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World J Gastroenterol. Nov 7, 2007; 13(41): 5481-5485
Published online Nov 7, 2007. doi: 10.3748/wjg.v13.i41.5481
Clinical significance of activity of ALT enzyme in patients with hepatitis C virus
Onder Akkaya, Murat Kiyici, Yusuf Yilmaz, Engin Ulukaya, Omer Yerci
Onder Akkaya, Yusuf Yilmaz, Department of Internal Medicine, Uludag University Medical School, Bursa, Turkey
Murat Kiyici, Department of Gastroenterology, Uludag University Medical School, Bursa, Turkey
Engin Ulukaya, Department of Biochemistry, Uludag University Medical School, Bursa, Turkey
Omer Yerci, Department of Pathology, Uludag University Medical School, Bursa, Turkey
Author contributions: All authors contributed equally to the work.
Correspondence to: Yusuf Yilmaz, MD, Uludag Universitesi Tip Fakultesi Ic Hastaliklari Gorukle, Bursa, 16059 Turkey. yusufyilmaz@uludag.edu.tr
Telephone: +90-533-4403995 Fax: +90-224-4534028
Received: July 8, 2007
Revised: August 17, 2007
Accepted: September 1, 2007
Published online: November 7, 2007
Abstract

AIM: To investigate serum alanine aminotransferase (ALT) levels in relation to the clinical, biochemical, ultrasonographic and histological characteristics of patients with hepatitis C virus.

METHODS: Duration of disease, HCV-RNA, liver steatosis, and the hepatitis activity index (HAI) were correlated with serum ALT in 36 patients with HCV. ALT values were also investigated in 16 control subjects without any liver diseases.

RESULTS: In bivariate analyses, ALT levels correlated with duration of HCV infection (P < 0.01), HCV-RNA (P < 0.05), and the HAI (P < 0.01). Among the components of the HAI, ALT concentrations were significantly associated with periportal bridging/necrosis (P < 0.01) and fibrosis (P < 0.05). In multivariate analysis, periportal bridging/necrosis (β = 0.508; P < 0.01), duration of HCV infection (β = 0.413; P < 0.01), and HCV-RNA (β = 0.253; P < 0.05) were independently associated with ALT activity. The normal ALT activity for men and women was < 23 IU/L and < 22 IU/L, respectively.

CONCLUSION: In patients with HCV, alterations in the liver tissue as reflected by ALT elevation are mainly associated with periportal bridging/necrosis, viral load and duration of disease. A cut-off value < 23 IU/L distinguished with high diagnostic accuracy healthy controls from patients with HCV.

Keywords: Hepatitis C virus; Disease duration; Viral Load; Inflammation; Normal alanine aminotransferase