Vol 14: Prognostic Values of Fluctuations in Serum Levels of Alanine Transaminase in Inactive Carrier State of HBV Infection.Reportar como inadecuado



 Vol 14: Prognostic Values of Fluctuations in Serum Levels of Alanine Transaminase in Inactive Carrier State of HBV Infection.


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This article is from Hepatitis Monthly, volume 14.AbstractBackground:: Current guidelines introduce periodic monitoring of serum alanine transaminase ALT as the first-line modality in follow-up patients, with a hepatitis B virus HBV inactive carrier state. Objectives:: This study aimed to determine the incidence rate and patterns of ALT fluctuations and prognostic values for the development of chronic HBV e antigen HBeAg-negative hepatitis B CHB, HBV surface antigen HBsAg seroclearance, and liver-related complications. Patients and Methods:: Treatment-naïve patients with a chronic HBV infection, HBeAg-HBeAb+, normal ALT levels, and HBV DNA 2000 IU-mL, were followed-up every 6-12 months by assessing serum ALT levels. Serum HBV DNA was measured in cases of elevated ALT levels. Results:: A total of 399 patients were followed-up for 8.9 years; ALT upper limit of normal ULN, i.e. 40 IU-L was detected in 103 25.8% patients, with an annual incidence rate of 2.9%. ALT elevation was associated with; male gender, age, and higher serum ALT levels at study entry. Among the cases of ALT elevations, 16 15.5% patients had ALT levels 2 × ULN. There were 38 36.9% patients who had ALT levels that remained ULN over six months, and 21 20.4% patients experienced at least two episodes of ALT elevations. In 15 14.6% patients, elevated ALT levels were associated with increased HBV replication i.e. HBV DNA 2 000 IU-mL and these were considered as CHB. However, elevation of ALT levels, even in the absence of HBV replication, increased the risk for the development of CHB up to 8-fold in prospective follow-ups. HBsAg seroclearance, cirrhosis, and hepatocellular carcinoma were detected in 43 10.8%, 4 1%, and 1 0.25% patients, respectively. Conclusions:: Fluctuations in serum ALT levels may change the prognosis of a HBV inactive carrier state.



Autor: Farzi, Hossein; Ebrahimi Daryani, Nasser; Mehrnoush, Leila; Salimi, Shima; Alavian, Seyed Moayed

Fuente: https://archive.org/







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