The clinical significance of persistently normal ALT in chronic hepatitis B infection.
作者： Michelle Lai , Benjamin J Hyatt , Imad Nasser , Michael Curry , Nezam H Afdhal
DOI: 10.1016/J.JHEP.2007.07.022
关键词: Liver biopsy 、 Hepatitis B 、 Internal medicine 、 Gastroenterology 、 HBeAg 、 Hepatitis B virus 、 Fibrosis 、 Immunology 、 Biopsy 、 Hepadnaviridae 、 Orthohepadnavirus 、 Medicine
摘要: Background/Aims Chronic hepatitis B virus (HBV) disease is caused by both necroinflammation and active viral replication. The role of ALT levels as a predictor liver injury has recently been questioned. aim the study was to determine whether normal associated with in cohort HBV patients undergoing biopsy. Methods This retrospective review chronic divided into 3 groups; (1) persistently (PNALT); (2) 1–1.5X ULN (3) ALT>1.5X ULN. Multiple clinical, biochemical, virological variables were evaluated. Results One hundred ninety-two met inclusion criteria, 59 PNALT, 26 ULN, 107 Increasing age, higher ALT, grade inflammation on biopsy, HBeAg positivity predicted fibrosis. 18% PNALT had stage 2+ fibrosis 34% 2 or inflammation. Overall 37% significant Subgroup analysis showed majority belonged high group that only minority who young immune tolerant findings Conclusions There biopsy should be considered older than 40 ALT.
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