Introduction: Hepatitis C virus (HCV) infection is usually monitored by the level of alanine transaminase
(ALT) and viral load. However, accumulating data indicate that these parameters are not always correlated
with the disease progression.
Aim of the Work: This study aims to evaluate the relationship between serum ALT, serum HCV-RNA titer
and the degree of histopathological liver damage in patients with chronic HCV.
Patients and Methods: A total of 150 patients who were recently diagnosed with chronic hepatitis C virus
infection were included in our study of which 121 were males and 29 were females. Serum ALT levels, serum
HCV-RNA and histopathological grading and staging were recorded.
Results: The patients’ age ranged from 20 to 59 years with a mean age of 38.55 ± 10.98 years. The mean
ALT level was 45.27 ± 32.31 IU/L, the mean HCV RNA level was 0.98×106 ± 2.17×106 IU/mL. Sixty seven
patients (44.7%) had an elevated serum ALT level (ALT>40 IU/L) while ALT was normal in 83 patients
(55.3%). The degree of liver cell damage (grade) is significantly correlated with the degree of hepatic fibrosis
(stage), both grade and stage are significantly more advanced in older patients (P= 0.0001). The grade and
stage of chronic hepatitis C tend to be significantly higher in patients with elevated serum ALT compared to
those with normal ALT levels (P= 0.022 and P= 0.038, respectively). HCV viral loads had no correlation with
serum ALT values, with the extent of histological damage or with degree of fibrosis.
Conclusion: Serum ALT level could reflect the histopathological changes of chronic hepatitis C virus in at
least a subset of hepatitis patients while serum HCV-RNA titer had no relationship to the degree of hepatic
damage. Histopathological examination of liver tissue is necessary for accurate evaluation of the extent of
liver damage.