الفهرس 
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Abstract
Background: AAT is a protective protein that controls tissue degradation. AAT deficiency is a possible cause of chronic liver disease. Aim of work: This work was done to study the magnitude of AAT deficiency in our chronic liver disease patients, its relation to chronic viral hepatitis mainly C and B and its impact on its course and prognosis. Methods: 74 patients were studied, classified into group I 56 cases of chronic viral infection, group II 1 8cases of HCC and 10 normal control subjects. AAT deficiency was detected in 35% of the whole studied group, 34% of group I and 39% of group II. HCV was positive in 52 patients, of them 21 (40%) were AAT deficient. HBV was positive in 22 cases, of them 5 (23%) were AAT deficient. Results: There was significant decrease in serum albumin in group I AAT deficient compared to AAT non deficient. There was significant increase in transaminases in group II AAT deficient compared to AAT non deficient. Positive correlation between serum AAT level and serum ferritin in the whole studied group. There was significant increase in necroinflammatory score in AAT deficient compared to AAT non deficient. Conclusion & Recommendations: AAT assay and phenotype identification are important especially in HCV patients. Liver biopsy and detection of AAT globules using immunohistochemistry in AAT deficient cases. Screening of Egyptian HCV positive patients for AAT deficiency before starting interferon therapy. Increasing number of liver transplantation centers because it provides metabolic cure of the disease. Gene therapy is a future hope for patients and relatives.