title: Common bile duct dilatation in drug users with chronic hepatitis C is associated with current methadone use.
abstract: OBJECTIVE
  Dilatation of the common bile duct (CBD) can be an ominous sign for malignancy of the pancreatobiliary tract; however, it has also been described as a presumably harmless side effect of opioid use. We investigated the prevalence and determinants of CBD dilatation among drug users receiving methadone maintenance therapy in the Netherlands.
  
  
  METHODS
  A cross-sectional study was conducted in a prospectively studied and well-defined cohort of drug users with chronic hepatitis C virus infection, attending the Public Health Service of Amsterdam, the Netherlands. Patients underwent abdominal ultrasonography as part of pretreatment screening. A multivariable logistic regression model was used to analyze potential demographic and drug use-related determinants of radiological CBD dilatation.
  
  
  RESULTS
  Between September 2004 and December 2011, 222 hepatitis C virus-infected drug users were evaluated. Dilatation of the CBD was found in 50 of 222 patients (22.5%), with a median diameter of 8.0 mm (interquartile range, 7.0 to 10.0; n = 43). Dilatation was associated with current use of methadone (adjusted odds ratio = 20.50; 95% confidence interval, 2.79 to 2.61 × 10(3)), independent of the current methadone dose, and with age per 10-year increase (adjusted odds ratio = 1.68; 95% confidence interval, 1.06 to 2.71). Regular use of heroin in the 6 months before ultrasonography was not found to be associated with dilatation.
  
  
  CONCLUSIONS
  Dilatation of the CBD is common in drug users under methadone treatment and seems to be a harmless side effect of opioid agonists.
authors.affiliation: From the Department of Research (SJL, BPXG, CEAL, MP), Cluster Infectious Diseases, Public Health Service Amsterdam, Amsterdam, the Netherlands; Center of Infectious Diseases and Immunology Amsterdam (BPXG, CEAL, MP) and Department of Gastroenterology and Hepatology (UB, CJW), Academic Medical Center, Amsterdam, the Netherlands; and Department of Internal Medicine (MP), Division of Infectious Diseases, Tropical Medicine and AIDS, Academic Medical Center, Amsterdam, the Netherlands.
authors.forename: Stije J
authors.initials: SJ
authors.lastname: Leopold
authors.forename: Bart P X
authors.initials: BP
authors.lastname: Grady
authors.forename: Catharina E A
authors.initials: CE
authors.lastname: Lindenburg
authors.forename: Maria
authors.initials: M
authors.lastname: Prins
authors.forename: Ulrich
authors.initials: U
authors.lastname: Beuers
authors.forename: Christine J
authors.initials: CJ
authors.lastname: Weegink
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D003137:Common Bile Duct Diseases / Q000000981:diagnostic imaging / Q000473:pathology / Q000821:virology*; D003430:Cross-Sectional Studies; D004108:Dilatation, Pathologic; D018450:Disease Progression; D005260:Female; D019698:Hepatitis C, Chronic / Q000000981:diagnostic imaging / Q000473:pathology*; D006801:Humans; D008297:Male; D008691:Methadone / Q000008:administration & dosage* / Q000009:adverse effects; D008875:Middle Aged; D058850:Opiate Substitution Treatment / Q000379:methods / Q000706:statistics & numerical data*; D009293:Opioid-Related Disorders / Q000188:drug therapy* / Q000473:pathology / Q000821:virology*; D014463:Ultrasonography
chemical_list: D008691:Methadone