title: Risk of alanine aminotransferase flare-up among asymptomatic hepatitis C virus RNA carriers: a 10-year follow-up study.
abstract: OBJECTIVE
  The aim of this study was to determine the cumulative rate of flare-up of serum alanine aminotransferase (ALT) level during a 10-year follow-up period, and characterize the clinical, virologic features in 120 hepatitis C virus (HCV) RNA-positive asymptomatic carriers with persistently normal ALT levels for 6 months.
  
  
  RESULTS
  All flare-up cases occurred during the first 5 years of the present study, 27.4% of carriers showed ALT flare-up during this period, but none in the second half of the study. Multivariate analysis showed that C100-3 antibody (Ab) and anti-human T cell leukemia virus (HTLV)-I Ab were two independent and significant predictors of ALT flare-up in hepatitis C virus (HCV) RNA asymptomatic carriers (P = 0.04, P = 0.03, respectively). Liver biopsy was performed in 44 patients (11 with flare-up of ALT level, whereas 33 had normal ALT levels). Histological features of chronic hepatitis with lymphoid infiltration in the portal tracts were commonly observed in all specimens, and no differences were noted between the flare-up ALT group and the persistently normal ALT group.
  
  
  CONCLUSIONS
  Our results indicated that flare-up of ALT levels in asymptomatic HCV-RNA carriers with normal ALT levels occurs during the first 5 years of diagnosis, and that the presence of C100-3 and anti-HTLV-I antibodies are good predictors of a transient rise in ALT.
authors.affiliation: Department of Internal Medicine, Kamigoto Hospital, Nagasaki, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Tsuji
authors.forename: K
authors.initials: K
authors.lastname: Yamasaki
authors.forename: M
authors.initials: M
authors.lastname: Yamanishi
authors.forename: M
authors.initials: M
authors.lastname: Kawakami
authors.forename: S
authors.initials: S
authors.lastname: Shirahama
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000410:Alanine Transaminase / Q000097:blood*; D000956:Antigens, Viral / Q000097:blood; D002353:Carrier State / Q000201:enzymology*; D005260:Female; D015481:HTLV-I Antibodies / Q000097:blood; D016174:Hepacivirus / Q000235:genetics; D006526:Hepatitis C / Q000201:enzymology* / Q000473:pathology; D006801:Humans; D008099:Liver / Q000201:enzymology* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012367:RNA, Viral / Q000097:blood; D012307:Risk Factors; D017361:Viral Nonstructural Proteins / Q000097:blood
chemical_list: D000956:Antigens, Viral; C064544:C100 protein, hepatitis C virus; D015481:HTLV-I Antibodies; D012367:RNA, Viral; D017361:Viral Nonstructural Proteins; D000410:Alanine Transaminase