Risk of alanine aminotransferase flare‐up among asymptomatic hepatitis C virus RNA carriers: A 10‐year follow‐up study

Tsuji, Kenichirou; Yamasaki, Kazumi; Yamanishi, Mikio; Kawakami, Masuhiro; Shirahama, Satoshi

doi:10.1046/j.1440-1746.2001.02474.x

Cited by 20 publications

(13 citation statements)

References 22 publications

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“…Approximately 20% of patients with normal ALT levels (N-ALT) show ALT elevation and fibrosis progression within 3-5 years [1][2][3][4][5], and consequently, 70-80% of N-ALT patients have mild to moderate fibrosis on liver biopsy. N-ALT patients have been excluded from conventional interferon (IFN) therapy, because their sustained virological response (SVR) rates on conventional IFN monotherapy have been reported to be only 6-15% [6][7][8][9], and ALT levels were noted to increase during or after treatment in 47-62% of the patients.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of pegylated interferon plus ribavirin combination therapy for hepatitis C patients with normal ALT levels: a matched case–control study

et al. 2011

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Section: Introductionmentioning

confidence: 99%

Efficacy of pegylated interferon plus ribavirin combination therapy for hepatitis C patients with normal ALT levels: a matched case–control study

et al. 2011

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“…It has been difficult to estimate precisely how many asymptomatic HCV-infected persons are at significant risk for progressive liver disease (17), because most of the epidemiological studies in Mexico on HCV infection have been conducted on blood donors, which has resulted in limited available information on the actual burden of HCV in the general population. In a previous study on blood donors (18), we found a 0.47% prevalence of HCV infection, which is the lowest prevalence reported in Mexico: intermediate prevalences were reported as 0.7-0.8% (19,20), with the highest prevalence being 1.47% (21).…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Hepatitis C Infection in a Population of Asymptomatic People in a Checkup Unit in Mexico City

et al. 2005

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Hepatitis C virus (HCV) infection has an estimated prevalence of 3% around the world. Unfortunately, many persons with HCV infection are asymptomatic. The aim of this study was to determine the prevalence of hepatitis C Virus infection in asymptomatic persons. This study was carried out in a population-based cross-sectional study in the Checkup Unit of University Hospital in Mexico City. Patients with two or more HCV risk factors were studied. Serum specimens from all patients were screened for HCV RNA by qualitative polymerase chain reaction (PCR). HCV RNA-positive serum was also screened by quantitative PCR and for HCV genotype. Three hundred asymptomatic people were included, 194 men and 106 women, with a mean age of 46.8+/-11.9. Six (2%) of the 300 people were positive and viremic. The most common risk factors in positive patients were manicures or pedicures with a nonpersonal instrument and more than three sexual partners. We concluded that hepatitis C is frequent in asymptomatic people, and those people are often viremic. In addition, this study suggests that the spectrum of liver disease in asymptomatic and newly diagnosed HCV-positive persons is broad.

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“…59 However, patients with normal ALT, both monoinfected and coinfected, are at risk of developing significant liver disease and these patients should be evaluated and offered anti-HCV treatment if indicated. 38,[60][61][62][63][64][65] End-stage liver disease Cirrhosis. Cirrhosis occurs as a result of progressive destruction of hepatic parenchymal tissue that is gradually replaced by extracellular matrix protein.…”

Section: Alanine Aminotransferase Levelsmentioning

confidence: 99%

Changing Treatment Paradigms: Hepatitis C Virus in HIV-Infected Patients

Kadam

Talal²

2007

AIDS Patient Care and STDs

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The evaluation of hepatic histology and treatment of hepatitis C virus (HCV)/HIV-coinfected patients is rapidly changing. HCV has become an important cause of mortality in HIV-infected patients. Consequently, assessment of liver histology in all coinfected patients is particularly important. The evaluation of hepatic histology is shifting from reliance on the liver biopsy toward noninvasive modalities. Additionally, the importance of HCV-associated morbidity and mortality in HIV-infected patients has prompted increasing numbers of these patients to be HCV treatment candidates. Prospective trials in coinfected patients have reported lower sustained virologic responses compared to HCV-monoinfected patients. Consequently, the numbers of coinfected nonresponders to pegylated interferon/ribavirin continues to increase. Because none of the presently available treatment modalities for pegylated interferon/ribavirin nonresponders are clearly efficacious, management decisions must be individualized. The options include, HCV-specific medications, maintenance therapy, the use of alternative interferon formulations, and observation. HCV-specific agents, particularly protease and polymerase inhibitors, show early promise in HCV-monoinfected individuals. Their use in coinfected patients, however, is likely to be delayed for several years, and they are likely to be used in combination with interferon. Low-dose pegylated interferon, administered in an attempt to slow fibrosis progression (maintenance therapy), is being evaluated in several large prospective trials in monoinfected and coinfected patients. Observation may be best for nonresponders with relatively mild hepatic histology. In summary, HCV treatment will likely follow the example forged by HIV. In the near future, combinations of different drugs will likely be used simultaneously to result in durable viral suppression.

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Risk of alanine aminotransferase flare‐up among asymptomatic hepatitis C virus RNA carriers: A 10‐year follow‐up study

Abstract: Our results indicated that flare-up of ALT levels in asymptomatic HCV-RNA carriers with normal ALT levels occurs during the first 5 years of diagnosis, and that the presence of C100-3 and anti-HTLV-I antibodies are good predictors of a transient rise in ALT.

Cited by 20 publications

References 22 publications

Efficacy of pegylated interferon plus ribavirin combination therapy for hepatitis C patients with normal ALT levels: a matched case–control study

Efficacy of pegylated interferon plus ribavirin combination therapy for hepatitis C patients with normal ALT levels: a matched case–control study

Prevalence of Hepatitis C Infection in a Population of Asymptomatic People in a Checkup Unit in Mexico City

Changing Treatment Paradigms: Hepatitis C Virus in HIV-Infected Patients

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