RELATIONSHIP OF AMINOTRANSFERASES TO LIVER HISTOLOGICAL STATUS IN CHRONIC HEPATITIS-C

Objectives: Serum aminotransferase levels characteristically fluctuate in chronic hepatitis C, but their relationship to grade (i,e,, inflam matory activity) and stage (i,e,, degree of fibrosis) of liver disease is uncertain, We therefore correlated aminotransferase levels and liv er biopsy findings in 90 patients with serologically confirmed chronic hepatitis C, Methods: Mode of transmission; disease duration; symptom s and signs of liver disease; alcohol intake; autoantibody, HIV, and h epatitis B virus status; and Liver biochemistries were obtained from r ecords, Liver biopsies were 1) given a morphological diagnosis, 2) eva luated for features of chronic hepatitis C, and 3) scored with a histo logical activity index, Results: Individual aminotransferase levels we re not related to clinical or laboratory variables, nor were they reli ably predictive of morphological diagnosis, No histological characteri stics were associated with a particular range of aminotransferase valu es, except aminotransferases >350 U/L, which were associated with piec emeal necrosis, Although mean values of aminotransferases were signifi cantly lower among patients with chronic persistent hepatitis (CPH) (i ,e,, with minimal activity) compared with chronic active hepatitis (CA LL (mild to moderate activity) (ALT 110 U/L +/- 71 SD vs 256 +/- 211; AST 57 U/L +/- 34 vs 123 +/- 88) and in the absence of piecemeal necro sis compared with in its presence (ALT 133 +/- 84 vs 207 +/- 149; AST 73 +/- 47 vs 120 +/- 83), overlap of values was considerable between d ifferent histological groups, Conclusion: Aminotransferases do not pre dict liver histological status in chronic hepatitis C, although greate r than or equal to 10-fold elevations suggest that piecemeal necrosis is present.