Serum aspartate but not alanine aminotransferase levels help to predict the histological features of chronic hepatitis C viral infections in adults

OBJECTIVES: The aims of this study were to assess the predictive values of age, gender, route of transmission, extent of steatosis, alcohol consumptio n, and serum aminotransferase values on the histological findings in patien ts with chronic hepatitis C viral infections. METHODS: We retrospectively reviewed the charts and liver biopsy findings f rom 79 adult patients with serological evidence of chronic hepatitis C vira l infections. RESULTS: The mean (+/- SD) age of the patient population was 43.5 +/- 10.8 yr; 47 patients (60%) were male. The routes of transmission were considered to be parenteral drugs in 44 patients (56%), previous blood transfusions i n 25 (32%), and miscellaneous parenteral and nonparenteral routes in 10 (13 %). The mean histological activity score of the group as described by Desme t et al. was 3.5 +/- 0.8 (maximum possible score, 18) and the fibrosis scor e 1.5 +/- 0.4 (maximum possible score, 4), indicating relatively mild disea se in the majority of cases. The extent of inflammation correlated with fib rosis (r = 0.72). By multivariate stepwise regression analyses, serum aspar tate aminotransferase (AST) values emerged as the most important predictive variable of histological activity (r = 0.62). When overall histological ac tivity was further divided into portal inflammation, piecemeal necrosis, an d lobular activity, correlations were found between AST values and portal i nflammation (r = 0.58) and piecemeal necrosis (r = 0.61) but not lobular ac tivity (r = 0.1). A correlation was also observed between AST values and th e extent of hepatic fibrosis (r = 0.64). On the other hand, serum ALT value s did not correlate with histological activity but did correlate weakly wit h the extent of hepatic fibrosis (r = 0.39 and 0.51, respectively). There w ere no significant correlations between age, gender, route of transmission, steatosis, or alcohol consumption with the extent of histological activity or fibrosis. CONCLUSIONS: Serum AST values correlate well with two of three features of hepatic inflammation and with the extent of hepatic fibrosis. These finding s suggest that, among other factors, serum AST values should be considered in decisions regarding the need for liver biopsy and treatment in patients with chronic hepatitis C viral infections. (Am J Gastroenterol 2000;95:1545 -1550. (C) 2000 by Am. Cell. of Gastroenterology).