Se. Mccormick et al., EVALUATION OF LIVER HISTOLOGY, ALT ELEVATION, AND HCV RNA TITER IN PATIENTS WITH CHRONIC HEPATITIS-C, The American journal of gastroenterology, 91(8), 1996, pp. 1516-1522
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.