Utility of α-Glutathione S-transferase assessment in chronic hepatitis C patients with near normal alanine aminotransferase levels

Objectives: To study whether determining alpha-glutathione S-transferase (α-GST) might improve the assessment of chronic hepatitis C (CHC) patients with near normal alanine aminotransferase levels (NNA). Design and methods: We studied 119 viraemic CHC patients. They were subdivided into two groups according to the pattern of alanine aminotransferase (ALT) alteration, i.e. consistently above (HA) or below (NNA) twice the upper normal value. In these patients we assessed α-GST and correlated its levels to clinical, histological, and virological findings, further evaluating whether α-GST might improve the assessment of CHC patients with NNA. Results: α-GST showed a significant correlation with aminotransferases, though not with histological necroinflammatory activity and fibrosis or with hepatitis C virus RNA levels. Twenty-seven patients had NNA (23%), and within this subgroup of patients α-GST identified a subset of patients with a higher viral load. Conclusions: α-GST in CHC patients is related to hepatocellular necrosis parameters, but unrelated both to histology and to viraemia. However, in patients with NNA, α-GST identified a subgroup of patients with a higher viral load. In this subgroup of patients α-GST alteration likely represents the expression of a more severe damage. Because this injury is not detectable by the usual biochemical or histological work-up, we suggest that α-GST could a useful tool for monitoring liver damage over time.