Association of Liver Histology with Serum ALT Levels in Patients with Chronic Hepatitis C

Abstract

Objective: To evaluate the incidence of liver damage based on grading of necro-inflammatory and fibrotic changes on hepatic cytology in patients suffering chronically with hepatitis C, presenting with alanine transaminase levels in normal ranges. Methodology: A cross-sectional survey was accomplished at department of medicine, PAF Hospital Mushaf, Sargodha for six months of duration from April 2012 to October 2012. 100 cases were evaluated. Liver biopsy was done using large bore sure cut biopsy needle under all aseptic measures after ultrasound marking and sent in 10% formalin for histological studies of inflammation and necrosis. Liver damage was declared for patients having grade 1 or more activity on METAVIR scoring system. Results: Majority of the patients were between 31-40 years of age and lowest age was 20 years. Average age of the patients was 33.2±7.4 years. Out of 100 patients, 47 patients (47.0%) were male while remaining 53 patients (53.0%) were females. Liver damage was found in 41.0% patients. Conclusion: Liver biopsy should be performed for a clear diagnosis in patients suffering from HCV with alanine transaminase level within the normal ranges. Patients may suffer advanced hepatic disease despite normal levels of hepatic enzymes.