Relationships between serum aminotransferase levels, liver histologies and virological status in patients with chronic hepatitis C in Taiwan

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Abstract
In patients with chronic hepatitis C, the relationships between serum alanine aminotransferase (ALT) levels, histological liver injury and serum hepatitis C virus (HCV) RNA titres remain controversial. To evaluate these relationships, 93 Chinese patients with histological diagnosis of chronic hepatitis C were enrolled for this study. Serum ALT levels, HCV‐RNA titres and HCV genotypes were examined. The histology was evaluated according to a modified histological activity score based on the degree of periportal necro‐inflammation, intralobular necro‐inflammation, portal inflammation, total necro‐inflammation and fibrosis. The mean serum ALT level was significantly higher in patients with severe intralobular necro‐inflammation activity than in patients with mild or no activity (P= 0.013). However, scores of intralobular activity were only weakly correlated with serum ALT levels (r= 0.27) and could not be used to adequately predict ALT values. Serum ALT levels showed no significant correlation with the scores of portal inflammation, periportal necro‐inflammation, total necro‐inflammation and fibrosis. Also, there was no significant difference in the mean serum ALT level among different serum HCV‐RNA levels and HCV genotypes. Serum HCV‐RNA titres and genotypes showed no significant correlation with liver histology and serum HCV‐RNA titres were only weakly correlated with the total necro‐inflammatory score (r= 0.27). In conclusion, although serum ALT levels were higher in patients with more severe intralobular necro‐inflammatory activity, the correlation was not strong enough to adequately predict ALT values. Serum HCV‐RNA titres and genotypes also showed no significant correlation with serum ALT levels and liver histologies.