EVALUATION OF LIVER HISTOLOGY, ALT ELEVATION, AND HCV RNA TITER IN PATIENTS WITH CHRONIC HEPATITIS-C

Objective: Hepatic histological evaluation is currently the gold stand ard to determine the degree of liver injury in chronic hepatitis C. It is unclear whether degree of serum ALT elevation or quantitative hepa titis C virus (HCV) RNA can predict level of histological damage, Meth ods: Fifty nine biopsies from 44 patients with chronic hepatitis C wer e reviewed, The amount of liver damage was quantified using the Histol ogy Activity Index (HAI) and was compared with serum ALT and, in 26 bi opsies, 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 statistica lly strong (r(s) = 0.4900), No significant correlation was noted betwe en 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 u se, There is no significant correlation between HCV RNA and serum ALT or HCV RNA and degree of hepatic injury in individual patients, Hepati c histological evaluation continues to be required for clinical assess ment of patients with chronic hepatitis C.