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Journal of Addiction Medicine:
doi: 10.1097/ADM.0000000000000006
Original Research

Common Bile Duct Dilatation in Drug Users With Chronic Hepatitis C Is Associated With Current Methadone Use

Leopold, Stije J. MSc; Grady, Bart P. X. MD; Lindenburg, Catharina E. A. MD; Prins, Maria PhD; Beuers, Ulrich MD, PhD; Weegink, Christine J. MD, PhD

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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 × 103), 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.

© 2014 American Society of Addiction Medicine

    

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