BACKGROUND & AIMS: Serum ALT remains the most accessible test available to clinicians for monitoring chronic hepatitis B virus infection, but appropriate action when ALT levels are only mildly elevated is ambiguous in standard guidelines. METHODS: A retrospective study was conducted to investigate the prevalence of significant histology in a patient population with mildly elevated serum ALT levels. A total of 193 consecutive patients were selected and divided into 2 groups according to HBeAg status. Patients were further divided into cohorts on the basis of their highest ALT elevation during follow-up and whether it was 1-1.5 times the upper limit of normal (ULN), 1.5-2 times the ULN, or greater than twice the ULN. The ULN that was used is 30 U/L for men and 19 U/L for women. RESULTS: In all cohorts there was a substantial fraction of patients with histologic disease as evaluated by liver biopsy. HBeAg-negative patients were older, had lower viral load, and had a higher prevalence of disease. After adjustments for age, HBeAg status and HBV DNA viral load were not predictors of significant histology. Age >35 years, male gender, and increasing ALT levels were predictors for significant histology on multivariate analysis. CONCLUSIONS: A substantial proportion of patients with mildly elevated ALT levels have significant histologic disease. The prevalence increased with the higher ALT levels and age.
BACKGROUND & AIMS: Serum ALT remains the most accessible test available to clinicians for monitoring chronic hepatitis B virus infection, but appropriate action when ALT levels are only mildly elevated is ambiguous in standard guidelines. METHODS: A retrospective study was conducted to investigate the prevalence of significant histology in a patient population with mildly elevated serum ALT levels. A total of 193 consecutive patients were selected and divided into 2 groups according to HBeAg status. Patients were further divided into cohorts on the basis of their highest ALT elevation during follow-up and whether it was 1-1.5 times the upper limit of normal (ULN), 1.5-2 times the ULN, or greater than twice the ULN. The ULN that was used is 30 U/L for men and 19 U/L for women. RESULTS: In all cohorts there was a substantial fraction of patients with histologic disease as evaluated by liver biopsy. HBeAg-negative patients were older, had lower viral load, and had a higher prevalence of disease. After adjustments for age, HBeAg status and HBV DNA viral load were not predictors of significant histology. Age >35 years, male gender, and increasing ALT levels were predictors for significant histology on multivariate analysis. CONCLUSIONS: A substantial proportion of patients with mildly elevated ALT levels have significant histologic disease. The prevalence increased with the higher ALT levels and age.
Authors: Sue Zhang; Jessica T Ristau; Huy N Trinh; Ruel T Garcia; Huy A Nguyen; Mindie H Nguyen Journal: Dig Dis Sci Date: 2012-03-31 Impact factor: 3.199
Authors: Sang Hoon Ahn; Henry L Y Chan; Pei-Jer Chen; Jun Cheng; Mahesh K Goenka; Jinlin Hou; Seng Gee Lim; Masao Omata; Teerha Piratvisuth; Qing Xie; Hyung Joon Yim; Man-Fung Yuen Journal: Hepatol Int Date: 2010-02-20 Impact factor: 6.047
Authors: L H Nguyen; J Hoang; N H Nguyen; V D Vu; C Wang; H N Trinh; J Li; J Q Zhang; M H Nguyen Journal: Aliment Pharmacol Ther Date: 2016-07-01 Impact factor: 8.171