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Alanine Aminotransferase Levels in Nile Delta Citizens Infected with Chronic Hepatitis C Virus

Year 2012, Volume: 9 Issue: 4, 247 - 252, 01.12.2012

Abstract

Approximately 30% of patients with chronic hepatitis C have persistently normal serum alanine aminotransferase (ALT) levels. In most of the previous studies, the follow-up period of ALT levels did not exceed 12 months. Our objective was to redefine the terms persistently normal alanine aminotransferase (PNALT), persistently elevated ALT (PEALT), and fluctuating ALT (FLUXALT) and to determine the proportion of each group among Nile Delta patients. 348 patients infected with chronic hepatitis C were included, HCV infection was proved by a polymerase chain reaction. We studied an average of 19 ALT measurements for each participant between 2004 and 2007 with 2-month interval between successive measurements. We defined a patient as having PNALT, PEALT, or FLUXALT when all the 19 ALT levels were normal (40 IU/L), or did not fit either of the above two categories, respectively, during the 36-month follow-up period. 73 patients had PNALT, 157 had PEALT, and 118 had FLUXALT (P

References

  • Thomas DL, Thio CL, Martin MP, et al. Genetic variation in IL28B and spontaneous clearance of hepatitis C virus. Nature 2009;461(7265):798-801.
  • Asselah T, Bieche I, Sabbagh A, et al. Gene expression and hepatitis C virus infection. Gut 2009;58(6):846-58.
  • Renou C, Pol S, Halfon P, Caillat-Zucman S. Controversies about the histological features of chronic HCV pa- tients with persistently normal alanine transaminase levels: what can be done about the present definition? Gastroenterology 2002;123:1748 (author reply 9).
  • National Institutes of Health Consensus Development Conference Statement: management of hepatitis C: 2002- June 10-12, 2002. Hepatology 2002;36:S3-20.
  • Tassopoulos NC. Treatment of patients with chronic hepa- titis C and normal ALT levels. J Hepatol 1999; 31(Suppl. 1):193-6.
  • Gholson CF, Morgan K, Catinis G, et al. Chronic hepatitis C with normal aminotransferase levels: a clinical histologic study. Am J Gastroenterol 1997;92:1788-92.
  • Nutt AK, Hassan HA, Lindsey J, Lamps LW, Raufman JP. Liver biopsy in the evaluation of patients with chronic hepatitis C who have repeatedly normal or near normal serum alanine aminotransferase levels. Am J Med 2000; 109:62-4.
  • Pradat P, Alberti A, Poynard T, et al. Predictive value of ALT levels for histologic findings in chronic hepatitis C: an European collaborative study. Hepatology 2002;36:973-7.
  • Alberti A, Noventa F, Benvegnu L, Boccato S, Gatta A. Prevalence of liver disease in a population of asymptom- atic persons with hepatitis C virus infection. Ann Intern Med 2002;137:961-4.
  • Rihn B, Hussenet F, Detry MB, Catelle A, Faou AL. Evaluation of a supplemental assay for the diagnosis of hepatitis C virus infections. Int J Infect Dis 2000;4(1):42- 5.
  • Knodell RG, Ishak KG, Black WC, et al. Formulation and application of a numerical scoring system for assessing histological activity in a symptomatic chronic active hep- atitis. Hepatology 1981;431-5.
  • Munor BH, Jacobsen BS, Duffy ME, Bratmar LE. Statistical methods for health care research ; University of Pennsilvania, Boston college, Lipincott; 2002; 1-412.
  • Lee JK, Shim JH, Lee HC, et al. Estimation of the healthy upper limits for serum alanine aminotransferase in asian populations with normal liver histology. Hepatology 2010; 51: 1577-83.
