Chronic hepatitis C with normal aminotransferase levels : A clinical histologic study

摘要: Objective: To define chronic hepatitis C virus (HCV) infection among patients with persistently normal aminotransferase levels (PNAL). Design: Retrospective chart review of all encountered during 1-yr positive antibody (anti-C100-3 ELISA), no alternative cause for their liver disease and PNAL 6 or more consecutive months prebiopsy. Blinded histology. Setting: Outpatient hepatology clinics two academic centers. Patients: Fifty 303 C. Measurements: Epidemiologic profiles, reasons seroscreening confirmatory analyses were tabulated. Histology was reviewed grading inflammatory activity stage fibrosis determined by protocol. Results: Among 50 PNAL, 35 (70%) female, 34 (68%) had parenterally acquired HCV, 44 (88%) abstained (>2 yr) from ethanol, HIV-negative none pharmacologically immunosuppressed. HCV uniformly confirmed RIBA II HCV-RNA assay. The mean level quantitative PCR 3.79 x 10 5 copies/ml (range, 500 to1.8 copies/ ml) B-DNA, 53 3.5-230 copies/ml). Traditional histoevaluation yielded (active, n = 15; persistent, 25), cirrhosis (n 7), histology 3). protocol (inflammatory grade/fibrotic stage) revealed 0/0 4), 1/0 6), 2/0 17), 2/1 3), 2/4 1), 3/0 2), 3/1 3/2 3/3 9). Conclusions: In infection, active inflammation, fibrosis, variable circulating may coexist particularly female non-drinkers. Asymptomatic carriers comprise to 8% PNAL. Management guidelines this group need be developed.