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Abstract
Hepatitis C virus (HCV) infection is a major cause of chronic liver disease worldwide: nearly 80% of HCV-infected patients develop chronic infection, and about 20% progress to cirrhosis.
Development of fibrosis is a step-by-step process starting from minimal fibrosis limited to the portal tracts, followed by more extensive fibrosis with septa expanding into the liver parenchyma that can form bridges between two portal tracts or portal tracts and central veins, eventually ending in complete cirrhotic nodules.
Liver histology is currently considered as the “reference standard” for evaluating hepatic damage on the basis of the degree of necrotic inflammatory activity and fibrosis, with the latter having prognostic significance and playing a major role in therapeutic decision making.
However, liver biopsy is an invasive procedure with mild and severe complications. Furthermore, its sensitivity in diagnosing liver cirrhosis is not absolute.
This has recently led various groups to investigate the non-invasive methods of detecting severe fibrosis/cirrhosis, including only biochemical (ALT, AST, and GGT) tests or in combination with platelet count.
This work was carried out in Tropical Medicine Department, Zagazig University Hospitals.
Thirty eight patients with clinical picture suggestive of chronic liver disease were studied.
All patients were subjected to full history taking, clinical examination, liver functions, complete blood cell count, coagulations profile, Hepatitis C antibodies, PCR for HCV, Liver biopsy and abdominal ultrasound.
The present study showed that platelet count was significant in detection of the grade of liver fibrosis with predictive value over 90 %.
Patients with elevated liver transaminases showed advanced fibrotic stages than others with normal enzymes.
PCR, in this study showed that HCV-RNA level has no predictive value in detection of fibrosis and cirrhosis in HCV.
CONCLUSION
The present study was concluded that:
1- The present study used serum transaminases and platelet count as non invasive parameters for determining the grade and the stage of liver cirrhosis in patients with chronic hepatitis C infection.
2- Serum transaminases and platelet count were an accurate non invasive parameters for detection of liver fibrosis in chronic hepatitis C infection
RECOMMENDATIONS
1- It is advisable to use platelet count and transaminases level as predictors of fibrosis and cirrhosis in chronic hepatitis C infection. They can minimize the need for liver biopsy especially in late stages of fibrosis.
2- Further studies are needed to be carried out on a large number of patients to prove such relations.