title: Relation of ALT and AST levels to the histopathological changes in liver biopsies of patients with chronic hepatitis C genotype 4.
abstract: OBJECTIVE
  Worldwide, Egypt has a high prevalence of adult hepatitis C virus (HCV) infection. Serum alanine aminotransferase (ALT) activity is most commonly measured to assess hepatic disease. The revision of the definition of the normal limits for the ALT level is advisable. The aim of this work was to compare the histopathological changes in the liver tissue biopsies of HCV-infected patients, clinically presenting with ALT levels below normal, based on the conventional, previously used upper limit of normal (ULN) of ALT (40U/L for men and 30U/L for women) with the proposed new ULN (30U/L for men, and 19U/L for women).
  
  
  METHODS
  This is a retrospective cross-sectional study. A total of 668 cases of chronic hepatitis C genotype 4 were included. Patients were classified according to grades of histological activity and fibrosis stages (by the Metavir scoring system). They were also classified into normal and high groups according to the old and new cutoffs of both aspartate transaminase (AST) and ALT levels.
  
  
  RESULTS
  The results of our study showed that the serum AST level in our study showed a better correlation with the histopathological changes in liver biopsy rather than ALT, especially when using the old cutoff of the ULN for AST. The serum ALT level in our study (both the old and the new cutoffs) did not show a significant correlation with the histopathological status in the liver biopsies of our patients.
  
  
  CONCLUSIONS
  This study concluded that the old cutoff of the ULN AST is a better predictor of fibrosis.
authors.affiliation: Department of Pathology, Faculty of Medicine, Cairo University, Cairo, Egypt.
authors.forename: Hany
authors.initials: H
authors.lastname: Khattab
authors.affiliation: Department of Endemic Medicine and Hepatology, Faculty of Medicine, Cairo University, Cairo, Egypt.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Fouad
authors.affiliation: Department of Pathology, Faculty of Medicine, Cairo University, Cairo, Egypt.
authors.forename: Maya
authors.initials: M
authors.lastname: Hamza
authors.affiliation: Department of Endemic Medicine and Hepatology, Faculty of Medicine, Cairo University, Cairo, Egypt. Electronic address: ma_mohey@yahoo.com.
authors.forename: Mohammad A
authors.initials: MA
authors.lastname: Mohey
authors.affiliation: Department of Endemic Medicine and Hepatology, Faculty of Medicine, Cairo University, Cairo, Egypt.
authors.forename: Wafaa
authors.initials: W
authors.lastname: El-Akel
authors.affiliation: Department of Tropical Medicine and Hepatology, Faculty of Medicine, Beni-Sueif University, Beni Sueif, Egypt.
authors.forename: Hossam
authors.initials: H
authors.lastname: Ghoneim
authors.affiliation: Department of Endemic Medicine and Hepatology, Faculty of Medicine, Cairo University, Cairo, Egypt.
authors.forename: Amr
authors.initials: A
authors.lastname: Abul-Fotouh
authors.affiliation: Department of Endemic Medicine and Hepatology, Faculty of Medicine, Cairo University, Cairo, Egypt.
authors.forename: Gamal
authors.initials: G
authors.lastname: Esmat
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000410:Alanine Transaminase / Q000097:blood*; D001219:Aspartate Aminotransferases / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D001706:Biopsy; D003430:Cross-Sectional Studies; D005260:Female; D005355:Fibrosis / Q000473:pathology; D005838:Genotype; D006526:Hepatitis C / Q000235:genetics; D019698:Hepatitis C, Chronic / Q000201:enzymology* / Q000473:pathology*; D006801:Humans; D008099:Liver / Q000201:enzymology* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D012367:RNA, Viral / Q000032:analysis; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D015415:Biomarkers; D012367:RNA, Viral; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase
keywords: ALT; AST; Genotype 4; HCV