Significance of Serum Butyrylcholinesterase in Evaluating the Liver Reserve in Chronic Hepatitis(C) Cirrhotic Patients

Abstract

Hepatitis C virus can cause both acute and chronic hepatitis. The acute process is self-limited, rarely causes hepatic failure and usually leads to chronic infection. Chronic HCV infection often follows a progressive course over many years and can ultimately result in cirrhosis, HCC and the need for liver transplantation. Liver cirrhosis is one of the major leading causes of morbidity and mortality worldwide including Egypt. Cirrhotic patients evaluated for the presence of complications by using Child-Pugh score. However; the cirrhotic patients particularly those with Child grades B and C with ascites or hemorrhagic tendency are usually treated with albumin or blood transfusion which may affect the numerical value for calculating the Child- Pugh score. Cholinesterase is a family of enzymes that catalyze the hydrolysis of the neurotransmitter acetylcholine into choline and acetic acid (Mohamed et al., 2017). There are 2 types; Acetyl cholinesterase also known as erythrocyte cholinesterase found in RBCs cell membrane and pseudo-cholinesterase known as plasma cholinesterase which is synthesized mainly in hepatocyte and is released into blood and its activity is reduced in liver dysfunction due to reduced synthesis (Yanai and Hoshino, 2010). The aim of this study is to evaluate serum cholinesterase level as a biomarker for detecting liver injury in patients with CHC. For this propose 40 patients with liver cirrhosis due to HCV infection and 10 healthy adults were selected and divided into 3 groups: • Group 1: 20 Patients having compensated liver cirrhosis due to HCV infection. • Group 2: 20 Patients having decompensated liver cirrhosis due to HCV infection • Group 3: 10 Healthy subjects matched for age and sex as a control. All the participitants were subjected to clinical evaluation; laboratory investigations including CBC, liver and kidney function tests, AFP, APRI sore, serum cholinesterase level evaluation, abdominal ultrasonography and liver Fibroscan. The obtained results showed that: • Sensitivity of cholinesterase is 100%, its specificity is 100% and its accuracy is 100%, in predicting liver injury in patients with chronic hepatitis C. • Cholinesterase is positively correlated with Hb, platelets and albumin.