Hypoalbuminemia: A marker of esophageal varices in chronic liver disease due to hepatitis B and C

Objective: To evaluate Serum albumin as a marker of Esophageal Varices (EV) in chronic liver disease (CLD) due to hepatitis B and C. Method: In this prospective, cross-sectional study, patients with CLD due to HBV and HCV were assessed as per Child-Pugh class. All patients had full blood count, HBsAg, Anti-HCV antibodies by ELISA, abdominal ultrasound and Esophago-gastroduodenoscopy (EGD). Patients were divided into Group A (serum albumin <3.5 gm %) and Group B (normal serum albumin). Results: Ninety-seven male (49.2%) and 100 female patients (50.8%)] with age range of 15 to 80 years were evaluated. Mean Serum albumin was 3.8 gm%, (range 2.4-4.9). EV were present in 63 patients (32%) and absent in 134 patients (68%). Group A had 57 patients (28.9% of the total) with 35 patients having EV. Group B had 140 patients (71.1% of the total) with 28 patients having EV. Sensitivityof hypoalbuminemia as a marker of EV was 53.2% and specificity 91%, positive predictive value 73.3% and negative predictive value 80.8% and odds ratio was 11.57. Spearman's rank correlation showed a significant negative correlation of '-0.494' between serum albumin and EV. ROC curve showed 70.7% area under the curve for albuminemia of <3.5 gm%. Conclusions: Hypoalbuminemia is a good surrogate marker for the presence of esophageal varices in CLD due to hepatitis B and C viruses.