Vol.14, No 1, 2007 pp. 19 - 24
UC
616.36-002.2:616.36.003.8-07
SERUM TRANSAMINASE LEVELS AND FIBROSE STAGE
IN ZERO BIOPSY OF THE LIVER IN CHRONIC HEPATITIS C
Elvira Luka1, Jasmina Gligorijević2, Ljiljana Konstantinović3
1Health center Novi Pazar, Serbia
2Institute for Pathology Niš, Serbia
3Clinic for Infective Diseases Niš, Serbia
E-mail: jasminag@EUnet.yu
Summary.
An infection by hepatitis virus C causes damage and inflammation in the liver, which is responsible for the development of liver fibrosis. Natural history of fibrosis in chronic hepatitis is gained to the inflammation in and around portal tracts, as an immunological event whose influence to fibro-genesis is not clarified. A marked characteristic of chronic hepatitis C (HHC) is mild symptomatology with frequent discrepancy of biochemical parameters and morphological findings, thus escaping the diagnosis in the early phases of disease. The aim of the investigation was to determine the correlation of serum transaminase levels to morphological changes and state of fibrosis in zero biopsy of the liver i.e. at the time of making the diagnosis of "chronic hepatitis C". The analyses were done in 23 patients with HHC, mean age 32.78 years, who underwent blind aspiration liver biopsies. Despite histological parameters, we analysed routes of the infection and serum levels of aspartat transaminase (AST) and alanin aminotransferase (ALT). The results showed that 50% of patients had only slightly elevated AST levels, while ALT was above normal ranges in all tested patients. HAI have demonstrated marked variations among individuals. Only five patients were without fibrosis. They had normal AST serum levels statistically significantly lower than in patients with fibrosis (p<0.05). The values of ALT were the highest in the cases with advanced fibrosis. The results showed statistically significant relation of ALT levels to the stage of fibrosis in HHC group of patients (p<0.01). In conclusion, AST and ALT serum levels are in significant mutual dependence ratio to a degree of fibroses, so they are recommended for taking care of the disease and degree of fibrosis.
Key words:
Hepatitis C, ALT, AST, fibrosis
NIVOI SEUMSKIH TRANSAMINAZA I STEPEN FIBROZE
U NULTOJ BIOPSIJI JETRE U HRONIČNOM C HEPATITISU
Kratak sadržaj:
Infekcija virusom hepatitisa C doprinosi oštećenju i zapaljenju jetre koje je odgovorno za nastanak fibroze u jetri. Prirodna istorija fibroze je povezana sa zapaljenjem u i oko portnog prostora kao imunološki događaj, čiji uticaj na fibrogenezu nije rasvetljen. Markantna odlika hroničnog hepatitisa C (HHC) je blaga simptomatologija i često, diskrepanca laboratorijskih pokazatelja funkcije jetre i morfoloških promena, što je razlog otkrivanju bolesti u odmaklim morfološkim fazama. Cilj ovog rada je utvrđivanje korelacije vrednosti serumskih transaminaza sa stepenom histološke aktivnosti i fibroze u vreme analize nulte biopsije jetre. Istraživanje obuhvata 23 pacijenta sa HHC kojime su podvrgnute aspiracionoj biopsiji jetre. Analiza obuhvata: put i način infekcije, starost, pol, vrednosti serumske aspartat amino transferaze (AST), alanin amino transferaze (ALT), stepen histološke aktivnosti (HAI) i stepen fibroze u momentu uzimanja nulte biopsije jetre. Rezultati su pokazali da oko 50% ispitanika ima samo blago povišene vrednosti AST, kao i normalne vrednosti ovog parametra u pet pacijenata. Vrednosti ALT su u svih pacijenata povišene. HAI je pokazao izrazite varijacije intenziteta, dok samo pet osoba nije imalo fibrozu. Ciroza je prisutna u tri pacijenta. Pacijenti bez fibroze imaju vrednosti AST u normalnim granicama i one su bile statistički značajno niže nego u osoba sa fibrozom i cirozom (p<0,05). Vrednosti ALT su najviše u osoba sa uznapredovalom fibrozom i analiza pokazuje statistički signifikantan odnos vrednosti ALT i fibroze u ispitivanoj grupi pacijenata sa HHC (p<0,01). Rezultati su pokazali prisustvo fibroze kao značajne posledice HHC u jetri pri nultoj biopsiji. Odnos međuzavisnosti vrednosti transaminaza, posebno ALT, prema HAI i stepenu fibroze preporučuju ih za praćenje toka bolesti i predviđanje razvoja fibroze.
Ključne reči:
Hepatitis C, ALT, AST, fibroza
