Plasma alpha-lipoprotein pattern and LCAT activity in acute viral hepatitis in children

The alpha-lipoprotein (a-Lp) electrophoretic pattern on agarose gel was studied serially in 65 children with acute viral hepatitis. In seven cases the high-density lipoprotein fractions (HDL) were also separated by ultracentrifugation and studied in relation to lecithin: cholesterol acyltransferase activity (LCAT) during the acute phase and recovery. The a-Lp band was initially absent on electrophoresis in 36 cases and never appeared in 3 of the children who died. In those who survived a-Lp reappeared with clinical improvement even before a definite increase in S-ASAT and bilirubin was evident. In the seven children in whom it was measured LCAT activity ranged during the acute phase from 17.4 to 57 nmol h-1 ml-1. In patients with initially 'normal' LCAT activity (group I, no. = 3) HDL was normal both in amount and composition. In patients with 'low' LCAT (group II, no. = 4) HDL was reduced and of abnormal composition. In both groups the a-Lp band was absent or considerably reduced on electrophoresis. In the latter group LCAT activity increased significantly on recovery, as did the amount of HDL which became normal in composition. These results suggest that in acute viral hepatitis in children changes in composition and concentration of HDL depend on the degree of hepatic functional disturbance, as judged by plasma LCAT activity. Nevertheless, it appears that HDL electrophoretic behaviour may be abnormal during the early stage of the disease while plasma LCAT activity is not significantly affected.