Histologic determinants of monoethylglycinexylidide formation in patients with chronic hepatitis C.
Patients affected by chronic hepatitis C (CHC) display a peculiar histologic picture characterized by the presence of steatosis and bile duct damage in addition to evidence of inflammation, necrosis, and fibrosis. In the staging of these patients, functional evaluation may be considered a complementary tool. The monoethylglycinexylidide (MEGX) test has been used in diagnostic and prognostic assessment of chronic liver disease as a quantitative liver function test. In this study the authors evaluated whether different sampling 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 MEGX15 better reflected the histologic findings of necrosis and inflammation, and MEGX60 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 progressively increased. Stepwise regression analysis identified necrosis and inflammation as histologic variables associated with both MEGX15 and MEGX30, and fibrosis as a variable associated with MEGX60. These results suggest that a decline in liver metabolic function corresponds to a progressive increase in liver damage, and that this circumstance should be taken into account when prescribing drugs to patients with CHC.
Testa
R
R
Department of Internal Medicine, University of Genoa, Italy.
Giannini
E
E
Ceppa
P
P
Botta
F
F
Romagnoli
P
P
Fasoli
A
A
Risso
D
D
D000328:Adult; D000368:Aged; D005260:Female; D019698:Hepatitis C, Chronic / Q000473:pathology* / Q000503:physiopathology; D006801:Humans; D008012:Lidocaine / Q000031:analogs & derivatives* / Q000032:analysis / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis
D008012:Lidocaine; C001173:monoethylglycinexylidide