Abstract
Objective:To assess the Histological alteration of liver in asymptomatic HCV PCR positive family blood donors.Methods:This is a prospective cross sectional study carried out at Blood Transfusion Services, Clinical & Molecular Laboratory and Pakistan Health Research Council, Jinnah Postgraduate Medical Centre, Karachi from January 2011 to December 2016. One hundred thirteen (113) Anti HCV and HCV RNA positive family blood donors with normal or slightly raised ALT during three consecutive bimonthly visits were included. After taking consent liver biopsy was done to see the histopathological changes in these study participants. The software program SPSS for windows (Ver.19) was utilized for all statistical analysis.Results:One hundred thirteen blood donors who were Anti HCV and HCV RNA positive were included. Ninety eight were male and 15 Female with a mean age of 32.3±6.94 years. Nineteen (16.8%) had significant inflammation of grade 2-3. Nine (8.0%) had significant fibrosis and steatosis was seen in 65 (57.5%) cases. Cirrhosis or advanced liver disease was not found in this series.Conclusion:HCV infected individual with normal ALT level having good physical health, without any sign of advanced liver disease on ultrasonography and routine laboratory investigation like AST, Gamma GT, Alkaline Phosphatase, serum albumin, A/G ratio, platelet count and PT, INR might be highly helpful to predict mild or progressive liver disease. Ultimately it reduces the need of liver biopsy, an invasive procedure having significant complications.
Highlights
Chronic HCV infection is a major health problem
Hepatic inflammation: A significant relationship was seen with severity of fibrosis, presence of steatosis, mean portal tract level, portal inflammation, lobular necrosis and piecemeal necrosis but there was no significant relationship between the severity of inflammation, age, gender and biochemical parameters (Table-I)
Hepatic fibrosis: A significant relationship was seen with severity of inflammation, portal inflammation, lobular necrosis, and piecemeal necrosis but there was no significant relationship between the severity of fibrosis, age, gender and biochemical parameters (Table-II)
Summary
Chronic HCV infection is a major health problem. About 71 million people have this infection and around 399,000 people die every year due to chronic HCV infection related liver complication. The prevalence of chronic HCV infection in South East Asia is 0.5% in general population and approximately 10 million people have this infection while Pakistan have world second highest prevalence, 2nd to Egypt, overall 6.7% population having HCV infection in this country.. Around 20% to 30% Patient with chronic HCV infection have normal ALT level.. It is a generally considered that Patients with normal ALT have lesser degree of inflammation & fibrosis and slower progression of disease as compared to cases with higher liver enzymes.. Around 20% to 30% Patient with chronic HCV infection have normal ALT level. It is a generally considered that Patients with normal ALT have lesser degree of inflammation & fibrosis and slower progression of disease as compared to cases with higher liver enzymes. Majority of the HCV carrier
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