Modified range of alanine aminotransferase is insufficient for screening of hepatitis C virus infection in hemodialysis patients.
OBJECTIVE
A moderate increase in serum alanine aminotransferase (ALT) has been reported to be a helpful, low-cost tool for predicting viremia in anti-hepatitis C virus (HCV)-positive hemodialysis (HD) patients. This study focused on evaluating the effectiveness of a lowered normal serum ALT value as a screening method for HCV infection in HD patients.


METHODS
Serum ALT levels were compared with HCV virologic status in 125 patients on maintenance HD.


RESULTS
The prevalence of HCV antibodies was 23%. A total of 3.7% of viremic HD patients did not have a detectable antibody response. Using the conventional upper limit of normal for ALT of 37 IU, there was no significant difference in the frequency of elevated ALT levels between HCV RNA-positive and-negative patients. However, if the upper limit of normal for ALT was lowered to 27 IU, the difference was significant. Nevertheless, 60% of viremic patients still fell within the normal range.


CONCLUSIONS
Although inexpensive and widely available, the monitoring of serum ALT levels is not useful as a screening method for HCV infection in HD patients.
Milotic
Irena
I
Clinic for Infectious Diseases, Clinical Hospital Centre Rijeka, Rijeka, Croatia. imilotic@hotmail.com
Pavic
Ivica
I
Maleta
Ivica
I
Troselj-Vukic
Biserka
B
Milotic
Franko
F
D000293:Adolescent; D000328:Adult; D000368:Aged; D000410:Alanine Transaminase / Q000097:blood*; D003430:Cross-Sectional Studies; D005260:Female; D019698:Hepatitis C, Chronic / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis
D000410:Alanine Transaminase