ABSTRACT
Objective: To determine the correlation between HCV genotypes and serum ALT levels in various patients of chronic hepatitis induced by hepatitis C virus, in our setup. Design: A prospective study carried out from August 2006 to December 2009. Setting: Research Medical Center LUMHS Jamshoro, Pathology Department Peoples University of Medical and Health Sciences Nawabshah and Biotechnology Department University of Karachi
Patients: A total of 344 HCV-PCR positive patients with different genotypes were evaluated 239 men and 105 women with ages between 18-55 years of age years were included in the study
Methodology: All the patients went for ELISA test for the presence of HCV antibodies by ELISA kit of Biokit Spain, then a 10.0 ml sample of blood was collected in a tube with separating gel, to obtain serum, which was O stored at -80°C, for the determination of HCV RNA by RT- PCR [Real time cephid smart cycler] and for determination of HCV-RNA genotypes by comparison in sizes of the products amplified by RTPCR using HCV genotype- specific primers, then subjecting the product to electrophoresis by Anagen kit. 5.0 ml of blood was also collected in a tube with separating gel, to obtain serum, which was stored at room temperature for the determination alanine aminotransferase by using UV enzymatic kinetic method
Results: when HCV genotypes were correlated with serum ALT levels, 09 cases were found < 50 mg % and among these 06 cases were of genotype 1a, 02 cases were of genotype 2a and one case of untyped. 55 cases shows serum ALT level between 50-100 mg % and among this majority of cases belongs to untyped category. 209 cases shows serum ALT level between 100-200 mg % and among this majority of cases belongs to genotype 3a. 71 cases shows serum ALT level >200 mg % and among this majority of cases belongs to genotype 3a
Conclusions: The data in the current study indicates the strong correlation between HCV genotypes and serum ALT levels. The genotypes 3a, 3b and 2 were found associated with high serum ALT levels and the genotype 1 was found associated with low levels of serum ALT
ABSTRACT
Objective: to determine the grading and staging of chronic hepatitis induced by hepatitis C virus in rural Sindh
Design: a prospective, observational study
Setting: medical Research Center Liaquat University of Medical and Health Sciences Jamshoro, Department of Pathology, Nawabshah Medical College for Girls Nawabshah and Biotechnology Department of University of Karachi, from August 2006 to June 2008
Patients: a total of 344 HCV-PCR positive patients were selected by non-probability convenient sampling technique. [Overall 239 men and 105 women with age 18-55 years included in the study]
Methodology: all the patients went for ELISA test for the presence of HCV antibodies by ELISA kit of Biokit Spain and HCV-RNA by RT-PCR on Cephid smart cycler, and then a hepatic biopsy was performed in clinically indicated patients and the biopsy fragments were submitted to conventional histopathological procedures
Results: according to histopathological analysis of 344 biopsy samples of chronic hepatitis C patients 38 [11.04%] patients presented with necro-inflammatory grade 1, 151 [43.89%] with grade 2, 117 [34.01%] with grade 3 and 38 [11.04%] cases presented with grade 4; while no biopsy specimen revealed necro-inflammatory grade 0. Majority of patients presented with fibrosis grade 2 and fibrosis grade 1 in 121 [35.17%] and 102 [29.65%] biopsy samples respectively followed by fibrosis grade 3 in 77 [22.38%], fibrosis grade 4 in 30 [8.72%] and fibrosis grade 0 in 14 [40.6%] cases
Conclusion: in current study we observed majority of cases in A2, A3 grade of inflammation and F1, F2, F3 stages of fibrosis, which indicates that patients came late for medical assessment which may cause difficulties in management. This warrants the necessity of HCV awareness programs in rural areas of Sindh