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Clinical Features of Hepatitis C Virus Carriers With Persistently normal Alanine Aminotransferase Levels

AUTHORS

Hirofumi Uto 1 , * , Hirofumi Uto 1 , * , Seiich Mawatari 2 , Seiich Mawatari 1 , Kotaro Kumagai 2 , Kotaro Kumagai 1 , Akio Ido 2 , Akio Ido 1 , Hirohito Tsubouchi 2 , Hirohito Tsubouchi 1

AUTHORS INFORMATION

1 Department of Human and environmental Sciences, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan

2 Department of Human and Environmental Sciences, Graduate School of Medical and Dental Sciences, Kagoshima University, Japan

Corresponding Authors:

How to Cite: Uto H, Uto H, Mawatari S, Mawatari S, Kumagai K, et al. Clinical Features of Hepatitis C Virus Carriers With Persistently normal Alanine Aminotransferase Levels, Hepat Mon. Online ahead of Print ; 12(2):77-84. doi: 10.5812/hepatmon.829.

ARTICLE INFORMATION

Hepatitis Monthly: 12 (2); 77-84
Published Online: January 31, 2012
Article Type: Review Article
Received: May 23, 2011
Accepted: January 18, 2012
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Abstract

Hepatitis C virus (HCV) infection causes chronic hepatitis, which frequently leads to hepatic fibrosis and hepatocellular carcinoma (HCC). Alanine aminotransferase (ALT) is a biomarker of hepatocyte injury and is associated with the progression of hepatic fibrosis. Advanced hepatic fibrosis also predisposes HCV carriers to a risk of HCC. In contrast, some cases with persistent HCV infection have normal ALT levels that persist for a long time, and these HCV carriers have no or mild hepatitis and hepatic fibrosis. These HCV carriers are defined as persistent normal ALT (PNALT) cases and their risk of HCC is low compared to HCV carriers with abnormal ALT. However, there are various definitions of normal ALT and PNALT, and advanced hepatic fibrosis may be missed without a liver biopsy. In addition, there is also a risk of ALT elevation in HCV carriers with PNALT, which increases the risk of progression to hepatic fibrosis and HCC. Most HCV carriers with PNALT have asymptomatic or nonspecific symptoms. HCV carrie with PNALT are also considered to be responsive to interferon-based treatment. Thus, assessment of hepatic fibrosis is important in HCV carriers, and the eradication of HCV infection is more likely in HCV carriers with evidence of hepatic fibrosis, regardless of their ALT levels.

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© 2012, Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/) which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.

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