CHRONIC HEPATITIS C-INFECTED PATIENTS;

Assessment of relationship between serum alanine aminotranferase levels and liver histology

Abstract

Background: In our region the sensitivity of serum alanine aminotransferase (ALT) levels in predicting the severity of
hepatitis C virus (HCV) infection is unclear. Objective: To compare histologic scoring of liver pathology in patients with chronic HCV
infection with normal or elevated serum ALT. Study Design: Prospective observational study. Place & Duration of Study: Liver clinic,
Ghulam Mohammad Mahar Medical College Hospital, Sukkur, between January 2010 and December 2010. Methods: Liver biopsies were
performed in patients with HCV infection and either normal (n=40) or elevated (n=76) serum ALT levels, and scored for activity and
fibrosis using the modified histological activity index. Results: Patients with normal ALT and elevated ALT had similar demographic
features. Median (range) histological activity grade was higher in patients with elevated ALT than in those with normal ALT (6 [1-15] vs. 5
[0-11], respectively; p=0.001), as was the fibrosis stage (2 [0-6] vs. 1 [0-6]; p=0.02). Two patients with normal ALT and 4 with elevated
ALT had liver cirrhosis. Conclusions: Among patients with chronic HCV infection, liver lesions are milder in those with normal serum ALT
levels than those with abnormal ALT levels. However, some patients with normal ALT too may have advanced liver disease.