الفهرس 
HCV VIROLOGYOnly 14 pages are availabe for public view
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Abstract
In this observational study, we recruited 50 patients (11females and 39 males) with mean age range (40.1± 9.3) infected with chronic HCV having persistently normal ALT. Duration of recruitment was from may 2007 to December 2008.The study was undertaken in the Department of Hepatology Gastroenterology and infectious Diseases at Benha University hospital and Police Hospital Agouza. The aim was to evaluate histopathological changes in patient with chronic hepatitis C and persistently normal ALT level.
All The patients were subjected to:
- Thorough history taking and examination
- Laboratory investigation:
• CBC, Liver profile (AST, ALT, PT, S. bilirubin, S. Albumin, prothrombin time and concentration).
• HCV Ab -HBsAg
• HCV RNA PCR.
• ANA – serum iron – serum ferritin
- Abdominal Ultrasonography.
- Rectal snip for presence of schistosomal ova
- Liver biopsy
The patients who had normal ALT but ultrasonographic evidence of cirrhosis, platelets count less than 150x109/L, prothrombin time more than 3 seconds higher than the control, ANA positive, positive rectal snip for schistosomal ova , elevated serum ferritin and patients with combined HBV infection were excluded.
The ALT value were identified and divided into either up to 30 U/l or up to 40 U/l.
The score of fibrosis was divided into either insignificant fibrosis stage (0-1) and significant fibrosis stage (2-4).
The results led to the following conclusions:
Significant fibrosis from (F2 to F4) were present in 23 (46%) patients with chronic hepatitis C and normal ALT .Cirrhosis (F4) was present in 6 (12%) patients.
Mild (grade A1) necroinflammatory changes was present in 40 patients(80%) while A2 in 10 patients(20%) but no patients showed A0 or A3.
5% Steatosis was present in 29 patients (58%) and 10% steatosis was present in 15 patients (30%) and 15% steatosis was present in 6 patients (12%).
The stage of fibrosis were significantly related to the degree of inflammatory changes and degree of steatosis but not related to either age, sex, ALT or viral load.
The grade of inflammation was related to the age but not related to either sex, ALT, viral load or histological steatosis.
The ALT or viral load value were not related to either clinical, laboratory or histological changes.