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Biological criteria for evaluating activity and remission in chronic hepatitis


, : Biological criteria for evaluating activity and remission in chronic hepatitis. Revista de Medicina Interna Neurologie Psihiatrie Neurochirurgie Dermato-Venerologie Serie Medicina Interna 37(6): 499-510

Over a five year period (1980-1984) a study was carried out on 159 patients with chronic hepatitis, of whom 63 with persistent chronic hepatitis and 96 with active-aggressive chronic hepatitis. For a correct listing of the forms of the disease ample biochemical and immunologic tests and serial histologic examinations were performed in all the cases. Activity and remission in chronic hepatitis was established on the basis of six biological tests (ASAT, ALAT, ASAT/ALAT ratio, YGI, IgG and AMN), correlated with the histologic data at different intervals. The six biological criteria are sufficient to establish periods of activity and remission in chronic hepatitis, to indicate the treatment and evaluate the results obtained as the proportion of error is very small. The need of biopsy puncture of the liver must be reconsidered when other tests are available, such as the biochemical and immunological ones which involve no risk. Similarly, the biological criteria proposed are useful for differentiating the moderate and the intensely active forms of the disease; the percentage of errors in the lot studied was below 25%. Serum aminotransferases may be considered the reference biochemical tests, as they furnish the best discrimination. Increase in serum YG1 and IgG is almost constant in chronic active hepatitis. The biological criteria were strongly modified in patients with AMN, especially in moderate or intensely positive titers. The most significant biological correlations were found in the group of patients with autoimmune chronic hepatitis in which the high ASAT concentrations an ASAT/ALAT ratio greater than 1.5 were accompanied by increased serum YGI and IgG and intensely positive AMN titers. In the patients with active chronic hepatitic followed by remission after prednisone and azathioprine, AMN disappeared or was only slightly positive. AMN together with the other biological criteria are useful for the diagnosis in the period of activity and for establishing the results obtained after treatment.

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