Liver histology in hepatitis C infection: a comparison between patients with persistently normal or abnormal transaminases.
Forty two cases of confirmed hepatitis C virus (HCV) infection with available liver histology were studied. Most patients, 23 of 42 (55%) had abnormal liver function tests but 19 of 42 (45%) had persistently normal liver transaminases (mean aspartate transaminase (AST) 24.1 IU/l, mean follow up 10 months). Histological examinations in the group with normal AST activities were normal in two of 19 (11%), showed non-specific reactive hepatitis in eight of 19 (42%), chronic persistent hepatitis in six of 19 (31%), and chronic active hepatitis in three of 19 (16%). Twenty three of 42 (55%) had either persistently or temporary raised liver transaminases (mean AST 96.2 IU/l, mean follow up 16 months). Histological examinations in this second group with abnormal liver biochemistry showed reactive hepatitis in five of 23 (22%), chronic persistent hepatitis in six of 23 (26%), chronic active hepatitis in 10 of 23 (43%), and cirrhosis in two (9%). Average alcohol intake was significantly higher in the group within abnormal liver function (17.8 v 6.4 units, p = 0.01). Although serious pathology was more frequent in the abnormal transaminase group, significant liver pathology (chronic persistent hepatitis or chronic active hepatitis) was found in nine of 19 (47%) of cases with repeatedly normal transaminases. Liver biopsy is advised in all cases of chronic hepatitis C infection to accurately assess both the degree of fibrosis and the current activity of the disease.
Healey
C J
CJ
Department of Gastroenterology, John Radcliffe Hospital, Oxford.
Chapman
R W
RW
Fleming
K A
KA
D000328:Adult; D000428:Alcohol Drinking; D001219:Aspartate Aminotransferases / Q000378:metabolism; D001782:Blood Donors; D005260:Female; D006526:Hepatitis C / Q000201:enzymology / Q000473:pathology*; D006521:Hepatitis, Chronic / Q000473:pathology*; D006801:Humans; D008099:Liver / Q000201:enzymology / Q000473:pathology*; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged
D001219:Aspartate Aminotransferases