Analysis of ALT and AST levels in HCV infected patients

Sadia Amjad, Ayesha Akram, Mudassar Iqbal, Manzoor Hussain, Mirwais Khan

Abstract


Background: Hepatitis C infection is spreading worldwide at an alarming rate and Pakistan is the second largest country to be infected with hepatitis C virus (HCV). Abnormal levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) has been reported to be associated with hepatitis C infection and HCV associated pathologies.

Methods: The serum of study participants was isolated and analyzed for confirmed HCV infection and HCV RNA was extracted by QIAamp DSP Virus Kit followed by quantification by real time PCR. For the measurement of ALT and AST analysis, aspartate aminotransferase activity assay kit and alanine aminotransferase activity assay kit of Sigma Aldrich were used.

Results: Gender-wise analysis showed that 58% females while 42% males were HCV infected. Participants’ age ranged between ≥15 to ≤75 years. A confirmatory test of HCV infection by real time PCR showed 63% positive while 37% participants to be negative for HCV infection. An age-wise comparison of AST and ALT level showed a higher level of ALT in all age groups of HCV patients with significant higher level in 21-60 years of males and 61—80 years of female. The gender-wise comparison of these enzyme level showed higher level of ALT and AST in females as compared to males. The correlation analysis showed a positive association between viral load and AST/ALT level.

Conclusion: Though irregular levels have been reported in HCV patients previously but this gender-based study shows an increased level of both the enzymes in females as compared to males. Moreover, ALT have increased levels in HCV patients as compared to AST indicating ALT to be more specific biomarker of HCV infection and liver damage.

Keywords: HCV; ALT; AST; Hepatitis C; CHC; Virus 


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References


Budkowska A. Intriguing structure of the HCV particle. Gut, (2017); 66(8): 1351-1352.

Morozov VA, Lagaye S. Hepatitis C virus: morphogenesis, infection and therapy. World journal of hepatology, (2018); 10(2): 186.

Lei J-H, Liang J, Gong X, Xiao X-Q, Chen Z, et al. Analysis of Transmission Routes of Hepatitis C Virus Based on Virus Genotyping in 341 Cases with Different Suspected Initial Infection Time Points in Hunan Province, China. Medical science monitor: international medical journal of

experimental and clinical research, (2018); 245232.

Dragomiretskaya N, Izha A, Kalinichenko N, Szark-Eckardt M, Klimczyk M, et al. Use of antiviral therapy in patients with chronic hepatitis C. Open Medicine, (2015); 10(1).

Foster GR, Pianko S, Brown A, Forton D, Nahass RG, et al. Efficacy of sofosbuvir plus ribavirin with or without peginterferon-alfa in patients with hepatitis C virus genotype 3 infection and treatment-experienced patients with cirrhosis and hepatitis C virus genotype 2 infection. Gastroenterology, (2015); 149(6): 1462-1470.

Khaliq S, Raza S. Current Status of Direct Acting Antiviral Agents against Hepatitis C Virus Infection in Pakistan. Medicina, (2018); 54(5): 80.

Hajarizadeh B, Grebely J, Dore GJ. Epidemiology and natural history of HCV infection. Nature reviews Gastroenterology & hepatology, (2013); 10(9): 553.

Messina JP, Humphreys I, Flaxman A, Brown A, Cooke GS, et al. Global distribution and prevalence of hepatitis C virus genotypes. Hepatology, (2015); 61(1): 77-87.

van Beek JH, de Moor MH, de Geus EJ, Lubke GH, Vink JM, et al. The genetic architecture of liver enzyme levels: GGT, ALT and AST. Behavior genetics, (2013); 43(4): 329-339.

Wang C-S, Chang T-T, Yao W-J, Wang S-T, Chou P. Impact of increasing alanine aminotransferase levels within normal range on incident diabetes. Journal of the Formosan Medical Association, (2012); 111(4): 201-208.

