Relationship between Enzyme Alanine Aminotransferase Level and Liver Histology in Chronic Hepatitis B

Abstract

Relationship between Enzyme Alanine Aminotransferase Level and Liver Histology in Chronic Hepatitis B

Supatsri Sethasine MD^*

Somnuek Jesdapatarakul MD^**

Busaba Supawattanabodee MSc (biostatistics)***

^* Department of medicine, BMA Medical College and Vajira Hospital

^** Department of pathology, BMA Medical College and Vajira Hospital

***Clinical Epidemiology Unit, BMA Medical College and Vajira Hospital

Objective: To study the relationship between enzyme alanine aminotransferase (ALT) level and liver histology in chronic hepatitis B patient (CHB).

Study design: Cross-sectional study.

Subjects: A total of 38 adult patients underwent percutaneous liver biopsy during January to December 2006 at liver clinic, BMA Medical College and Vajira Hospital were enrolled.

Methods: Clinical and histological data were assessed from medical record and pathological report.

Main outcome measures: Histological activity index score, portal inflammatory score, fibrotic score and level of enzyme ALT.

Results: From 38 patients, 21 patients (55.3%) had ALT level of 3-5 times above the upper normal limit (ULN) and 5 patients (13.2%) had ALT level more than 5 time of the upper normal limit. 60% of patients had portal inflammation score ≥ 3 and 21% of patients had fibrosis score ≥ 3. Portal inflammatory score was increased according to increase level of ALT significantly (p-value < 0.05). The study revealed that portal inflammatory score in CHB with fibrosis score ≥ 3 was significantly higher than non-fibrotic CHB (2.75 vs 1.64, p-value < 0.05). ALT level and HBV DNA level between CHB with fibrosis score ≥ 3 and non-fibrotic CHB were not different (127 U/L vs 112 U/L), (1.1 x 10⁶cp/ml vs 1.2 x 10⁶ cp/ml) (p-value > 0.05).

Conclusion: The level of alanine aminotransferase enzyme related well with the degree of portal necro-inflammatory score but did not relate with the degree of fibrosis.

Vajira Med J 2007 ; 51 : 9- 17