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J Addict Med. 2014 Jan-Feb;8(1):53-8. doi: 10.1097/ADM.0000000000000006.

Common bile duct dilatation in drug users with chronic hepatitis C is associated with current methadone use.

Author information

  • 1From the Department of Research (SJL, BPXG, CEAL, MP), Cluster Infectious Diseases, Public Health Service Amsterdam, Amsterdam, the Netherlands; Center of Infectious Diseases and Immunology Amsterdam (BPXG, CEAL, MP) and Department of Gastroenterology and Hepatology (UB, CJW), Academic Medical Center, Amsterdam, the Netherlands; and Department of Internal Medicine (MP), Division of Infectious Diseases, Tropical Medicine and AIDS, Academic Medical Center, Amsterdam, the Netherlands.

Abstract

OBJECTIVES:

Dilatation of the common bile duct (CBD) can be an ominous sign for malignancy of the pancreatobiliary tract; however, it has also been described as a presumably harmless side effect of opioid use. We investigated the prevalence and determinants of CBD dilatation among drug users receiving methadone maintenance therapy in the Netherlands.

METHODS:

A cross-sectional study was conducted in a prospectively studied and well-defined cohort of drug users with chronic hepatitis C virus infection, attending the Public Health Service of Amsterdam, the Netherlands. Patients underwent abdominal ultrasonography as part of pretreatment screening. A multivariable logistic regression model was used to analyze potential demographic and drug use-related determinants of radiological CBD dilatation.

RESULTS:

Between September 2004 and December 2011, 222 hepatitis C virus-infected drug users were evaluated. Dilatation of the CBD was found in 50 of 222 patients (22.5%), with a median diameter of 8.0 mm (interquartile range, 7.0 to 10.0; n = 43). Dilatation was associated with current use of methadone (adjusted odds ratio = 20.50; 95% confidence interval, 2.79 to 2.61 × 10(3)), independent of the current methadone dose, and with age per 10-year increase (adjusted odds ratio = 1.68; 95% confidence interval, 1.06 to 2.71). Regular use of heroin in the 6 months before ultrasonography was not found to be associated with dilatation.

CONCLUSIONS:

Dilatation of the CBD is common in drug users under methadone treatment and seems to be a harmless side effect of opioid agonists.

PMID:
24394497
[PubMed - indexed for MEDLINE]
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