Serum aspartate but not alanine aminotransferase levels help to predict the histological features of chronic hepatitis C viral infections in adults

OBJECTIVES: The aims of this study were to assess the predictive values of age, gender, route of transmission, extent of steatosis, alcohol consumption, and serum aminotransferase values on the histological findings in patients with chronic hepatitis C viral infections. METHODS: We retrospectively reviewed the charts and liver biopsy findings from 79 adult patients with serological evidence of chronic hepatitis C viral infections. RESULTS: The mean (± SD) age of the patient population was 43.5 ± 10.8 yr; 47 patients (60%) were male. The routes of transmission were considered to be parenteral drugs in 44 patients (56%), previous blood transfusions in 25 (32%), and miscellaneous parenteral and nonparenteral routes in 10 (13%). The mean histological activity score of the group as described by Desmet et al. was 3.5 ± 0.8 (maximum possible score, 18) and the fibrosis score 1.5 ± 0.4 (maximum possible score, 4), indicating relatively mild disease in the majority of cases. The extent of inflammation correlated with fibrosis (r = 0.72). By multivariate stepwise regression analyses, serum aspartate aminotransferase (AST) values emerged as the most important predictive variable of histological activity (r = 0.62). When overall histological activity was further divided into portal inflammation, piecemeal necrosis, and lobular activity, correlations were found between AST values and portal inflammation (r = 0.58) and piecemeal necrosis (r = 0.61) but not lobular activity (r = 0.1). A correlation was also observed between AST values and the extent of hepatic fibrosis (r = 0.64). On the other hand, serum ALT values did not correlate with histological activity but did correlate weakly with the extent of hepatic fibrosis (r = 0.39 and 0.51, respectively). There were no significant correlations between age, gender, route of transmission, steatosis, or alcohol consumption with the extent of histological activity or fibrosis. CONCLUSIONS: Serum AST values correlate well with two of three features of hepatic inflammation and with the extent of hepatic fibrosis. These findings suggest that, among other factors, serum AST values should be considered in decisions regarding the need for liver biopsy and treatment in patients with chronic hepatitis C viral infections. (C) 2000 Am. Coll. of Gastroenterology.