An important group of patients with chronic hepatitis C term consequences of the chronic liver disease. On the other hand, the absence of symptoms, the limited efficacy and costs have normal serum alanine aminotransferase (ALT) levels despite having hepatitis C virus (HCV) RNA detectable in se-of current therapies, and the potential of causing harm make it important to demonstrate clear efficacy in this special rum. These patients are typically identified after donating blood and being found to be positive for antibody to HCV group before the recommendations for patients with abnormal ALT levels can be applied to those with normal ALT (anti-HCV). A strict definition of this patient population is needed, which should include presence of anti-HCV, HCV levels. RNA detectable by polymerase chain reaction (PCR), and per-DEFINITION AND PREVALENCE sistently normal ALT levels. These patients are usually asymptomatic, but almost all have histological evidence of chronic A standard definition for this group of patients is needed; hepatitis on liver biopsy. The liver histological lesions are generally, they are defined as having the presence of 1) serum generally mild, and cirrhosis is rare. The long-term outcome antibody to HCV (anti-HCV); 2) HCV RNA as detected by of this group of patients with chronic HCV infection is not polymerase chain reaction (PCR); and 3) ALT levels that known, but the prognosis is probably good. In small, uncon-are persistently within the limits of the normal range. The trolled trials of alpha interferon in this group of patients, end-persistence of normal values should be documented by reof-treatment virological responses occurred in approximately peated testing (at least three values) over a 6-month period; 50% and sustained responses 6 to 12 months afterwards in this requirement will distinguish these patients from those 20%. These rates of response are not very different from those who have fluctuating ALT levels, which on some occasions reported in patients with abnormal ALT levels. Importantly, may be in the normal range. in most studies, serum ALT levels became abnormal duringThe frequency of normal serum ALT levels among chronic therapy in approximately half of patients, and levels remained HCV carriers is not well known. In the United States, approxabnormal in a proportion after therapy. These findings suggest imately 0.3% of first-time blood donors test positive for antithat alpha interferon therapy is not usually beneficial and HCV, 1 and between 39% and 69% of these have anti-HCV may be harmful in patients with chronic hepatitis C who have that can be confirmed by recombinant immunoblot assay. normal ALT levels, perhaps as a result of the immunomodula-Among anti-HCV-positive, immunoblot-positive subjects, tory actions of alpha interferon that may alter the balance of 27% to 59% have normal serum ALT values.2-4 Among the host immune reactions and viral replication, which seem to immunoblot-positive subjects with normal serum ALT levels, be responsible for the liver injury in chronic he...
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
customersupport@researchsolutions.com
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.