title: Serum alanine aminotransferase level and response to interferon-ribavirin combination therapy in patients with chronic hepatitis C.
abstract: OBJECTIVE
  To determine the difference in sustained virological response to interferon-ribavirin combination therapy between patients with normal ALT and those with raised ALT in chronic hepatitis C.
  
  
  METHODS
  Quasi-experimental study.
  
  
  METHODS
  Department of Gastroenterology and Hepatology, Shaikh Zayed Postgraduate Medical Institute, Lahore, from February 2004 to June 2005.
  
  
  METHODS
  Patients with positive HCV RNA by PCR and compensated liver disease were included and divided in two groups. One group with ALT below upper normal limit (UNL= 65U/L) and second group with raised ALT (> 1x UNL). After treatment with standard interferon alpha 2a and ribavirin, both groups were checked for sustained viral response (SVR) six months after end of treatment and compared for response to therapy with Chi square test.
  
  
  RESULTS
  Of the 70 patients included, 25 had normal ALT (< 1 x upper normal limit UNL) and 45 had ALT above upper normal limit (> 1 x UNL). Of these, 63 patients completed treatment. Sustained viral response (SVR) was seen in 13 of 22 patients with normal ALT who completed therapy and 22 of 41 patients with raised ALT who completed treatment. Difference in SVR in two groups was not significant (p 0.679). When patients with raised ALT were sub-classified, significantly better response was seen in patients with ALT > or = 2 times the upper normal limit (p 0.021).
  
  
  CONCLUSIONS
  Patients with normal baseline ALT respond equally well to combination therapy as is seen in patients with raised ALT.
authors.affiliation: Department of Gastroenterology and Hepatology, Shaikh Zayed Postgraduate Medical Institute, Lahore. Pakistan. drnawalshahid@yahoo.com
authors.forename: Shahid
authors.initials: S
authors.lastname: Sarwar
authors.forename: Arshad Kamal
authors.initials: AK
authors.lastname: Butt
authors.forename: Anwaar A
authors.initials: AA
authors.lastname: Khan
authors.forename: Altaf
authors.initials: A
authors.lastname: Alam
authors.forename: Irfan
authors.initials: I
authors.lastname: Ahmad
authors.forename: Akif
authors.initials: A
authors.lastname: Dilshad
mesh_terms: D000328:Adult; D000410:Alanine Transaminase / Q000097:blood*; D004359:Drug Therapy, Combination; D005260:Female; D019698:Hepatitis C, Chronic / Q000188:drug therapy* / Q000201:enzymology*; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000008:administration & dosage*; D008297:Male; D011994:Recombinant Proteins; D012254:Ribavirin / Q000008:administration & dosage*
chemical_list: D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D012254:Ribavirin; D000410:Alanine Transaminase