Subject: A follow-up study to determine the value of liver biopsy and need
for antiviral therapy for hepatitis C virus carriers with persistently
normal serum aminotransferase

Okanoue T, Makiyama A, Nakayama M, Sumida Y, Mitsuyoshi H, Nakajima T, Yasui
K, Minami M, Itoh Y.

Molecular Gastroenterology and Hepatology, Graduate School of Medical
Science, Kyoto Prefectural University of Medicine, Kamigyo-ku, Kyoto
602-8566, Japan.

BACKGROUND/AIMS: Long-term follow-up study was performed to identify the
candidates for antiviral therapy for hepatitis C virus (HCV) infection among
carriers with persistently normal aminotransferase (ALT</=30U/L) levels
(PNAL). METHODS: One hundred and twenty-nine HCV carriers with PNAL who
underwent liver biopsy and had platelet count over 150,000/mul were entered
and 69 were followed for over 5 years. Thirty-five patients underwent serial
liver biopsies. Serum ferritin and thioredoxin levels were also determined.
RESULTS: Seventeen patients had normal liver histology, 10 had moderate
chronic hepatitis and the remainder 102 had mild hepatitis. Serum ferritin
and thioredoxin levels were normal. The mean follow-up period for the 69
patients was 8.5 years. Of these 69 patients, 10 had persistently normal ALT
levels (group A), 39 had transient elevation of ALT (group B), and 20
changed to symptomatic chronic hepatitis (group C). The rate of progression
of fibrosis for groups A, B, and C were 0.05, 0.04, and 0.08, respectively.
Hepatocellular carcinoma was not diagnosed in any of the patients.
CONCLUSIONS: Around 90% of HCV carriers with PNAL have normal to mild liver
histology. This long-term follow-up study demonstrated that 30% of such
carriers became candidates for antiviral therapy within 5 years.

PMID: 16024129 [PubMed - as supplied by publisher]

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=1
6024129&dopt=Abstract
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