ABSTRACT

In this study, liver histology of the patients with chronic hepatitis C who have normal or near-normal serum alanine aminotransferase (ALT) levels were compared with the patients who have high levels of ALT.

Forty patients with hepatitis C who had repeatedly normal or nearnormal ALT levels and 40 patients who had persistently elevated ALT levels entered the study. In all patients, ALT levels were measured on two or more occasions bejare a liver biopsy was performed. All patients were hepatitis C virus RNA-positive by reverse transcriptase-polymerase chain reaction. Liver biopsies were performed with standart techniques. Biopsy specimens were read by the same pathologist and scored using the Modified Knodell Scoring System. Among the 40 patients with persistently elevated ALT levels, 37,5% had mild or minimal hepatitis, 62,5% had moderate to severe hepatitis. In the second group of patients these percentages were 52,5% and 47,5% respectively.The degree of liver damage did not differ between two groups of patients (p>0.05). In the group ofpatients with elevated ALT levels 55,3% had mild to moderate fibrosis, 31,6% had severe fibrosis, and 13,2% had cirrhosis.ln the second group ofpatients these percentages were 78,9% and 21,1% respectively.Cirrhosis was absent in this group ofpatients. Patients suffering from ALT increase show ed higher fibrosis score than those who did not (p<0,05).

In conclusion this study showed that in patients with chronic hepatitis C the liver biopsy is more convenient than serum ALT level for demonstrating the liver damage. ALT level may show the grade of fibrosis.