Liu Z, Que S, Xu J, Peng T. Alanine aminotransferase-old biomarker and new concept: a review. International journal of medical sciences, (2014); 11(9): 925.

Huang X-J, Choi Y-K, Im H-S, Yarimaga O, Yoon E, et al. Aspartate aminotransferase (AST/GOT) and alanine aminotransferase (ALT/GPT) detection techniques. Sensors, (2006); 6(7): 756-782.

Sookoian S, Castaño G, Frider B, Flichman D. How to distinguish normal liver from chronic hepatitis in anti-HCV positive individuals with normal alanine aminotransferase levels. MEDICINA-BUENOS AIRES-, (2002); 62(3): 226-230.

Puoti C. HCV carriers with persistently normal ALT Levels: not too much healthy, not true patients. Romanian journal of gastroenterology, (2004); 13(4): 329-332.

Anderson FH, Zeng L, Rock NR, Yoshida EM. An assessment of the clinical utility of serum ALT and AST in chronic hepatitis C. Hepatology Research, (2000); 18(1): 63-71.

Petruzziello A, Marigliano S, Loquercio G, Cozzolino A, Cacciapuoti C. Global epidemiology of hepatitis C virus infection: An up-date of the distribution and circulation of hepatitis C virus genotypes. World journal of gastroenterology, (2016); 22(34): 7824.

Cacciola I, Scoglio R, Alibrandi A, Squadrito G, Raimondo G, et al. Evaluation of liver enzyme levels and identification of asymptomatic liver disease patients in primary care. Internal and emergency medicine, (2017); 12(2): 181-186.

Pokorska-Śpiewak M, Kowalik-Mikołajewska B, Aniszewska M, Pluta M, Marczyńska M. Novel serum biomarkers modified by the body mass index z-score for the detection of liver fibrosis and steatosis in children with chronic hepatitis C. BMC infectious diseases, (2017); 17(1): 361.

Kostadinova L, Shive CL, Zebrowski E, Fuller B, Rife K, et al. Soluble markers of immune activation differentially normalize and selectively associate with improvement in AST, ALT, albumin, and transient elastography during IFN-free HCV therapy. Pathogens & immunity, (2018); 3(1): 149.

Tang N, Zhang Y, Liu Z, Fu T, Liang Q, et al. Correlation analysis between four serum biomarkers of liver fibrosis and liver function in infants with cholestasis. Biomedical reports, (2016); 5(1): 107-112.

Pradat P, Alberti A, Poynard T, Esteban JI, Weiland O, et al. Predictive value of ALT levels for histologic findings in chronic hepatitis C: a European collaborative study. Hepatology, (2002); 36(4): 973-977.

Giannini E, Risso D, Botta F, Chiarbonello B, Fasoli A, et al. Validity and clinical utility of the aspartate aminotransferase–alanine aminotransferase ratio in assessing disease severity and prognosis in patients with hepatitis C virus–related chronic liver disease. Archives of internal medicine, (2003); 163(2): 218-224.

Sheth SG, Flamm SL, Gordon FD, Chopra S. AST/ALT ratio predicts cirrhosis in patients with chronic hepatitis C virus infection. The American journal of gastroenterology, (1998); 93(1): 44.

Anand BS, Velez M. Assessment of correlation between serum titers of hepatitis C virus and severity of liver disease. World journal of gastroenterology: WJG, (2004); 10(16): 2409.

Zechini B, Pasquazzi C, Aceti A. Correlation of serum aminotransferases with HCV RNA levels and histological findings in patients with chronic hepatitis C: the role of serum aspartate transaminase in the evaluation of disease progression. European journal of gastroenterology & hepatology, (2004); 16(9): 891-896.

Khattab H, Fouad A, Hamza M, Mohey MA, El-Akel W, et al. Relation of ALT and AST levels to the histopathological changes in liver biopsies of patients with chronic hepatitis C genotype 4. Arab Journal of Gastroenterology, (2015); 16(2): 50-53.


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