Perihepatic lymph nodes as a marker of antiviral response in patients with chronic hepatitis C infection

OBJECTIVE. In patients with chronic hepatitis C, the sonographically determined total perihepatic lymph node volume reflects liver histology and viremia. Thr aim of this prospective study was to assess whether the response to antiviral therapy is reflected by changes in the total perihepatic lymph node volume. SUBJECTS AND METHODS. In 59 patients with chronic hepatitis C infection, the total perihepatic lymph node volume was assessed using sonography before the initiation of antiviral treatment, at the end of treatment. and at the end of a 6-month follow-up period. Hepatitis C viremia was assessed by reverse transcription-polymerase chain reaction assay at the same time points. Liver biopsy was performed in all patients before therapy and in 40 of the 59 patients 6 months after therapy. RESULTS. At the end of follow-up. the total perihepatic lymph node volume was significantly smaller in the 15 patients with a sustained virologic response than in the 44 patients who failed to respond to treatment (0.5 +/- 0.3 ml versus 2.0 +/- 1.2 ml, p < 0.0001). In the group of sustained virologic responders, the decline of the perihepatic lymph node volume was associated with an improvement in liver histology. CONCLUSION. Total perihepatic lymph node volume changes according to the antiviral response and leads to progressive normalization of the perihepatic lymph node volume in sustained virologic responders. A decrease in the perihepatic lymph node volume is associated with an improvement in liver histology.