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The role of real-time ultrasonography in predicting esophageal varices in hemophiliacs co-infected with hepatitis C and human immunodeficiency virus.
- Source :
-
Haematologica [Haematologica] 2005 Feb; Vol. 90 (2), pp. 207-13. - Publication Year :
- 2005
-
Abstract
- Background and Objectives: Endoscopic procedures are the gold standard for the diagnosis of esophageal varices but these invasive methods are complex to perform in hemophilic patients co-infected with hepatitis C virus/human immunodeficiency virus (HCV/HIV). Real-time ultrasonography has been reported to be an effective, non-invasive procedure able to monitor patients with chronic liver disease and to give useful information for the diagnosis of liver cirrhosis, portal hypertension and the presence of esophageal varices.<br />Design and Methods: Seventy patients with severe hemophilia were evaluated by esophago-gastro-duodenoscopy (EGDS) and ultrasonography; 40 had HCV/HIV co-infection and 30, comparable for age and HCV exposure time, were HCV+/HIV-. Hepatic longitudinal diameter, splenic longitudinal diameter, portal vein diameter and the average speed of portal flow were measured. The congestion index was calculated.<br />Results: Thirteen out of 40 (32.5%) HCV/HIV coinfected patients had esophageal varices. None out of 30 HCV+/HIV- patients had esophageal varices (p< 0.001). Univariate analysis showed that the 13 HCV/HIV coinfected patients with esophageal varices had significantly higher hepatic longitudinal diameter (p=0.006), splenic longitudinal diameter (p=0.0002), portal vein diameter (p=0.0005) and congestion index (p=0.0001) than did the remaining 27 HCV/HIV coinfected patients. The stepwise logistic regression analysis indicated that, of the various ultrasonographic parameters evaluated, splenic longitudinal diameter and portal vein diameter had the greatest diagnostic efficiency in diagnosing a high proportion of patients with esophageal varices. The diagnostic efficiency of the combined criterion expressed by the area under the ROC curve was 0.8803. Interpretation and Conclusions. Real-time ultrasonography, by evaluation of splenic longitudinal diameter and portal vein diameter, is an effective non-invasive technique able to classify correctly a large proportion of HCV/HIV co-infected hemophilic patients with esophageal varices.
- Subjects :
- Adult
Computer Systems
Endoscopy
False Positive Reactions
Female
Hemostasis
Humans
Male
Middle Aged
Prospective Studies
ROC Curve
Esophageal and Gastric Varices diagnosis
Esophageal and Gastric Varices diagnostic imaging
HIV Infections complications
Hemophilia A complications
Hepatitis C complications
Ultrasonography methods
Subjects
Details
- Language :
- English
- ISSN :
- 1592-8721
- Volume :
- 90
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Haematologica
- Publication Type :
- Academic Journal
- Accession number :
- 15710573