Duplex Doppler assessment of portal vein congestive index in asymptomatic hepatitis B virus infected patients in a resource limited set-up: a case-control study

Background: A good number of patients with viral hepatitis are asymptomatic and detected as incidental findings. Early detection of the hemodynamic changes as well as prompt treatment is paramount to prevent the development of complications such as portal hypertension, liver cirrhosis and hepatocellular carcinoma. The congestive index (CI) of the portal vein has a high sensitivity and specificity in the diagnosis of hepatic fibrosis and portal hypertension and it is therefore imperative to assess these categories of patients using this index. The objective of this study is to compare the portal vein CI of patients with asymptomatic hepatitis B viral infection and normal individuals"Methods and Patients : This is an institution-based case-control study comprising 112 cases with serological diagnosis of hepatitis B viral infection and 112 age and sex-matched controls that were seronegative for hepatitis B and C viral infection and had normal LFT parameters. The CI of the participants were obtained using duplex Doppler ultrasound, and the data obtained were analyzed using statistical package for social sciences (IBM SPSS version 23.0. Armonk, NY).Result: 224 participants made of 112 cases and 112 age and sex-matched controls were evaluated. The age of the participants ranged from 18-63 years. 113 (50.4%) of the participants were males, while 111 (49.6%) were females. The mean value of the portal vein CI was 0.04±0.003cmS among controls and 0.06±0.01cmS among cases; however, the difference was not statistically significant (p 0.192). CI was noted to increase with age and was higher among the male gender, but the difference was also not significant statistically. Also, LFT parameters among the participants was higher in cases than the control and most were statistically significant except for ALP andAST.Conclusion: The CI of the portal vein and LFT parameters were higher in cases than control and and it may therefore be a useful tool in the assessment of patients with hepatitis, particularly in symptomatic cases.