Long-term follow-up of patients with hepatitis C with a normal alanine aminotransferase

Department of Gastroenterology, Ogaki Municipal Hospital, Ogaki, Gifu, Japan.
Journal of Medical Virology (Impact Factor: 2.35). 03/2009; 81(3):446-51. DOI: 10.1002/jmv.21342
Source: PubMed


An attempt was made to identify factors influencing the cumulative probability of an increased alanine aminotransferase (ALT) level and hepatocarcinogenesis in hepatitis C patients with a normal ALT level initially. A total of 398 consecutive patients with a normal ALT level initially for 6 months or more and follow-up period longer than 3 years during the period January 1995 to December 2004 were included. Patients were classified by ALT level into three groups: Group A (3-20 IU/L), Group B (21-30 IU/L), and Group C (31-35 IU/L). Factors associated with the cumulative probability of increased ALT level and hepotocarcinogenesis were evaluated. Women in groups B and C and men in Group C showed high cumulative probabilities of increased ALT levels. Factors associated with increased ALT were a high ALT level (Group B, relative risk; 1.758 [95% confidence interval: 1.290-2.392], P < 0.001, Group C, 3.328 [2.256-4.909], P < 0.001), high lactate dehydrogenase level (2.352 [1.445-3.829], P = 0.001), or low total cholesterol level (1.957 [1.330-2.882], P = 0.001). Factors associated with incidence of hepatocellular carcinoma were increased age (3.088 [1.025-9.308], P = 0.045), high ALT level (Group C, 5.803 [1.530-22.066], P = 0.010), and high total bilirubin level (8.309 [2.235-30.888], P = 0.002). In patients with hepatitis C with a normal ALT level initially, an ALT level of 21-35 IU/L is a risk factor for an increased ALT level and hepatocarcinogenesis.

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