gms | German Medical Science

10. Kongress für Infektionskrankheiten und Tropenmedizin (KIT 2010)

Deutsche Gesellschaft für Infektiologie,
Deutsche AIDS-Gesellschaft,
Deutsche Gesellschaft für Tropenmedizin und Internationale Gesundheit,
Paul-Ehrlich-Gesellschaft für Chemotherapie

23.06. - 26.06.2010, Köln

Evaluation of risk for esophageal varices by transient elastometry (Fibroscan®) in patients with liver cirrhosis and HIV- and HCV-infection

Risikoevaluierung von Ösophagusvarizen durch transiente Elastometrie mittels Fibroscan® bei Patienten mit Leberzirrhose durch HIV- und HCV-Infektion

Meeting Abstract

  • M.K. Mausolf - Vivantes Auguste Viktoria Klinikum, Gastroenterologie und Infektiologie, Berlin, Germany
  • M. Berger - Vivantes Auguste Viktoria Klinikum, Gastroenterologie und Infektiologie, Berlin, Germany
  • J. Breitkreutz - Vivantes Auguste Viktoria Klinikum, Gastroenterologie und Infektiologie, Berlin, Germany
  • J. Hartikainen - Vivantes Auguste Viktoria Klinikum, Gastroenterologie und Infektiologie, Berlin, Germany
  • U. Joppek - Vivantes Auguste Viktoria Klinikum, Gastroenterologie und Infektiologie, Berlin, Germany
  • H. Stocker - Vivantes Auguste Viktoria Klinikum, Gastroenterologie und Infektiologie, Berlin, Germany
  • C. Weber - Vivantes Auguste Viktoria Klinikum, Gastroenterologie und Infektiologie, Berlin, Germany
  • K. Arastéh - Vivantes Auguste Viktoria Klinikum, Gastroenterologie und Infektiologie, Berlin, Germany
  • P. Ingiliz - Vivantes Auguste Viktoria Klinikum, Gastroenterologie und Infektiologie, Berlin, Germany

10. Kongress für Infektionskrankheiten und Tropenmedizin (KIT 2010). Köln, 23.-26.06.2010. Düsseldorf: German Medical Science GMS Publishing House; 2010. DocP58

DOI: 10.3205/10kit114, URN: urn:nbn:de:0183-10kit1144

Published: June 2, 2010

© 2010 Mausolf et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.


Outline

Text

Objectives: To evaluate the risk for esophageal varices in patients with end-stage liver disease by transient elastometry (Fibroscan®).

Methods: Patients of our outpatient liver unit with Fibroscan® values higher than 12.5 kPa underwent esophago-gastro-duodenoscopy. An interval of 12 months between gastroscopy and elastometry was accepted. Safety criteria for Fibroscan were 10 valid measurements, a success rate over 60% and an interquartile range <30%, and patients not meeting these criteria were excluded. Esophageal varices ≥1 according to the Paquet classification were taken into account.

Results: 68 patients were included. Of those, 29.4% were female and 88% caucasian. Median age was 49 years, median body mass index (BMI) was 23.42 kg/m2. Liver disease was caused by hepatitis C virus (HCV) infection in 29%, bý human immunodeficiency virus (HIV)-HCV coinfection in 46%, by HIV monoinfection in 9% and miscellanous in 16%.

17 patients (25%) had gastroscopic evidence of esophageal varices ≥1 according to the Paquet classification. Patients with varices were mainly male, but were not different to the non-varices group with regards to age, BMI or diagnosis.

Median Fibroscan® values were 35.8 kPa in the varices group and 19.2kPa in the non-varices group.

Conclusion: Transient elastometry strongly indicates the presence of varices in patients with end-stage liver disease by higher stiffness values. However, the thresholds used to classify liver cirrhosis (e.g. 12.5 kPa) do not indicate the presence of varices. Further evaluation is needed to classify patients at high risk for gastric bleeding with non-invasive techniques.