title: Long-term follow-up of patients with hepatitis C with a normal alanine aminotransferase.
abstract: An attempt was made to identify factors influencing the cumulative probability of an increased alanine aminotransferase (ALT) level and hepatocarcinogenesis in hepatitis C patients with a normal ALT level initially. A total of 398 consecutive patients with a normal ALT level initially for 6 months or more and follow-up period longer than 3 years during the period January 1995 to December 2004 were included. Patients were classified by ALT level into three groups: Group A (3-20 IU/L), Group B (21-30 IU/L), and Group C (31-35 IU/L). Factors associated with the cumulative probability of increased ALT level and hepotocarcinogenesis were evaluated. Women in groups B and C and men in Group C showed high cumulative probabilities of increased ALT levels. Factors associated with increased ALT were a high ALT level (Group B, relative risk; 1.758 [95% confidence interval: 1.290-2.392], P < 0.001, Group C, 3.328 [2.256-4.909], P < 0.001), high lactate dehydrogenase level (2.352 [1.445-3.829], P = 0.001), or low total cholesterol level (1.957 [1.330-2.882], P = 0.001). Factors associated with incidence of hepatocellular carcinoma were increased age (3.088 [1.025-9.308], P = 0.045), high ALT level (Group C, 5.803 [1.530-22.066], P = 0.010), and high total bilirubin level (8.309 [2.235-30.888], P = 0.002). In patients with hepatitis C with a normal ALT level initially, an ALT level of 21-35 IU/L is a risk factor for an increased ALT level and hepatocarcinogenesis.
authors.affiliation: Department of Gastroenterology, Ogaki Municipal Hospital, Ogaki, Gifu, Japan. tkumada@he.mirai.ne.jp
authors.forename: Takashi
authors.initials: T
authors.lastname: Kumada
authors.forename: Hidenori
authors.initials: H
authors.lastname: Toyoda
authors.forename: Seiki
authors.initials: S
authors.lastname: Kiriyama
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Sone
authors.forename: Makoto
authors.initials: M
authors.lastname: Tanikawa
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Hisanaga
authors.forename: Akira
authors.initials: A
authors.lastname: Kanamori
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Atsumi
authors.forename: Makiko
authors.initials: M
authors.lastname: Takagi
authors.forename: Satoshi
authors.initials: S
authors.lastname: Nakano
authors.forename: Takahiro
authors.initials: T
authors.lastname: Arakawa
authors.forename: Masashi
authors.initials: M
authors.lastname: Fujimori
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000410:Alanine Transaminase / Q000097:blood*; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis; D002648:Child; D002784:Cholesterol / Q000097:blood; D005260:Female; D006526:Hepatitis C / Q000473:pathology*; D006801:Humans; D007770:L-Lactate Dehydrogenase / Q000097:blood; D008099:Liver / Q000473:pathology*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011379:Prognosis
chemical_list: D002784:Cholesterol; D007770:L-Lactate Dehydrogenase; D000410:Alanine Transaminase