  • Inglesby TV, Rai R, Astemborski J, et al. A prospective community-based evaluation of liver enzymes in individu- als with hepatitis C after drug use. Hepatology 1999;29: 590-6.
  • Healey CJ, Chapman RW, Fleming KA. Liver histology in hepatitis C infection: a comparison between patients with persistently normal or abnormal transaminases. Gut 1995;37:274-8.
  • Haber MM, West AB, Haber AD, Reuben A. Relationship of aminotransferases to liver histological status in chronic hepatitis C. Am J Gastroenterol 1995;90:1250-7.
  • Prati D, Taioli E, Zanella A, et al. Updated definitions of healthy ranges for serum alanine aminotransferase lev- els. Ann Intern Med 2002;137:1-10.
  • Alberti A, Morsica G, Chemello L, et al. Hepatitis C vire- mia and liver disease in symptom-free individuals with anti-HCV. Lancet 1992;340:697-8.
  • Daniel S, Ben-Menachem T, Vasudevan G, Ma CK, Blumenkehl M. Prospective evaluation of unexplained chronic liver transaminase abnormalities in asymptom- atic and symptomatic patients. Am J Gastroenterol 1999; 94:3010-4.
  • Puoti C, Magrini A, Stati T, et al. Clinical, histological, and virological features of hepatitis C virus carriers with persistently normal or abnormal alanine transaminase. Hepatology 1997;26:1393-8.
  • Bruce MG, Bruden D, McMahon BJ, et al. Hepatitis C in- fection in Alaska natives with persistently normal, persis- tently elevated or fluctuating alanine aminotransferase levels. Liver International 2006;26:643-9.
  • Shindo M, Arai K, Sokawa Y, Okyono T. The virological and histological states of anti-hepatitis C virus-positive sub- jects with normal liver biochemical values. Hepatology 1995;22:418-25.
  • Pasquale G, Sagnelli E, Coppola N, et al. Is liver biopsy necessary for hepatitis C virus carriers with persistent- ly normal aminotransferase levels? Eur J Gastroenterol Hepatol 2003;15:831-3.
  • Jamal MM, Soni A, Quinn PG, Wheeler DE, Arora S, Johnston DE. Clinical features of hepatitis C-infected patients with persistently normal alanine aminotransfer- ase levels in the Southwestern United States. Hepatology 1999;30:1307-11.
  • Kronenberger B, Ruster B, Lee JH, et al. Hepatocellular proliferation in patients with chronic hepatitis C and per- sistently normal or abnormal aminotransferase levels. J Hepatol 2000;33:640-7.
  • Persico M, Persico E, Suozzo R, et al. Natural history of hepatitis C virus carriers with persistently normal ami- notransferase levels. Gastroenterology 2000;118:760-4.
  • Herve S, Savoye G, Riachi G, et al. Chronic hepatitis C with normal or abnormal aminotransferase levels: is it the same entity? Eur J Gastroenterol Hepatol 2001;13: 495-500.
  • Mathurin P, Moussalli J, Cardanel JF, et al. Slow progres- sion rate of fibrosis in hepatitis C virus patients with persistently normal alanine aminotransferase activity. Hepatology 1998;27:868-72.
  • Bacon BR. Treatment of patients with hepatitis C and normal serum aminotransferase levels. Hepatology 2002 Nov; 36(5 Suppl 1):S 179-84.
  • Renou C, Halfon P, Pol S, et al. Histological features and HLA class II alleles in hepatitis C virus chronically infected patients with persistently normal alanine aminotransfer- ase levels. GUT 2002;51:585-90.
  • Kyrlagkitsis I, Portmann B, Smith H, O'grady J, Cramp ME. Liver histology and progression of fibrosis in individuals with chronic hepatitis C and persistently normal ALT. Am J Gastroenterol 2003;98:1588-93.

Alanine Aminotransferase Levels in Nile Delta Citizens Infected with Chronic Hepatitis C Virus

