Serum Gamma-Glutamyl Transferase “GGT” Level as an Indicator of Liver Histopathology in Chronic Hepatitis C Patients, MOHAMMAD ABD ELHAMID, MOHAMMAD E. EL-SHEWI and MOHABAT H. GODA
Abstract
Backgroud: Serum gamma-glutamyl transferase (GGT) enzyme activity found predominantly in diseases of the liver, biliary tract and pancreas. GGT level could act as predictor to liver fibrosis.
Aims: To investigate the relationship between GGT levels and histopathological hepatic assessment in patients with chronic hepatitis C.
Material and Methods: This study included 130 patients suffering from chronic hepatitis C (CHC) infection who referred to Hepatology and Gastroenterology outpatient clinic at Shebin El-Kom Teaching Hospital to be enrolled in the National Committee for Control of Viral Hepatitis (NCCVH) from March to November 2014 before starting antiviral therapy by with peg-interferon/ribavirin (peg-IFN/RBV). All patients were evaluated histopathologically by liver biopsy and GGT level was meased.
Results: GGT is elevated in CHC patients (Mean ± SD 68.8±39.6) the upper limit of GGT (up to 30 U/L). While, there was no correlation between GGT levels and quantative PCR assay of HCV RNA. There was a positive correlation between body mass index (BMI) and degree of hepatic steatosis in the studied cases (p-value <0.001). Histopathological assessment of liver biopsy by Ishak and Metaver scoring systems revealed highly significant statistical difference between different stages of fibrosis and degrees of hepatic steatosis regarding GGT level (p-value <0.001) with positive correlation between GGT levels and staging of fibrosis, hepatitis activity index (HAI) and degree of steatosis (p-value <0.001).
According to the area under the curve (0.944), GGT was a significant indicator to advanced fibrosis at a cutoff point 63.5U/L with sensitivity 91.9% & specificity 79.6% in indi-cating advanced liver fibrosis.
Conclusion: GGT levels can be taken into consideration to predict stage of liver fibrosis and degree of hepatic steatosis.