Significance of Serum Alpha-Glutathione S-Transferase Assessment in Hepatitis C Patients with Different Alanine Aminotransferase Patterns

Abstract

BackgroundAlpha-Glutathione S-transferase (α-GST) is a liver enzyme which showed properties making it useful in assessment of liver cell damage. A number of studies demonstrated its early elevation in different hepatic insults, but its pattern in HCV was controversial. Consequently, we planned this work to study the significance of Serum Alpha-Glutathione S-Transferase (α-GST) assessment in hepatitis C patients with different alanine aminotransferase (ALT) patterns.MethodsSixty-five untreated male patients with history of hepatitis C virus (HCV) positive antibodies and 21 healthy age- and sex-matched control subjects were enrolled in this study. Sera were collected for confirmation of the presence of HCV antibodies (by ELISA) as well as for assessment of the levels of α-GST, ALT, aspartate aminotransferase, alkaline phosphatase, gamma glutamyl-transferase, total proteins, albumin and HCV RNA. HCV RNA was detected by the reverse transcription polymerase chain reaction (RT-PCR). Based on ALT level, patients were divided into three groups. Twelve patients with normal ALT levels (NALT), 29 with near normal ALT levels (NNALT), and 24 with high ALT levels (HALT). All data were statistically analyzed for significance and correlation as well as sensitivity, specificity, positive and negative predictive values.ResultsThe mean value of α-GST in HCV patients was significantly higher compared to the control with 82% sensitivity, 85% specificity, 98% positive predictive value and 63% negative predictive value. These results were more or less similar to the results of ALT and higher than the results of all the other assayed liver function tests. The sensitivity, and positive and negative predictive values of α-GST were lower than aminotransferases, but higher than the other assayed liver function tests in NNALT and HALT groups. Nevertheless, in NALT, these parameters were higher for α-GST than all the other assayed liver function tests including aminotransferases.ConclusionsAssay of α-GST has an adjuvant in evaluation of liver cell damage in HCV patients. However, its role is much more valuable in patients with normal aminotransferases for early detection of liver cell damage.

Plasmaα-GlutathioneS-Transferase Evaluation in Patients with Acute and Chronic Liver Injury

“…We found a significant positive correlation between α -GST and ALT and AST in the examined group of patients with acute viral hepatitis B or C, and this observation is similar to the results obtained by Abdel-Moneima and Sliemb [19]. The authors [19] also noticed an elevation of plasma α -GST in HCV patients with high ALT levels, but the sensitivity of α -GST in this group was lower than that of ALT and AST.…”

“…We found a significant positive correlation between α -GST and ALT and AST in the examined group of patients with acute viral hepatitis B or C, and this observation is similar to the results obtained by Abdel-Moneima and Sliemb [19]. The authors [19] also noticed an elevation of plasma α -GST in HCV patients with high ALT levels, but the sensitivity of α -GST in this group was lower than that of ALT and AST. They [19] claimed that these results could diminish the usefulness of assessment of α -GST compared with that of aminotransferases in patients with high ALT and that the measurement of α -GST would be more valuable in early detection of liver damage in HCV patients with normal ALT.…”

“…Abdel-Moneima and Sliemb [19] found a significant increase in the blood level of α -GST in all HCV groups compared with the control group. Even if normal ALT levels were observed, α -GST was significantly increased compared with the control [19].…”

“…Abdel-Moneima and Sliemb [19] found a significant increase in the blood level of α -GST in all HCV groups compared with the control group. Even if normal ALT levels were observed, α -GST was significantly increased compared with the control [19]. Furthermore, the authors [19] noticed that the sensitivity of α -GST was similar to the sensitivity of ALT in all HCV groups and higher than the sensitivity of AST.…”

“…Even if normal ALT levels were observed, α -GST was significantly increased compared with the control [19]. Furthermore, the authors [19] noticed that the sensitivity of α -GST was similar to the sensitivity of ALT in all HCV groups and higher than the sensitivity of AST. Sídlová et al [18] found significantly higher α -GST levels in patients with cystic fibrosis, even in those with normal results of standard liver tests and ultrasound scan, suggesting that serum α -GST is a more sensitive marker than transaminases for the detection of liver damage associated with cystic fibrosis.…”