{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T23:15:29Z","timestamp":1789773329859,"version":"4.0.1"},"reference-count":39,"publisher":"Public Library of Science (PLoS)","issue":"10","license":[{"start":{"date-parts":[[2022,10,13]],"date-time":"2022-10-13T00:00:00Z","timestamp":1665619200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Objectives<\/jats:title>\n<jats:p>To investigate the clinical characteristics, risk factors, and predictors of esophagogastric variceal bleeding in patients with hepatitis C virus (HCV)-induced liver cirrhosis.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>This comparative observational study was carried out on 100 patients suffering from post hepatitis cirrhosis and portal hypertension who were admitted to the Internal Medicine Department, Al-Azhar University Hospital, Damietta Egypt. Patients were classified into two groups: 50 of them presented with esophagogastric varices with acute variceal bleeding, and 50 patients presented without bleeding. Data were collected, coded, revised, and entered into the Stata software version 16.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>The mean age of patients with bleeding was slightly higher than those without bleeding (55.58 \u00b1 5.89 vs. 52.54 \u00b1 9.01 years), p = 0.049. Mild ascites, positive H.Pylori, and Child-Pugh score B and C were an independent predictors of esophagogastric variceal bleeding (OR = 0.036, 95% CI: 0.0004\u20130.36; p = 0.005), (OR = 7.36, 95% CI: 1.44\u201337.59; p = 0.016), (OR = 19.0, 95% CI: 2.02\u2013186.3; p = 0.010), and (OR = 40.51, 95% CI: 2.18\u2013751.31; p = 0.013). The sensitivity of this model was 93.88%, specificity was 53.85%, PPV was 88.46%, NPV was 70.0%, correctly classified patients were 85.48%, and AUC was 90.27%. In the second model, pepsinogen level higher than 43.5 \u03bcg\/l, AST (&gt;54.5), Bilirubin (&gt;1.45), and Hemoglobin (&gt;11.5) were a significant independent predictors of esophagogastric variceal bleeding (OR = 1.18, 95% CI: 1.09\u20131.27; p&lt;0.001), (OR = 1.14, 95% CI: 1.03\u20131.27; p = 0.007), (OR = 5.55, 95% CI: 1.21\u201325.43; p = 0.027), and (OR = 0.05, 95% CI: 0.008\u20130.32; p = 0.002), respectively. The sensitivity of this model was 92%, specificity was 98%, PPV was 97.87%, NPV was 92.45%, correctly classified patients were 95%, and AUC was 98.68%.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>The independent predictors of esophagogastric variceal bleeding were ascites, positive H. pylori, Child-Pugh score B and C, pepsinogen level higher than 43.5 \u03bcg\/l, AST (&gt;54.5), bilirubin (&gt;1.45), and hemoglobin (&gt;11.5). Laboratory investigations are more reliable in predicting variceal bleeding and excluding non-variceal bleeding; however, clinical symptoms should not be neglected, especially H. pylori infection, ascites, and Child-Pugh score.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0275373","type":"journal-article","created":{"date-parts":[[2022,10,13]],"date-time":"2022-10-13T17:38:44Z","timestamp":1665682724000},"page":"e0275373","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":13,"title":["Clinical characteristics and predictors of esophagogastric variceal bleeding among patients with HCV-induced liver cirrhosis: An observational comparative study"],"prefix":"10.1371","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9813-9777","authenticated-orcid":true,"given":"Saad El Deen Mohamed","family":"El Sheref","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shimaa","family":"Afify","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9925-9279","authenticated-orcid":true,"given":"Mahmoud S.","family":"Berengy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2022,10,13]]},"reference":[{"key":"pone.0275373.ref001","doi-asserted-by":"crossref","first-page":"252","DOI":"10.1272\/jnms.80.252","article-title":"Risk factors for bleeding esophagogastric varices.","volume":"80","author":"H Yoshida","year":"2013","journal-title":"J Nippon Med Sch"},{"key":"pone.0275373.ref002","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1586\/egh.12.83","article-title":"Assessing portal hypertension in liver diseases","volume":"7","author":"A Berzigotti","year":"2013","journal-title":"Expert Rev Gastroenterol Hepatol"},{"key":"pone.0275373.ref003","doi-asserted-by":"crossref","first-page":"541836","DOI":"10.1155\/2013\/541836","article-title":"Gastrointestinal Bleeding in Cirrhotic Patients with Portal Hypertension.","volume":"2013","author":"E. 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