Histologic determinants of monoethylglycinexylidide formation in patients with chronic hepatitis C

Patients affected by chronic hepatitis C (CHC) display a peculiar histologi c picture characterized by the presence of steatosis and bile duct damage i n addition to evidence of inflammation, necrosis, and fibrosis. In the stag ing of these patients, functional evaluation may be considered a complement ary tool. The monoethylglycinexylidide (MEGX) test has been used in diagnos tic and prognostic assessment of chronic liver disease as a quantitative li ver function test. In this study the authors evaluated whether different sa mpling times for the test could reflect different histologic patterns. The authors studied 82 patients with biopsy-proven CHC who underwent functional evaluation by means of MEGX test. The authors found that MEGX(15) better r eflected the histologic findings of necrosis and inflammation, and MEGX(60) the presence of fibrosis. Neither steatosis nor bile duct damage showed a strong correlation with either sampling time. Moreover, MEGX levels showed a progressive decrease as histologic grading of chronic hepatitis progressi vely increased. Stepwise regression analysis identified necrosis and inflam mation as histologic variables associated with both MEGX(15) and MEGX(30), and fibrosis as a variable associated with MEGX(60). These results suggest that a decline in Liver metabolic function corresponds to a progressive inc rease in liver damage, and that this circumstance should be taken into acco unt when prescribing drugs to patients with CHC.