology. 2003;38:518–526. CrossRef
- Bayati N, Silverman AL, Stuart GC. Serum alpha-fetoprotein levels and liver histology in patients with chronic hepatitis C. Am J Gasteroenterol. 1998;93:2452–2456. CrossRef
- Choi, PC, Kim HJ, Choi WH, Park D, Park JH, Cho YK, et al. Model for end-stage liver disease, model for end-stage liver disease-sodium and Child-Turcotte-Pugh scores over time for the prediction of complications of liver cirrhosis. Liver international 2009; 221–226.
- Soresi M, Carroccio A, Agate V, et al. Evaluation by ultrasound of abdominal lymphadenopathy in chronic hepatitis C. Am J Gastroenterol. 1999;94:497–501. CrossRef
- Dod GD, Baron RL, Oliver JH, Federle MP, Baumgartel PB. Enlarged abdominal lymph nodes in end-stage cirrhosis: CT-histopathologic correlation in 507 patients. Radiology. 1997;203:127–130.
- Saadoun D, Asselah T, Resche-Rigon M, Charlotte F, Bedossa P, Valla D, Piette JC, Marcellin P, Cacoub P. Hepatology 2006; 43:1337–1345.
- Muller P, Renou C, Harafa A, et al. Lymph node enlargement within the hepatoduodenal ligament in patients with chronic hepatitis C reflects the immunological cellular response of the host. J Hepatol. 2003;39:807–813. CrossRef
- Adinolfi LE, Utili R, Andreana A, et al. Serum HCV RNA levels correlate with histological liver damage and concur with steatosis in progression of chronic hepatitis C. Dig Dis Sci. 2001;46:1677–1683. CrossRef
- Rustgi VK. The epidemiology of hepatitis C infection in the United States. J Gasteroenterol. 2007;42:513–521. CrossRef
- Roselle GA, Danko LH, Kralovic SM, Simbartl LA, Kizer KW. National hepatitis C surveillance day in the veterans health administration of the department of veterans affairs. Mil Med. 2002;167:756–759.
- Briggs ME, Baker C, Hall R, et al. Prevalence and risk factors for hepatitis C virus infection at an urban Veterans Administration medical center. Hepatology. 2001;34:1200–1205. CrossRef
- Ishii H, Saito H. Perihepatic lymphadenopathy in chronic liver disease. J Gasteroenterol Hepatol. 2000;15:695–696. CrossRef
- Neri S, Ierna D, Mauceri B, et al. Can ultrasounographic findings of perihepatic lymphadenopathy promote investigation to detect possible presence of virus C infection in non-symptomatic subjects? Hepatol Res. 2003;27:124–128. CrossRef
- Clinical Significance of Perihepatic Lymphadenopathy in Patients with Chronic Hepatitis C Infection
Digestive Diseases and Sciences
Volume 56, Issue 7 , pp 2137-2144
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