AST, ALT and Albumin Level in Chronic Hepatitis B Patients with and without Complications of Cirrhosis and Hepatocellular Carcinoma

Authors

  • Viky Nafi'ah Rahma Maulidia Airlangga University
  • Puspa Wardhani Airlangga University
  • Bagus Setyoboedi Airlangga University

DOI:

https://doi.org/10.24293/ijcpml.v26i3.1588

Keywords:

Aspartate aminotransferase, alanine aminotransferase, albumin, chronic hepatitis B, cirrhosis, hepatocellular carcinoma

Abstract

Complications of Chronic Hepatitis B (CHB) infection are liver cirrhosis and Hepatocellular Carcinoma (HCC). Aspartate Aminotransferase (AST), Alanine Aminotransferase (ALT), and albumin may be used as indicators of hepatocyte damage. This study aimed to determine differences between AST, ALT, and albumin in CHB patients without complications with CHB patients with cirrhosis and HCC complications. An analytical cross-sectional study was conducted in March-May 2019 on 62 CHB patients with or without cirrhosis or HCC complications using the total sampling method. AST and ALT were calculated using the Siemens Dimension device and IFCC method. The data were analyzed using independent samples T-test Albumin in CHB patients without complications was higher than CHB patients who had complications of liver cirrhosis (p=0.002). The AST and ALT were not significantly different. Aspartate aminotransferase in CHB with cirrhosis complications differed from CHB patients who had HCC complications (p=0.015), however, not different in ALT and albumin. Aspartate aminotransferase, ALT, and albumin in CHB patients without complications were different from those with HCC complications. Albumin in CHB patients without complications was different from CHB patients with cirrhosis complications. Aspartate aminotransferase in CHB patients with cirrhosis complications was different from CHB patients who had HCC complications. As a result of these differences, an integrated approach to intervening liver damage may be needed to prevent the progression of the disease from becoming more severe.

Downloads

Download data is not yet available.

Author Biographies

Viky Nafi'ah Rahma Maulidia, Airlangga University

Airlangga University

Puspa Wardhani, Airlangga University

Department of Clinical Pathology

Bagus Setyoboedi, Airlangga University

Department of Pediatrics

References

Perhimpunan Peneliti Hati Indonesia. Panduan tata laksana infeksi hepatitis B kronik. Jakarta, Perhimpunan Peneliti Hati Indonesia. 2006 [cited at April 15, 2018]. Available at http://www.pphi-online.org/

Khumaedi A, Gani R, Hasan I. Pencegahan transmisi vertikal hepatitis B: Fokus pada penggunaan antivirus antenatal. Jurnal Penyakit Dalam Indonesia, 2017; 3(4): 225.

Alter M. Epidemiology of hepatitis B in Europe and worldwide. Journal of Hepatology, 2003; 39: 64-69.

World Health Organization. Guidelines for the prevention, care, and treatment of persons with chronic hepatitis B infection. Geneva, World Health Organization. 2015 [cited at April 15, 2018]. Available at https://www.who.int/hepatitis/publications/hepatitis-b-guidelines/en/

Hou J, Liu Z, Gu, F. Epidemiology and prevention of hepatitis B virus infection. International Journal of Medical Sciences, 2005; 2(1): 50-57.

Pusat Data dan Informasi Kementerian Kesehatan Republik Indonesia. InfoDATIN hepatitis. Jakarta Selatan, Pusat Data dan Informasi Kementerian Kesehatan Republik Indonesia. 2014 [cited at April 15, 2018]. Available at http:// www.pusdatin.kemkes.go.id.

Kementerian Kesehatan Republik Indonesia. 150 ribu orang potensial mengalami hepatitis B kronis. Biro Komunikasi dan Pelayanan Masyarakat, Kementerian Kesehatan Republik Indonesia. 2017 [cited at April 15, 2018]. Available www.depkes.go.id/article/view/17072800006/150-ribu-orang-potensial-alami-hepatitis-kronis.html

Betharina N, Hendriyono FX, Mashuri. Perbedaan hasil laboraturium penderita hepatitis B dan C kronis dengan derajat fibrosis hati. Berkala Kedokteran, 2017; 13(1): 41-46.

Thapa B, Walia A. Liver function tests and their interpretation. The Indian Journal of Pediatrics, 2007; 74(7): 663-671.

Sherlock S, Dooley J. Diseases of the liver and biliary system. 11th. Ed., United States of America, Blackwell Publishing, 2002; 32-34.

Dufour DR. Liver disease: Clinical chemistry and molecular diagnostics. 4thEd., Missouri, Elsevier, 2006; 1777-1827.

Asian Pacific Association for the study of liver. Asian-Pacific clinical practice guidelines on the management of hepatitis B. Hepatology International, 2016; 10(1): 1-98.

Wang SH, Yeh SH, Lin WH, Wang HY, Chen DS, Chen PJ. Identification of androgen response elements in the enhancer I of hepatitis B virus: A mechanism for sex disparity in chronic hepatitis B. Hepatology, 2009; 50(5): 1392-1402.

