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LIVER HISTOLOGICAL ALTERATIONS IN PATIENTS WITH CHRONIC HEPATITIS C AND NORMAL ALT LEVELS IN THE CITY OF SALVADOR, NORTHEAST-BRAZIL
Aspartato Aminotransferases/sangue
Hepacivirus/imunologia
Hepatite C Crônica/patologia
Fígado/patologia
Doadores de Sangue
Brasil/epidemiologia
Ensaio de Imunoadsorção Enzimática
Anticorpos Anti-Hepatite C/sangue
Hepatite C Crônica/enzimologia
Hepatite C Crônica/epidemiologia
Fatores de Risco
Índice de Gravidade de Doença
Feminino
Humanos
Masculino
Author
Affilliation
Federal University of Bahia. Gastro-Hepatology Service Hospital Prof. Edgard Santos. / Hospital São Rafael. Gastro-hepatology Service. Salvador, Bahia, Brasil
Fundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, Bahia, Brasil / Federal University of Bahia. Pathology Department. Salvador, Bahia, Brasil
Federal University of Bahia. Gastro-Hepatology Service Hospital Prof. Edgard Santos. / Hospital São Rafael. Gastro-hepatology Service. Salvador, Bahia, Brasil
University of Bahia. Post-graduate course in Medicine and Health Federal. Salvador, Bahia, Brasil
Federal University of Bahia. Gastro-Hepatology Service Hospital Prof. Edgard Santos. / Hospital São Rafael. Gastro-hepatology Service. Salvador, Bahia, Brasil
INSERM. Viral Hepatitis LAaoratory. Lyon, France
Federal University of Bahia. Gastro-Hepatology Service Hospital Prof. Edgard Santos. / Hospital São Rafael. Gastro-hepatology Service. Salvador, Bahia, Brasil
Fundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Salvador, Bahia, Brasil / Federal University of Bahia. Pathology Department. Salvador, Bahia, Brasil
Federal University of Bahia. Gastro-Hepatology Service Hospital Prof. Edgard Santos. / Hospital São Rafael. Gastro-hepatology Service. Salvador, Bahia, Brasil
University of Bahia. Post-graduate course in Medicine and Health Federal. Salvador, Bahia, Brasil
Federal University of Bahia. Gastro-Hepatology Service Hospital Prof. Edgard Santos. / Hospital São Rafael. Gastro-hepatology Service. Salvador, Bahia, Brasil
INSERM. Viral Hepatitis LAaoratory. Lyon, France
Federal University of Bahia. Gastro-Hepatology Service Hospital Prof. Edgard Santos. / Hospital São Rafael. Gastro-hepatology Service. Salvador, Bahia, Brasil
Abstract
Patients with chronic hepatitis C can have variable clinical progression. Hepatic histological
alterations appear to be milder in asymptomatic subjects who have persistently normal ALT
levels. Aims: To evaluate the severity of histological liver alterations in blood donors with normal
and elevated ALT levels. Methods: We evaluated volunteer blood donors from the main blood bank
of the city of Salvador-Brazil. Those who were anti-HCV positive were invited to participate in the
study. Serum ALT and AST levels were measured at two time points, two months apart. Donors
were divided into two groups: group I, individuals with ALT ≥ 1.5 times the upper limit of normal
in at least one time point and group II, individuals with normal or near normal ALT, at both time
points. Results: We evaluated 30,232 blood donors and 528 (1.7%) of them were anti-HCV positive.
Eighty-two attended our service and HCV infection was confirmed in 66 individuals. Male gender
predominated in both groups; the mean age was 36 for group I, and 33 for group II. Tattoos and
intravenous illicit drug use were frequently-encountered risk factors. Liver biopsy was done in
43 subjects. Among donors with elevated ALT, two (10%) had minimum alterations, while in
group II normal liver or minimum alterations were observed in six (26%) subjects. Chronic
hepatitis or cirrhosis was encountered in 35 (81%) individuals: three (15%) and five (21%)
subjects had chronic hepatitis without inflammatory activity, 10 (50%) and 11 (48%) had minimum
to moderate activity and five (25%) and one (4.3%) had cirrhosis, in groups I and II, respectively
(P was not significant). Conclusions: The prevalence of anti-HCV among this population of volunteer
blood donors was 1.7%, and these subjects had few liver histological alterations or chronic
hepatitis and cirrhosis. Liver injury severity was significant in patients with elevated ALT, however
subjects with normal levels may also present chronic hepatitis and cirrhosis.
DeCS
Alanina Transaminase/sangueAspartato Aminotransferases/sangue
Hepacivirus/imunologia
Hepatite C Crônica/patologia
Fígado/patologia
Doadores de Sangue
Brasil/epidemiologia
Ensaio de Imunoadsorção Enzimática
Anticorpos Anti-Hepatite C/sangue
Hepatite C Crônica/enzimologia
Hepatite C Crônica/epidemiologia
Fatores de Risco
Índice de Gravidade de Doença
Feminino
Humanos
Masculino
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