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Biochemical scores could reflect histological activity in chronic hepatitis C
R Testa1, A Picciotto, G Lapertosa
1Dipartimento di Medicina Interna, Università di Genova, Italy.
Insights
This study developed a Biochemical Activity Index (BAI) using liver tests to assess chronic active hepatitis (CAH) activity. The BAI effectively differentiates between moderate and severe CAH, offering a non-invasive method for monitoring liver disease progression.
Area of Science:
- Hepatology
- Biochemistry
- Medical Diagnostics
Background:
- Chronic active hepatitis (CAH) is a significant liver condition.
- Accurate assessment of liver disease activity is crucial for patient management.
- Histological Activity Index (HAI) is a standard but invasive method for grading liver disease.
Purpose of the Study:
- To correlate liver function tests with the histological activity index (HAI) in patients with Hepatitis C Virus (HCV)-positive CAH.
- To develop and validate a Biochemical Activity Index (BAI) for assessing liver disease activity.
- To establish a non-invasive method for monitoring the severity of chronic liver disease.
Main Methods:
- Multivariate regression analysis was employed to correlate liver tests with HAI in 81 HCV-positive CAH patients.
- Patients were divided into moderate and severe CAH groups based on median HAI values.
- Backward stepwise analysis identified key biochemical parameters (ALT, gammaglobulins, gammaglutamyl transpeptidase, prolyl-hydroxylase) for the BAI.
Main Results:
- Multiple regression analysis enhanced the significance of nine biochemical parameters related to HAI.
- A combination of ALT, gammaglobulins, gammaglutamyl transpeptidase, and prolyl-hydroxylase showed the best correlation with HAI (R = 0.520, p < 0.0001).
- The derived BAI demonstrated a significant difference between moderate (7.7 +/- 1.3) and severe (12.2 +/- 2) CAH (p < 0.0001).
Conclusions:
- The developed BAI serves as a reliable indicator for assessing the activity of chronic liver diseases.
- This biochemical index offers a potentially non-invasive alternative to liver biopsy for monitoring disease progression.
- The BAI can aid clinicians in better managing patients with chronic hepatitis C.
Abstract:
Eighty-one patients with HCV positive chronic active hepatitis (CAH) were studied to correlate, in multivariate regression analysis, liver tests with the histological activity index (HAI). The median HAI value (9.4) divided the patients into two groups; 44 under the 9.4 value (moderate CAH) and 37 above (severe CAH). Multiple regression improved the significance of nine biochemical parameters related to HAI in univariate analysis, and backward stepwise analysis identified the combination of alanine-aminotransferase (ALT), gammaglobulins (gamma GL), gammaglutamyl transpeptidase (gamma GT) and prolyl-hydroxylase (PH) as the best relationship with HAI (R = 0.520, p < 0.0001). A biochemical activity index (BAI) calculated as: 2.304 + ALT x 0.013 + gamma GL x 1.76 + gamma GT x 0.008 + PH x 0.012 showed the higher significant difference between moderate (7.7 +/- 1.3) and severe (12.2 +/- 2) CAH (p < 0.0001). These results suggest that this BAI could be a pointer for checking activity of chronic liver diseases.