PLASMA ALPHA GLUTATHIONE-S-TRANSFERASE IN PATIENTS WITH CHRONIC VIRAL HEPATITIS
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Alpha glutathione-S-transferases (a-GST) are the cytoplasmic class of enzymes responsible for cellular detoxifying processes. This study included fifty HCV chronic hepatitis patients ; fifty HBV chronic hepatitis patients and 30 healthy controls. Plasma a-GST was assessed in all subjects. Alpha-GST values were significantly higher in patients with chronic viral hepatitis than control. In 68.8% of 16 HCV-RNA positive and 72.2% of 18 HBV-DNA positive asymptomatic cases with normal ALT levels, alfa glutathione-S-transferase values were elevated. The highest increment of a-GST was documented in patients with chronic hepatitis without cirrhosis. No correlation between HCV-RNA and histological activity, ALT, AST and a-GST values was observed; while a positive correlation was found between HBV-DNA, histologic activity, ALT and a-GST values in patients with chronic HBV hepatitis. Also, there was a correlation between a-GST, ALT, AST and histopathological hepatitis activity scores. Independent predictors of histopathologic disease activity on logistic regression analysis were a-GST, ALT, AST and serum albumin. Diagnostic sensitivity of a-GST was the highest (84% in chronic HCV patients and 82% in chronic HBV patients) followed by ALT (was 68% in chronic FICV and 66% in chronic HBV patients) and when combined assessment of a-GST+ ALT were done, sensitivity increased from 84% to 94% in patients with chronic HCV and from 82% to 92% in patients with chronicHBV infection. It was concluded from the current study that alpha-GST is a more sen.,itive, specific and non-invasive marker of hepatocellular damage than ALT and AST in both chronic hepatitis B and C patients and also in detecting asymptomatic cases. The association of serum alpha- GST with ALT improves the biochemical assessment of liver cell injury in those patients. Alpha-GST determination may be useful to exclude liver damage in anti-HCV positive cases without viral replication (HCV-RNA negative).