GAMMA GLUTAMYLTRANSFERASE IMPACT IN THERAPEUTIC RESPONSE OF CHRONIC HEPATITIS C: a systematic review of the literature

Abstract

-Background -The standard treatment of chronic hepatitis C is the administration of pegylated interferon α2a or α2b in combination with ribavirin, but adverse effects can be observed, as well as the high cost of this therapy. Therefore, there is interest in understanding the predictors of sustained virologic response, as the gamma glutamyltransferase. Objective -To evaluate the serum levels of gamma glutamyltransferase as a predictor of response to treatment with pegylated interferon α and ribavirin in chronic hepatitis C. Methods -This is a systematic review of literature, conducted by consulting PUBMED, LILACS, MEDLINE, SCOPUS, Cochrane electronic databases, and active search of articles selected between January 2000 and April 2013. Results -A total of 4,785 titles were iden tified. Out of those material, following inclusion and exclusion criteria, 273 abstracts were selected, by two independent researchers. After reading those texts, the reviewers consensually included ten studies for systematization and classification, according to the criteria of the Oxford Scale. 1B studies are predominant (prospective cohort study -six studies). Rapid virologic response and early virological response were considered as estimates for the sustained virological response. The frequency of virologic response was identified in three studies and early virological response in two, with a total of 392 and 413 patients, respectively; sustained virologic response was reported in nine articles corresponding to 3,787 patients (76.5 %). Conclusion -Gamma glutamyltransferase is a predictor of sustained virologic response in the treatment of chronic hepatitis C with pegylated interferon α2a or α2b associated with ribavirin. HEADINGS -Gamma glutamyltransferase. Hepatitis C. Sustained virological response. Review.

Factors linked to hepatocellular carcinoma development beyond 10 years after viral eradication in patients with hepatitis C virus

“…Of these, GGT ≥ 56 U/L showed the highest aHR at 4.157 (95%CI 1.400–12.350, p = 0.0103). GGT is an enzyme located on the outer surface of cell membranes in the liver, kidney, biliary tract, intestines, heart, spleen, pancreas and brain 40 . It catalyses the transfer of gamma‐glutamyl groups from glutathione to amino acids and dipeptides.…”

“…It was demonstrated that serum GGT activity is directly proportional to the level of oxidative stress 41 . Elevated serum GGT activity is associated with increased overall mortality and an elevated risk of cardiovascular complications, diabetes, arterial hypertension and cancer, especially that involving the prostate, breast and liver 40 . GGT is also used in the diagnosis of liver conditions, mainly alcohol‐related and cholestatic liver diseases 42 .…”

“…GGT is an enzyme located on the outer surface of cell membranes in the liver, kidney, biliary tract, intestines, heart, spleen, pancreas and brain. 40 It catalyses the transfer of gamma-glutamyl groups from glutathione to amino acids and dipeptides. It was demonstrated that serum GGT activity is directly proportional to the level of oxidative stress.…”

“…41 Elevated serum GGT activity is associated with increased overall mortality and an elevated risk of cardiovascular complications, diabetes, arterial hypertension and cancer, especially that involving the prostate, breast and liver. 40 GGT is also used in the diagnosis of liver conditions, mainly alcoholrelated and cholestatic liver diseases. 42 In our study, there was no significant association between the amount of alcohol consumption and the occurrence of HCC beyond 10 years after SVR.…”