Histopathological grading and staging in liver biopsies of hepatitis C patients and their association with ALT levels

ABSTRACT

To perform the histological evaluation of liver biopsies and see its association with the serological levels of ALT. This was a prospective study based on liver biopsies of fifty hepatitis C patients, whose serum ALT levels were also estimated. H and E stained slides were examined to determine the histological activity and fibrosis score. Grade 1 activity was found in 44% of patients; whereas 42% had an activity of grade 3. About 44% cases having grade 1 activity had a mean ALT of 52.3 U/L while 42% cases having severe activity had a mean ALT of 76.14 U/L. The present study revealed a significant relationship of ALT with fibrosis [p < 0.005]. A steady and proportional rise in mean age with increasing score of fibrosis stage was also evident. Higher ALT levels are associated with more pronounced forms of necroinflammatory activity; however normal ALT level does not rule out severity of the disease suggesting that all such patients require liver biopsy to unearth clinically subtle but advanced liver disease