This study was aimed at evaluating the gastric endoscopic features in patients with liver cirrhosis and at assessing whether endoscopic findings correlated with the severity of portal hypertension and of the underlying liver disease. We studied 394 cirrhotic patients and 110 controls. Prevalence of a mosaic-like pattern of the gastric mucosa was significantly higher in cirrhotics than controls (80.5 vs. 0.9%; p < 0.001). Red spots of the gastric mucosa were found in 8.1% of cirrhotic patients and in none of the control subjects. Erosions and petechiae were found in 14.5 and 5.4% of the control population, but their prevalence was significantly higher in cirrhotics (28.7 and 12.7%, respectively; p < 0.05). Severity of the mosaic-like pattern as well as the presence of red spots were closely related to the size and hemorrhagic risk of esophageal varices and to the presence of fundic varices. Also, severe mosaic-like patterns were found more frequently in patients with severe impairment of liver function, as assessed by the Child-Pugh’s criteria. Furthermore, the mosaic-like pattern was more severe in cirrhotic patients with a higher degree of portal hypertension as indirectly assessed by measurement of esophageal intravariceal pressure. In conclusion, (1) a mosaic-like pattern and red spots of the gastric mucosa are the only specific signs of congestive gastropathy in liver cirrhosis, and (2) the severity of the mosaic-like pattern correlates with the severity of liver dysfunction and of portal hypertension.
It is still controversial whether the familial environment plays a role in the diffusion of HCV infection. The aim of this study was to evaluate the prevalence of anti-HCV positivity in the household contacts of patients with HCV-related chronic hepatitis. Nearly all the household contacts of 113 subjects with anti-HCV+ chronic hepatitis (100/113 spouses and 260/290 children) were investigated. Anti-HCV was determined by means of ELISA II and was confirmed by RIBA II. Anti-HCV positivity was found in 27% of the spouses and in 1.9% of the children. Prevalence of anti-HCV positivity in spouses correlated positively with the duration of the marital status. Seventeen/32 (53.1%) of anti-HCV-positive subjects were found to have chronic hepatitis. This study indicates that intrafamilial diffusion of HCV infection is mostly accounted for by horizontal, in particular spouse to spouse, transmission and that spouse to spouse transmission of HCV infection correlates positively with the duration of marital status.
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