S Longo1, G Cotella, F Carletta, M Catacchio, S Antonaci. 1. Internistic and Interventional Ultrasonography Service, Department of Medicine, Immunology and Infectious Disease, Internal Medicine, Cesare Frugoni Policlinic, University of Bari, Italy.
Abstract
INTRODUCTION: To determine whether ultrasound (US) findings of perihepatic lymphadenopathy in patients with chronic hepatitis C (HCV) are predictive of failure to achieve sustained virological responses (SVR) to treatment with pegylated interferon (PEG-INF) alpha and ribavirin. MATERIALS AND METHODS: The study population included 89 patients with HCV treated with PEG-INF and ribavirin in 2003-2007. US scans and liver biopsies were performed at baseline; US was repeated during treatment and 6 months after its completion. Patients with SVRs at the 6-month follow-up were classified as responders; all others (those with no response or shorter responses) were considered nonresponders. RESULTS: Baseline US revealed perihepatic lymphadenopathy in 21.3% of the patients, and 31.6% of these patients were responders. In the responder subgroup, 16% of the patients experienced reductions in lymph node volume during treatment, whereas in the nonresponders, lymph node volume increased during treatment. In patients with no lymphadenopathy at baseline US, no lymph nodes were observed at US after the end of treatment, in either the responders or nonresponders. CONCLUSIONS: US is becoming increasingly important in the follow-up of chronic HCV patients. In our study, patients with hilar lymphadenopathy were usually nonresponders, and at the end of treatment their lymph node volume was significantly greater than that observed in the responder subgroup.
INTRODUCTION: To determine whether ultrasound (US) findings of perihepatic lymphadenopathy in patients with chronic hepatitis C (HCV) are predictive of failure to achieve sustained virological responses (SVR) to treatment with pegylated interferon (PEG-INF) alpha and ribavirin. MATERIALS AND METHODS: The study population included 89 patients with HCV treated with PEG-INF and ribavirin in 2003-2007. US scans and liver biopsies were performed at baseline; US was repeated during treatment and 6 months after its completion. Patients with SVRs at the 6-month follow-up were classified as responders; all others (those with no response or shorter responses) were considered nonresponders. RESULTS: Baseline US revealed perihepatic lymphadenopathy in 21.3% of the patients, and 31.6% of these patients were responders. In the responder subgroup, 16% of the patients experienced reductions in lymph node volume during treatment, whereas in the nonresponders, lymph node volume increased during treatment. In patients with no lymphadenopathy at baseline US, no lymph nodes were observed at US after the end of treatment, in either the responders or nonresponders. CONCLUSIONS: US is becoming increasingly important in the follow-up of chronic HCV patients. In our study, patients with hilar lymphadenopathy were usually nonresponders, and at the end of treatment their lymph node volume was significantly greater than that observed in the responder subgroup.
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