title: Serum alanine aminotransferase measurement as a guide to selective testing for hepatitis C during medical checkup.
abstract: The efficiency of elevated serum alanine aminotransferase values for selecting subjects to be tested for hepatitis B or C infections in a large French population undergoing a medical checkup was investigated. For 5 consecutive weeks, serum alanine aminotransferase values were controlled in 9044 subjects; 308 subjects (202 males) were selected with alanine aminotransferase levels 1.2-fold above the normal value (58 iu/l for men, 34 iu/l for women). For each selected case, an age- and sex-cross-matched control was included. Of the 308 subjects with elevated alanine aminotransferase values, one was HBsAg positive and 15 (seven males) were anti-HCV positive. All anti-HCV sera tested by enzyme immunoassay were also positive by three immunoblots and 11/15 (73%) were HCV-RNA positive by reverse transcription-polymerase chain reaction. Of the 308 control subjects, two were HBsAg positive and four (two males) were weakly anti-HCV positive by enzyme immunoassay. Only one weakly anti-HCV positive serum was reactive by one immunoblot and all were HCV-RNA negative. This study shows the usefulness of alanine aminotransferase screening to detect hepatitis C virus infection in the general French population. Many of the anti-HCV positive subjects detected in this study were not aware of their hepatitis C virus seropositivity (12/15) or that they were viremic (11/15). Use of this low-cost assay will considerably reduce the number of subjects to be tested for hepatitis C virus serological status and therefore the cost. It may make possible the investigation of large populations by setting up public health programs to detect and treat hepatitis C virus. Hepatitis C virus infected subjects detected in these programs could benefit from medical follow up, including antiviral therapy.
authors.affiliation: Institut Régional pour la Santé, La Riche, France.
authors.forename: F
authors.initials: F
authors.lastname: Dubois
authors.forename: M
authors.initials: M
authors.lastname: François
authors.forename: N
authors.initials: N
authors.lastname: Mariotte
authors.forename: E
authors.initials: E
authors.lastname: Caces
authors.forename: S
authors.initials: S
authors.lastname: Vol
authors.forename: P
authors.initials: P
authors.lastname: Roingeard
authors.forename: F
authors.initials: F
authors.lastname: Barin
authors.forename: A
authors.initials: A
authors.lastname: Goudeau
authors.forename: J
authors.initials: J
authors.lastname: Tichet
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000410:Alanine Transaminase / Q000097:blood*; D002648:Child; D005260:Female; D016174:Hepacivirus / Q000235:genetics / Q000276:immunology; D006508:Hepatitis Antibodies / Q000032:analysis; D006526:Hepatitis C / Q000517:prevention & control*; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D012367:RNA, Viral / Q000032:analysis
chemical_list: D006508:Hepatitis Antibodies; D012367:RNA, Viral; D000410:Alanine Transaminase