Year 2012, Volume: 9 Issue: 4, 247 - 252, 01.12.2012

Abstract

-

References

  • Thomas DL, Thio CL, Martin MP, et al. Genetic variation in IL28B and spontaneous clearance of hepatitis C virus. Nature 2009;461(7265):798-801.
  • Asselah T, Bieche I, Sabbagh A, et al. Gene expression and hepatitis C virus infection. Gut 2009;58(6):846-58.
  • Renou C, Pol S, Halfon P, Caillat-Zucman S. Controversies about the histological features of chronic HCV pa- tients with persistently normal alanine transaminase levels: what can be done about the present definition? Gastroenterology 2002;123:1748 (author reply 9).
  • National Institutes of Health Consensus Development Conference Statement: management of hepatitis C: 2002- June 10-12, 2002. Hepatology 2002;36:S3-20.
  • Tassopoulos NC. Treatment of patients with chronic hepa- titis C and normal ALT levels. J Hepatol 1999; 31(Suppl. 1):193-6.
  • Gholson CF, Morgan K, Catinis G, et al. Chronic hepatitis C with normal aminotransferase levels: a clinical histologic study. Am J Gastroenterol 1997;92:1788-92.
  • Nutt AK, Hassan HA, Lindsey J, Lamps LW, Raufman JP. Liver biopsy in the evaluation of patients with chronic hepatitis C who have repeatedly normal or near normal serum alanine aminotransferase levels. Am J Med 2000; 109:62-4.
  • Pradat P, Alberti A, Poynard T, et al. Predictive value of ALT levels for histologic findings in chronic hepatitis C: an European collaborative study. Hepatology 2002;36:973-7.
  • Alberti A, Noventa F, Benvegnu L, Boccato S, Gatta A. Prevalence of liver disease in a population of asymptom- atic persons with hepatitis C virus infection. Ann Intern Med 2002;137:961-4.
  • Rihn B, Hussenet F, Detry MB, Catelle A, Faou AL. Evaluation of a supplemental assay for the diagnosis of hepatitis C virus infections. Int J Infect Dis 2000;4(1):42- 5.
  • Knodell RG, Ishak KG, Black WC, et al. Formulation and application of a numerical scoring system for assessing histological activity in a symptomatic chronic active hep- atitis. Hepatology 1981;431-5.
  • Munor BH, Jacobsen BS, Duffy ME, Bratmar LE. Statistical methods for health care research ; University of Pennsilvania, Boston college, Lipincott; 2002; 1-412.
  • Lee JK, Shim JH, Lee HC, et al. Estimation of the healthy upper limits for serum alanine aminotransferase in asian populations with normal liver histology. Hepatology 2010; 51: 1577-83.
  • Inglesby TV, Rai R, Astemborski J, et al. A prospective community-based evaluation of liver enzymes in individu- als with hepatitis C after drug use. Hepatology 1999;29: 590-6.
  • Healey CJ, Chapman RW, Fleming KA. Liver histology in hepatitis C infection: a comparison between patients with persistently normal or abnormal transaminases. Gut 1995;37:274-8.
  • Haber MM, West AB, Haber AD, Reuben A. Relationship of aminotransferases to liver histological status in chronic hepatitis C. Am J Gastroenterol 1995;90:1250-7.
  • Prati D, Taioli E, Zanella A, et al. Updated definitions of healthy ranges for serum alanine aminotransferase lev- els. Ann Intern Med 2002;137:1-10.
  • Alberti A, Morsica G, Chemello L, et al. Hepatitis C vire- mia and liver disease in symptom-free individuals with anti-HCV. Lancet 1992;340:697-8.
  • Daniel S, Ben-Menachem T, Vasudevan G, Ma CK, Blumenkehl M. Prospective evaluation of unexplained chronic liver transaminase abnormalities in asymptom- atic and symptomatic patients. Am J Gastroenterol 1999; 94:3010-4.
  • Puoti C, Magrini A, Stati T, et al. Clinical, histological, and virological features of hepatitis C virus carriers with persistently normal or abnormal alanine transaminase. Hepatology 1997;26:1393-8.
  • Bruce MG, Bruden D, McMahon BJ, et al. Hepatitis C in- fection in Alaska natives with persistently normal, persis- tently elevated or fluctuating alanine aminotransferase levels. Liver International 2006;26:643-9.
  • Shindo M, Arai K, Sokawa Y, Okyono T. The virological and histological states of anti-hepatitis C virus-positive sub- jects with normal liver biochemical values. Hepatology 1995;22:418-25.
  • Pasquale G, Sagnelli E, Coppola N, et al. Is liver biopsy necessary for hepatitis C virus carriers with persistent- ly normal aminotransferase levels? Eur J Gastroenterol Hepatol 2003;15:831-3.
  • Jamal MM, Soni A, Quinn PG, Wheeler DE, Arora S, Johnston DE. Clinical features of hepatitis C-infected patients with persistently normal alanine aminotransfer- ase levels in the Southwestern United States. Hepatology 1999;30:1307-11.
  • Kronenberger B, Ruster B, Lee JH, et al. Hepatocellular proliferation in patients with chronic hepatitis C and per- sistently normal or abnormal aminotransferase levels. J Hepatol 2000;33:640-7.
  • Persico M, Persico E, Suozzo R, et al. Natural history of hepatitis C virus carriers with persistently normal ami- notransferase levels. Gastroenterology 2000;118:760-4.
  • Herve S, Savoye G, Riachi G, et al. Chronic hepatitis C with normal or abnormal aminotransferase levels: is it the same entity? Eur J Gastroenterol Hepatol 2001;13: 495-500.
  • Mathurin P, Moussalli J, Cardanel JF, et al. Slow progres- sion rate of fibrosis in hepatitis C virus patients with persistently normal alanine aminotransferase activity. Hepatology 1998;27:868-72.
  • Bacon BR. Treatment of patients with hepatitis C and normal serum aminotransferase levels. Hepatology 2002 Nov; 36(5 Suppl 1):S 179-84.
  • Renou C, Halfon P, Pol S, et al. Histological features and HLA class II alleles in hepatitis C virus chronically infected patients with persistently normal alanine aminotransfer- ase levels. GUT 2002;51:585-90.
  • Kyrlagkitsis I, Portmann B, Smith H, O'grady J, Cramp ME. Liver histology and progression of fibrosis in individuals with chronic hepatitis C and persistently normal ALT. Am J Gastroenterol 2003;98:1588-93.
There are 31 citations in total.

