Hany Khattab1, Ahmed Fouad2, Maya Hamza1, Mohammad A Mohey3, Wafaa El-Akel2, Hossam Ghoneim4, Amr Abul-Fotouh2, Gamal Esmat2. 1. Department of Pathology, Faculty of Medicine, Cairo University, Cairo, Egypt. 2. Department of Endemic Medicine and Hepatology, Faculty of Medicine, Cairo University, Cairo, Egypt. 3. Department of Endemic Medicine and Hepatology, Faculty of Medicine, Cairo University, Cairo, Egypt. Electronic address: ma_mohey@yahoo.com. 4. Department of Tropical Medicine and Hepatology, Faculty of Medicine, Beni-Sueif University, Beni Sueif, Egypt.
Abstract
BACKGROUND AND STUDY AIMS: Worldwide, Egypt has a high prevalence of adult hepatitis C virus (HCV) infection. Serum alanine aminotransferase (ALT) activity is most commonly measured to assess hepatic disease. The revision of the definition of the normal limits for the ALT level is advisable. The aim of this work was to compare the histopathological changes in the liver tissue biopsies of HCV-infected patients, clinically presenting with ALT levels below normal, based on the conventional, previously used upper limit of normal (ULN) of ALT (40U/L for men and 30U/L for women) with the proposed new ULN (30U/L for men, and 19U/L for women). PATIENTS AND METHODS: This is a retrospective cross-sectional study. A total of 668 cases of chronic hepatitis C genotype 4 were included. Patients were classified according to grades of histological activity and fibrosis stages (by the Metavir scoring system). They were also classified into normal and high groups according to the old and new cutoffs of both aspartate transaminase (AST) and ALT levels. RESULTS: The results of our study showed that the serum AST level in our study showed a better correlation with the histopathological changes in liver biopsy rather than ALT, especially when using the old cutoff of the ULN for AST. The serum ALT level in our study (both the old and the new cutoffs) did not show a significant correlation with the histopathological status in the liver biopsies of our patients. CONCLUSION: This study concluded that the old cutoff of the ULN AST is a better predictor of fibrosis.
BACKGROUND AND STUDY AIMS: Worldwide, Egypt has a high prevalence of adult hepatitis C virus (HCV) infection. Serum alanine aminotransferase (ALT) activity is most commonly measured to assess hepatic disease. The revision of the definition of the normal limits for the ALT level is advisable. The aim of this work was to compare the histopathological changes in the liver tissue biopsies of HCV-infectedpatients, clinically presenting with ALT levels below normal, based on the conventional, previously used upper limit of normal (ULN) of ALT (40U/L for men and 30U/L for women) with the proposed new ULN (30U/L for men, and 19U/L for women). PATIENTS AND METHODS: This is a retrospective cross-sectional study. A total of 668 cases of chronic hepatitis C genotype 4 were included. Patients were classified according to grades of histological activity and fibrosis stages (by the Metavir scoring system). They were also classified into normal and high groups according to the old and new cutoffs of both aspartate transaminase (AST) and ALT levels. RESULTS: The results of our study showed that the serum AST level in our study showed a better correlation with the histopathological changes in liver biopsy rather than ALT, especially when using the old cutoff of the ULN for AST. The serum ALT level in our study (both the old and the new cutoffs) did not show a significant correlation with the histopathological status in the liver biopsies of our patients. CONCLUSION: This study concluded that the old cutoff of the ULN AST is a better predictor of fibrosis.
Authors: Leonn Mendes Soares Pereira; Ednelza da Silva Graça Amoras; Simone Regina Souza da Silva Conde; Sâmia Demachki; Eduardo José Melo Dos Santos; Sandra Souza Lima; Ricardo Ishak; Antonio Carlos Rosário Vallinoto Journal: Mol Med Date: 2020-01-29 Impact factor: 6.354