Comparison between serum alpha-glutathione S-transferase and aminotransaminases in detecting cytolysis in hepatitis C-infected children

Background: alpha-Glutathione S-transferase (alpha GST) has been proposed a s a more sensitive indicator than serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) in detecting hepatocellular damage due to chronic hepatitis C virus (HCV) infection. Methods: The accuracy of alpha-GST was compared with that of ALT and AST in detecting cytolysis in 103 blood samples issued from 31 children positive for HCV RNA. Results: alpha-GST had a lower sensitivity than ALT or AST (32% vs. 54.4% f or each aminotransferase). The sensitivity of ALT and/or AST was 60.2%, whe reas that of ALT and/or alpha-GST and AST and/or alpha-GST was lower (58.3% and 57.3%, respectively). Among 41 serum samples with negative ALT and AST , only 2 had positive alpha-GST, whereas alpha-GST failed to detect cytolys is in 31 samples with elevated ALT and/or AST. No correlation was found bet ween alpha-GST, ALT, or AST and the Knodell score. Conclusions: The combination of ALT with AST is actually the best compromis e in detecting cytolysis in untreated HCV-infected patients.