Introduction and study aim: Portal hypertension is one of the most important complications of liver cirrhosis. Endoscopic screening of all patients with liver cirrhosis would result in a large number of unnecessary additional burdens to endoscopic units. Activation of Kupffer cells is involved in the pathogenesis of portal hypertension. Soluble (s) CD163 is a macrophage scavenger receptor and a specific marker for macrophage activation in portal hypertension. This study was designed to assess soluble plasma (s) CD163 as noninvasive parameter for detection of esophageal varices in Child A compensated cirrhotic hepatitis C patients. Patients and Methods: This study included 86 subjects among of them 70 (Child A) post hepatitis C compensated cirrhotic patients in whom fibroscan were above 13 Kps (F4) and 16 healthy individuals as a control group who were enrolled in Hepatology Department and outpatient clinic at kafr Elsheikh liver research center at the period from June 2014 to June 2015. Upper gastrointestinal endoscopy was done to detect esophageal varices (EVs) and simultaneously serum soluble (s) CD163 measurement by ELISA was assessed in all individuals. Results: There was increase in soluble (s) CD163 in cirrhotic patients with and without esophageal varices, fairly three times more than control groups (10.46±1.73and 5.47±0.72 Vs 2.85±0.33 mg/L) (P value=0.001). In addition, (s) CD163 is nearly doubled in patients with esophageal varices (mean=10.46±1.73mg/L) than patients without varices (mean=5.47±0.72mg/L) (p value=0.001). By multivariate analysis of all studied parameters in cirrhotic patients, presence of EVs was associated with a low platelet count ( p=0.02), high body mass index ( p=0.029 ), low hemoglobin (p =0.001), low albumin (p=0.001), increased PV diameter (p =0.002 ), increased spleen size (p=0.001), high Child A score (in A6 than A5) (p =0.001 ), high FIB4 score (p =0.003), high Fibroscan results in (KPs) (p=0.001 ), high serum (S) CD163 level (p =0.001). Conclusion: (s) CD163 as serum marker of portal hypertension could potentially predict the presence of esophageal varices in Child A compensated cirrhotic hepatitis C patients. |
