Perihepatic lymphadenopathy: a marker of response to interferon alpha in chronic hepatitis C.
OBJECTIVE
Recently it was shown that perihepatic lymphadenopathy (PHL) correlates with histological activity in chronic hepatitis C. However, the question whether there is a correlation between the response to interferon alpha and PHL has not yet been raised.


METHODS
We examined 103 patients who had been treated with interferon alpha for hepatitis C. Prior to treatment all patients had undergone high resolution ultrasonography. Thirty-six patients had follow up ultrasound scans during the course of the treatment. According to size and number of lymph nodes we introduced a grading of the PHL and determined grade I as minimal, grade II as medium and grade III as extensive PHL.


RESULTS
Classification of PHL prior to treatment revealed 40 patients with PHL I, 30 with grade II and 33 with grade III. Hepatic inflammatory activity according to the Ishak score was increased in patients with PHL III (9.1+/-2.4) compared to PHL II (6.7+/-2.9) and PHL I (7.3+/-3.1) (p=0.01). In patients with PHL grade I prior to treatment 45% were initial responder, patients with grade II or III showed response rates of 40% and 33%, respectively. During therapy we found an increase of PHL in one out of 13 primary responder vs. 10 out of 23 non-responder (p=0.03).


CONCLUSIONS
In conclusion, monitoring of PHL by abdominal ultrasonography is a simple, non-invasive and cheap additional marker of response to interferon alpha.
Department of Gastroenterology and Hepatology, Medizinische Hochschule, Hannover, Germany.
H
H
Wedemeyer
J
J
Ockenga
H
H
Frank
H L
HL
Tillmann
A
A
Schuler
M
M
Caselitz
M
M
Gebel
C
C
Trautwein
M P
MP
Manns
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D019698:Hepatitis C, Chronic / Q000000981:diagnostic imaging* / Q000188:drug therapy*; D006801:Humans; D016898:Interferon-alpha / Q000627:therapeutic use*; D008206:Lymphatic Diseases / Q000145:classification / Q000000981:diagnostic imaging* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D014463:Ultrasonography
D016898:Interferon-alpha