Serum protease inhibitors in acute viral hepatitis

Serum levels of α₁-antitrypsin (α₁-AT) and α₂-macroglobulin (α₂-M) and, as controls, α₁-acid glycoprotein (α₁-AG) and haptoglobin were evaluated by means of laser nephelometry in 17 patients with acute viral hepatitis (AVH) type A, 16 with AVH-B, 12 with AVH-NANB and 8 with fulminant hepatitis B. On admission, α₁-AT levels were elevated in one third of AVH-A and AVH-B cases, but subsequently declined; α₂-M levels were elevated in about 40% of AVH-B patients during the 2nd, 3rd and 4th week after admission. No significant correlation was found between elevated levels of protease inhibitors and aminotransferase values or drug addiction and δ coinfection. α₁-acid glycoprotein and haptoglobin levels were always normal or low. Protease inhibitors did not show any elevation in fulminant hepatitis, while changes were found only in a few patients with AVH-NANB. Thus, no clearcut pattern of changes in protease inhibitors has been found in association with each type of hepatitis, although α₁-AT and α₂-M elevations are mainly found in AVH-B.