EVALUATION OF LIVER HISTOLOGY, ALT ELEVATION, AND HCV RNA TITER
IN PATIENTS WITH CHRONIC HEPATITIS-C
OBJECTIVE:
Hepatic histological evaluation is currently the gold standard to
determine the degree of liver injury in chronic hepatitis C. It is
unclear whether degree of serum ALT elevation or quantitative
hepatitis C virus (HCV) RNA can predict level of histological
damage,
METHODS:
Fifty nine biopsies from 44 patients with chronic hepatitis C were
reviewed, The amount of liver damage was quantified using the
Histology Activity Index (HAI) and was compared with serum ALT and,
in 26 biopsies, quantitative HCV RNA (branched DNA amplification,
Quantiplex, Chiron),
RESULTS:
A statistically significant linear relationship was noted between
degree of ALT elevation and amount of liver injury based on HAI
score (p < 0.05) although this relationship was not
statistically strong (r(s) = 0.4900), No significant correlation
was noted between serum ALT and HCV RNA titer (r(s) = 0.4044) or
between quantitative HCV RNA titer and HAI score (r(s) = 0.3506),
No individual component of the HAI correlated with ALT or HCV
RNA,
CONCLUSIONS:
Although there is a correlation between serum ALT and degree of
hepatic injury based on HAI score, this relationship is weak and
probably of no clinical use, There is no significant correlation
between HCV RNA and serum ALT or HCV RNA and degree of hepatic
injury in individual patients, Hepatic histological evaluation
continues to be required for clinical assessment of patients with
chronic hepatitis C.
Authors: MH SJOGREN, WALTER REED ARMY MED CTR, DEPT CLIN
INVEST, DEPT GASTROENTEROL, WASHINGTON, DC 20307 Publication:
AMERICAN JOURNAL OF GASTROENTEROLOGY 1996 AUG; 91(8):1516-1522
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