Quantitative testing of liver function in patients with cirrhosis due to chronic hepatitis C to assess disease severity

Background/Aims: Quantitative testing of liver function (QTLF) may allow a prognostic assessment of patients with various liver diseases. However, the n are insufficient data about patients with liver cirrhosis due to hepatiti s C. Patient/Methods: 86 consecutive patients (58 males, 28 females, age: 4 8.3+/-11.7 years) with chronic hepatitis C (HCV RNA pos.) underwent sonogra phically guided liver biopsy to confirm the diagnosis of cirrhosis. QTLF in cluded aminopyrine breath test (microsomal liver function), galactose elimi nation capacity (cytosolic liver function), sorbitol clearance (liver plasm a flow) and indocyanine green clearance (liver perfusion). Values were corr elated with the Child-Pugh classification. Results. 55% of the patients (n= 47) had cirrhosis of Child-Pugh grade A, 28% of grade B (n=24) and 17% of g rade C (n=15). QTLF showed a steady decrease from Child-Pugh grade A to gra de B and to grade C. Contrary to markedly reduced tests of metabolic liver function in Child-Pugh grade patients, surrogate tests of hepatic perfusion were at the lower normal limit. All QTLF were significantly reduced in Chi ld-Pugh grade B and C patients compared to healthy controls. Differences be tween the three Child grades were significant. Conclusion: In patients with cirrhosis due to hepatitis C, QTLF correlated inversely with Child-Pugh gr ades. Since in cirrhosis of grade A, surrogate tests of hepatic perfusion r emained at the lower normal limit, whereas those of metabolic function were decreased, QTLF may be a tool to predict prognosis or complications in ear ly cirrhosis due to chronic hepatitis C.