کد مقاله | کد نشریه | سال انتشار | مقاله انگلیسی | نسخه تمام متن |
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3314447 | 1211200 | 2007 | 8 صفحه PDF | دانلود رایگان |
Background/AimsChronic hepatitis B virus (HBV) disease is caused by both necroinflammation and active viral replication. The role of ALT levels as a predictor of liver injury has recently been questioned. The aim of the study was to determine whether normal ALT is associated with liver injury in a cohort of HBV patients undergoing liver biopsy.MethodsThis is a retrospective review of chronic HBV patients divided into 3 groups; (1) persistently normal ALT (PNALT); (2) ALT 1–1.5X ULN and (3) ALT > 1.5X ULN. Multiple clinical, biochemical, virological variables were evaluated.ResultsOne hundred and ninety-two patients met the inclusion criteria, 59 with PNALT, 26 with ALT 1–1.5X ULN, and 107 with ALT > 1.5X ULN. Increasing age, higher ALT, higher grade of inflammation on biopsy, and HBeAg positivity predicted fibrosis. 18% of patients with PNALT had stage 2+ fibrosis and 34% had grade 2 or 3 inflammation. Overall 37% of patients with PNALT had significant fibrosis or inflammation. Subgroup analysis showed the majority with fibrosis belonged to the high normal ALT group and that only a minority who were young and immune tolerant had significant findings on biopsy.ConclusionsThere is significant fibrosis and inflammation in 37% of patients with PNALT and a liver biopsy should be considered in patients older than 40 with high normal ALT.
Journal: Journal of Hepatology - Volume 47, Issue 6, December 2007, Pages 760–767