Ahlbory"Dieker DL, Stride BD, Leder G, Schkoldow J, Trölenberg S, et al. DNA binding by estrogen receptor"alpha is essential for the transcriptional response to estrogen in the liver and the uterus. Mol. Endocrinol, 2009; 23(10): 1544-1555.

Waxman DJ, Holloway MG. Sex differences in the expression of hepatic drug metabolizing enzymes. Mol. Pharmacol, 2009; 76(2): 215-228.

Yang WJ, Chang CJ, Yeh SH, Lin WH, Wang SH, et al. Hepatitis B virus X protein enhances the transcriptional activity of the androgen receptor through c"Src and glycogen synthase kinase"3 beta kinase pathways. Hepatology, 2009; 49(5): 1515-1524.

Jia W, Qi X, Ji YY, Xun YH, Wang H, et al. Low serum hepatitis B surface antigen level predicts compensated cirrhosis caused by chronic hepatitis Bin HBeAg positive patients in East China. Hepat Mon, 2015; 15(8): e30385.

Dufour DR, Lott JA, Nolte FS, Gretch DR, Koff RS, Seeff LB. Diagnosis and monitoring of hepatic injury. I. Performance characteristics of laboratory tests. Clinical Chemistry, 2000; 46(12): 2027-2049.

Wroblewski F. The clinical significance of alterations in transaminase activities of serum and other body fluids. Advances in Clinical Chemistry, 1958; 1: 313-351.

Rej R. Aminotransferases in disease. Clinical Laboratory Medicine, 1989; 9(4): 667-687.

Kamimoto Y, Horiuchi S, Tanase S, Morino Y. Plasma clearance of intravenously injected aspartate aminotransferase isozymes: Evidence for preferential uptake by sinusoidal liver cells. Hepatology, 1985; 5(3): 367-375.

Henricksen JH, Siemssen O, Krintel JJ, Malchow-Mí¸ller A, Bendtsen F, Ring-Larsen H. Dynamics of albumin in plasma and ascites fluid in patients with cirrhosis. Journal of Hepatology, 2001; 16: 53-60.

D'Amico G. The clinical course of cirrhosis. Population-based studies and the need of personalized medicine. Journal of Hepatology, 2014; 60(2): 241-242.

Bernardi M, Moreau R, Angeli P, Schnabl B, Arroyo V. Mechanisms of decompensation and organ failure in cirrhosis: From peripheral arterial vasodilation to systemic inflammation hypothesis. Journal of Hepatology. 2015; 63(5): 1272-1284.

Elsing C, Harenberg S, Stremmel W, Hermann T. Serum levels of soluble Fas, nitric oxide, and cytokines in acute decompensated cirrhotic patients. World J Gastroenterol, 2007; 13(3): 421-425.

Chen S, Jia J, Gao Y, Li H, Fang M, et al. Clinical evaluation of hepatitis B core-related antigen in chronic hepatitis B and hepatocellular carcinoma patients. International Journal of Clinical Chemistry, 2018; 486: 237-244.

Lemoine A, Saffroy R, Debuire B. Mechanisms of hepatocarcinogenesis. Atlas Genet Cytogenet Oncol Haematol, 2007; 11(1): 65-70.

Bertino G, Di Carlo I, Ardiri A, Calvagno GS, Demma S, et al. Systemic therapies in hepatocellular carcinoma: Present and future. Future Oncol, 2013; 9(10): 1533-1548.

Domingo EO, Lingao AL, Lao JY, et al. The significance of common laboratory tests in hepatocellular carcinoma. Philippine Journal of Internal Medicine, 2013; 51: 1-3.

Carr B, Guerra V. Serum albumin levels in relation to tumor indis in hepatocellular carcinoma patients. The International Journal of Biological Markers, 2017; 32(4): 391-396.

Witjes C, Ijzermans J, van der Eijk A, Hansen B, Verhoef C, et al. Quantitative HBV-DNA and AST are strong predictors for survival after HCC detection in chronic HBV patiens. The Netherlands Journal of Medicine, 2011; 54: 508-513 .

Merza M. Characteristics of chronic hepatitis B virus patients related liver cirrhosis in a tertiary care referral hospital, Duhok, Iraqi Kurdistan. Journal of Gastroenterology, Pancreatology & Liver Disorders, 2017; 4(5): 1-5.

Lopez JB, Balasegaram M, Thambyrajah V, Timor J. the value of liver function test in hepatocellular carcinoma. The Malaysian Journal of Pathology, 1996; 18(2): 95-99.

Ishiguro S, Inoue M, Tanaka Y, Mizokami M, Iwasaki M, Tsugane S. Serum aminotransferase level and the risk of hepatocellular carcinoma: A population-based cohort study in Japan, Eur J Cancer Prev, 2009; 18(1): 26-31.

Downloads

Submitted

2019-11-19

Accepted

2020-05-20

Published

2020-09-30

How to Cite

[1]
Maulidia, V.N.R., Wardhani, P. and Setyoboedi, B. 2020. AST, ALT and Albumin Level in Chronic Hepatitis B Patients with and without Complications of Cirrhosis and Hepatocellular Carcinoma. INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY. 26, 3 (Sep. 2020), 344–349. DOI:https://doi.org/10.24293/ijcpml.v26i3.1588.

Issue

Section

Articles