Details

Primary Language English
Journal Section Original Articles
Authors

Ehab Elsayed Abdel-khalek This is me

Ashraf El-fakhry This is me

Mohamed Helaly This is me

İbrahim Abdel-aal This is me

Khaled Zalata This is me

Publication Date December 1, 2012
Published in Issue Year 2012 Volume: 9 Issue: 4

Cite

APA Abdel-khalek, E. E., El-fakhry, A., Helaly, M., Abdel-aal, İ., et al. (2012). Alanine Aminotransferase Levels in Nile Delta Citizens Infected with Chronic Hepatitis C Virus. European Journal of General Medicine, 9(4), 247-252.
AMA Abdel-khalek EE, El-fakhry A, Helaly M, Abdel-aal İ, Zalata K. Alanine Aminotransferase Levels in Nile Delta Citizens Infected with Chronic Hepatitis C Virus. European Journal of General Medicine. December 2012;9(4):247-252.
Chicago Abdel-khalek, Ehab Elsayed, Ashraf El-fakhry, Mohamed Helaly, İbrahim Abdel-aal, and Khaled Zalata. “Alanine Aminotransferase Levels in Nile Delta Citizens Infected With Chronic Hepatitis C Virus”. European Journal of General Medicine 9, no. 4 (December 2012): 247-52.
EndNote Abdel-khalek EE, El-fakhry A, Helaly M, Abdel-aal İ, Zalata K (December 1, 2012) Alanine Aminotransferase Levels in Nile Delta Citizens Infected with Chronic Hepatitis C Virus. European Journal of General Medicine 9 4 247–252.
IEEE E. E. Abdel-khalek, A. El-fakhry, M. Helaly, İ. Abdel-aal, and K. Zalata, “Alanine Aminotransferase Levels in Nile Delta Citizens Infected with Chronic Hepatitis C Virus”, European Journal of General Medicine, vol. 9, no. 4, pp. 247–252, 2012.
ISNAD Abdel-khalek, Ehab Elsayed et al. “Alanine Aminotransferase Levels in Nile Delta Citizens Infected With Chronic Hepatitis C Virus”. European Journal of General Medicine 9/4 (December 2012), 247-252.
JAMA Abdel-khalek EE, El-fakhry A, Helaly M, Abdel-aal İ, Zalata K. Alanine Aminotransferase Levels in Nile Delta Citizens Infected with Chronic Hepatitis C Virus. European Journal of General Medicine. 2012;9:247–252.
MLA Abdel-khalek, Ehab Elsayed et al. “Alanine Aminotransferase Levels in Nile Delta Citizens Infected With Chronic Hepatitis C Virus”. European Journal of General Medicine, vol. 9, no. 4, 2012, pp. 247-52.
Vancouver Abdel-khalek EE, El-fakhry A, Helaly M, Abdel-aal İ, Zalata K. Alanine Aminotransferase Levels in Nile Delta Citizens Infected with Chronic Hepatitis C Virus. European Journal of General Medicine. 2012;9(4):247-52.