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Aliment Pharmacol Ther. 2006 Oct 15;24(8):1133-49.

Review article: management of patients with chronic hepatitis C virus infection and "normal" alanine aminotransferase activity.

Author information

  • 1Department of Internal Medicine, , Saarland University Hospital, 66421 Homburg/Saar, Germany. zeuzem@uniklinik-saarland.de

Abstract

BACKGROUND:

Hepatitis C virus infection, a major cause of chronic liver disease, occurs with normal serum alanine aminotransferase activity in approximately 25% of patients. These patients have historically remained untreated but substantial evidence indicates liver damage, progression of disease and impaired quality of life in some individuals.

AIM:

To review the current management of patients with chronic hepatitis C and normal alanine aminotransferase activity.

METHODS:

This review represents the summary of discussions at a Clinical Workshop with a comprehensive literature searching of available databases (PubMed and Embase).

RESULTS:

Current limits defining normal serum alanine aminotransferase activity are not representative of a "healthy" status. Most patients with hepatitis C and normal alanine aminotransferase levels have histologically proven liver damage that, although generally mild, may be significant (> or =F2) in up to 20% of patients and progresses at approximately 50% of the rate in patients with elevated alanine aminotransferase levels. Some patients have persistently normal alanine aminotransferase activity and may have a more benign outcome, but a significant proportion (> or =20%) experience periods of increased serum alanine aminotransferase activity which may be associated with enhanced disease progression.

CONCLUSIONS:

A treatment approach that considers host and virus-related variables and optimizes patient and cost benefits may therefore provide more effective management of patients with chronic hepatitis C and normal alanine aminotransferase activity.

[PubMed - indexed for MEDLINE]
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