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Large perihepatic lymph nodes found prevalent in HBV patients

Patients with chronic hepatitis B virus infection had larger lymph nodes and greater seroconversion rate vs. patients without the infection and in patients with the infection who did not experience seroconversion, according to study data.

“It has been observed that enlargement of perihepatic lymph nodes may be seen in patients with chronic hepatitis B, particularly during acute flares,” the researchers wrote. “We hypothesized that there may be a correlation between the nodal change patterns in [chronic hepatitis B] patients with acute flare and [hepatitis B e antigen] status.”

Researchers analyzed the size of perihepatic lymph nodes in 87 patients with acute flares of chronic hepatitis B (CHB) and followed them for a median of 43 months. All patients were divided into three groups based on hepatitis B e antigen (HBeAg) status: 26 were HBeAg-positive with HBeAg seroconversion during follow-up, 29 were HBeAg-positive without HBeAg seroconversion during follow-up and 32 were HBeAg-negative during acute exacerbation. 

Overall, patients positive for HBeAg and seroconversion during follow-up had the highest incidence rate for enlarged lymph nodes compared with those positive for HBeAg without seroconversion and HBeAg-negative (92.3% vs. 75.8% vs. 46.8%; P = .003).

The baseline median nodal volume was 37.7 mm³ in patients positive for HBeAg and seroconversion, 25.48 mm³ for HBeAg-positive patients without seroconversion and 18.11 mm³ for HBeAg-negative patients (P = .0113).

Nodal changes between acute flare and recovery stages were more eminent in the patients positive for HBeAg (P = .001), with patients positive for HBeAg and seroconversion showing a 29.58 mm³ change in volume, HBeAg-positive patients without seroconversion showing 10.36 mm³ change and HBeAg-negative patients  showing just a 1.77 mm³ change in volume (P = .0009).

Univariate analysis showed that patients positive for HBeAg were younger (P < .01), had earlier liver parenchymal change (P < .0055), higher HBV DNA levels (P < .005) and larger nodal size (P < .001) compared with the HBeAg-negative patients. The only major differences between the HBeAg-positive and negative patients were nodal width at acute flare stage (P < .0253) and HBV DNA levels (P < .0168).

The area under receiving operating characteristic curve was used to measure nodal width, and predicted HBeAg seroconversion in patients with CHB with acute flare at 0.8052. The curve also predicted that if nodal width during acute flare was above 8 mm and the interval change of nodal width was over 3 mm, the incidence rate for HBeAg seroconversion would be 75% (P < .001), according to the research.

“Larger perihepatic lymph nodes are seen in CHB acute flare patients with positive HBeAg and the magnitude of nodal width change may predict HBeAg seroconversion at recovery,” the researchers concluded. – by Melinda Stevens

Disclosure: The researchers report no relevant financial disclosures.