Serum complement C4a and its relation to liver fibrosis in children with chronic hepatitis C

Table 1 Clinical, laboratory and histopathological characteristics of the studied patients n (%)

Parameter	HCV patients (n = 30)
Clinical findings
Jaundice	0 (0.0)
Hepatomegaly	4 (13.3)
Splenomegaly	1 (3.3)
Ascites	0 (0.0)
Liver function tests
Total bilirubin (mg/dL)	1.23 ± 1.051
Direct bilirubin (mg/dL)	0.30 ± 0.26
Albumin (g/L)	43.17 ± 7.5
Alanine transaminase (U/L)	55.57 ± 126.16
Aspartate transaminase (U/L)	72.10 ± 131.97
Gamma glutamyl transpeptidase (U/L)	38.90 ± 21.92
Alkaline phosphatase (U/L)	253.48 ± 97.38
Complete blood count
Hemoglobin (g/L)	113.6 ± 11.2
White blood cells (× 103/ L)	8.77 ± 7.52
Platelets (× 103/L)	383.57 ± 390.87
Fibrosis stage
No (F0)	1 (3.3)
Mild (F1)	12 (40)
Moderate (F2-F3)	17 (56.7)
Activity grade
Minimal	10 (33.3)
Mild	20 (66.7)
Steatosis	8 (26.7)

HCV: Hepatitis C virus; F0/1/2/3: Fibrosis score 0/1/2/3.

Table 2 Histopathological findings in patients with normal vs elevated transaminases n (%)

Histopathology	Normal transaminases	Elevated transaminases
Fibrosis stage
No fibrosis (n = 1)	1 (100)
Mild fibrosis (n = 12)	5 (41.7)	7 (58.3)
Moderate fibrosis (n = 17)	8 (47.1)	9 (52.9)
Activity grade
Minimal activity (n = 10)	5 (50)	5 (50)
Mild activity (n = 20)	9 (45)	11 (55)

Table 3 Serum complement C4a according to different transaminases levels, viral loads and histopathological findings

Parameter	C4a (mg/L)	P value
Fibrosis stage		0.786
No/Mild (n = 13)	154.65 ± 20.59
Moderate (n = 17)	152.97 ± 17.72
Activity grade		0.809
Minimal (n = 10)	155.1 ± 21.93
Mild (n = 20)	152.99 ± 17.43
Steatosis		0.186
Present (n = 8)	146.13 ± 3.32
Absent (n = 22)	156.45 ± 21.19
Normal transaminases (n = 14)	155.36 ± 21.33	0.868
Elevated transaminases (n = 16)	152.25 ± 16.62
Viremia		0.561
Low viremia (n = 17)	156.37 ± 18.91
Moderate viremia (n = 9)	152.43 ± 22.19
High viremia (n = 4)	145.2 ± 3.96

Table 4 Correlation of complement C4a with laboratory and histopathological parameters in liver biopsy

Parameter	C4a (mg/L)
	r	P value
Total bilirubin (mg/dL)	-0.022	0.910
Direct bilirubin (mg/dL)	-0.038	0.841
Albumin (g/L)	0.162	0.393
Alanine transaminase (U/L)	-0.148	0.332
Aspartate transaminase (U/L)	-0.026	0.891
Gamma glutamyl transpeptidase (U/L)	0.000	1.000
Alkaline phosphatase (U/L)	0.176	0.446
Hemoglobin (g/dL)	-0.100	0.599
White blood cells (× 103/L)	0.054	0.777
Platelets (× 103/L)	0.228	0.226
HCV-RNA (IU/mL)	-0.210	0.265
Fibrosis stage	-0.208	0.269
Activity grade	-0.114	0.548

HCV: Hepatitis C virus.