INCREASED SERUM APOPTOTIC CYTOKERATIN-18 FRAGMENTS IN CHRONIC HEPATITIS C (CHC) PATIENTS WITH NORMAL ALANINE AMINOTRANSFERASE (ALT).
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For 40 adult patients with CHC Or. I; 21 with normal ALT and Or. II; of 19 with elevated ALT levels togetherwith 20 trols Or. III. Results showed that Gr.I and Or. II serum CK-18 fragments levels were significantly correlated with age and was higher than that of Or. III (p<0.05) but lower than in Or. II (p<0.05).There was a statistically significant positive correlation (p<0.05) between serum CK-18 and ALT and AST levels (p < 0.05 and < 0.01 ,respectively) in Gr.I & Gr.II and also highly significant positive correlation with HCV-RNA- load (p<0.001).Liver biopsies in Gr.1 showed METAVIR (Al) activity in 17 out of 21 patients and fibrosis (F2) was significantly higher than in Gr.I1(p<0.05). while those with (F3) showed no such difference A statistically positive correlation (P<0.05) was observed betwet--n CK- 18 and METAVIR necroinflamatory grade (A) and fibrosis stage (F). In conclusion, in CHC patients with persistently normal ALT, serum CK-18 fragments level is increased and correlates with the necroinfiammatory changes in liver tissue as well as the viral load.