PERIHEPATIC LYMPHADENOPATHY - A MARKER OF RESPONSE TO INTERFERON-ALPHA IN CHRONIC HEPATITIS-C

BACKGROUND/AIMS: Recently it was shown that perihepatic lymphadenopath y (PHL) correlates with histological activity in chronic hepatitis C. However, the question whether there is a correlation between the respo nse to interferon alpha and PHL has not yet been raised. METHODOLOGY: We examined 103 patients who had been treated with interferon alpha fo r hepatitis C. Prior to treatment all patients had undergone high reso lution ultrasonography. Thirty-six patients had follow up ultrasound s cans 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. RESU LTS: Classification of PHL prior to treatment revealed 40 patients wit h PHL I, 30 with grade II and 33 with grade III. Hepatic inflammatory activity according to the Ishak score was increased in patients with P HL 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 increas e of PHL in one out of 13 primary responder vs. 10 out of 23 non-respo nder (p=0.03). CONCLUSIONS: In conclusion, monitoring of PHL by abdomi nal ultrasonography is a simple, noninvasive and cheap additional mark er of response to interferon alpha.