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Quantitative testing of liver function in relation to fibrosis in patients with chronic hepatitis B and C

C Herold1, R Heinz, G Niedobitek

  • 1Dept. of Medicine I and Institute of Pathology, University of Erlangen-Nuernberg, Erlangen, Germany.

Liver
|July 17, 2001
PubMed

Insights

Quantitative liver function tests reveal that viral hepatitis impairs metabolic function before perfusion. These tests, including the aminopyrine breath test and galactose elimination capacity, can guide drug development for viral hepatitis.

Area of Science:

  • Hepatology
  • Clinical Biochemistry
  • Virology

Background:

  • Quantitative testing of liver function (QTLF) offers potential advantages over conventional methods for assessing liver disease prognosis.
  • Limited data exist on QTLF in chronic hepatitis B and C, especially concerning fibrosis.
  • This study investigates a comprehensive panel of QTLF in these patient groups.

Purpose of the Study:

  • To evaluate the utility of a broad panel of quantitative liver function tests (QTLF) in patients with chronic hepatitis B and C.
  • To correlate QTLF with liver histology, including inflammation and fibrosis.
  • To assess the impact of fibrosis and inflammation on different aspects of liver function.

Main Methods:

  • 367 patients with chronic hepatitis B or C underwent liver biopsy and QTLF.
  • QTLF included assessments of hepatic metabolism (aminopyrine breath test, galactose elimination capacity) and hepatic perfusion (sorbitol clearance, indocyanine green clearance).
  • QTLF results were correlated with liver histology and Child-Pugh classification.

Main Results:

  • Metabolic liver function decreased significantly in patients with no and moderate fibrosis, while perfusion remained normal.
  • Severe fibrosis and cirrhosis led to a significant decline in all QTLF parameters.
  • Hepatic inflammation impacted metabolic function regardless of inflammatory grade, but viral etiology and HCV genotypes did not alter QTLF.

Conclusions:

  • Viral damage to the liver affects hepatic metabolism prior to impacting hepatic perfusion.
  • Metabolic liver function tests are valuable for identifying drugs that can restore liver function in viral hepatitis.
  • QTLF, particularly metabolic tests, can be applied irrespective of the fibrosis stage in viral hepatitis.
Abstract

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