Assessment of clinical utility of low and high normal alanine aminotransferase values in patients with chronic hepatitis B virus infection in Bangladesh.
OBJECTIVE
There is a lack of consensus about the currently accepted range of normal values for serum alanine aminotransferase (ALT) levels because some investigators have claimed that the true values are significantly lower than those listed by kit manufacturers.


METHODS
A total of 255 chronic hepatitis-B-virus (HBV)-infected patients with traditional, normal levels of ALT (≤42 U/l) were divided into 2 groups: (1) low normal ALT (men: ≤30 U/l; women: ≤19 U/l) and (2) high normal ALT (men: 31-42 U/l; women: 20-42 U/l). The extent of hepatic inflammation and fibrosis was evaluated in these patients by examining liver biopsy specimens.


RESULTS
The levels of HBV DNA were >10,000 copies/ml in 58.4, 52.9 and 61.2% of the patients with traditional normal ALT, low normal ALT and high normal ALT values, respectively (p > 0.05). Also, the moderate degrees of hepatic necroinflammation [histological activity index (HAI)-NI score of ≥9] and severe hepatic fibrosis (HAI-F score of ≥3) were similar among the 3 groups of patients (p > 0.05).


CONCLUSIONS
The newly defined low normal cutoff values for ALT did not exhibit any added clinical benefit for assessing the extent of liver damage in patients with chronic HBV infection in Bangladesh.
Al-Mahtab
Mamun
M
Department of Hepatology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh.
Rahman
Salimur
S
Akbar
Sheikh Mohammad Fazle
SM
Kamal
Mohammad
M
Khan
Mohammad Sakirul Islam
MS
D000293:Adolescent; D000328:Adult; D000410:Alanine Transaminase / Q000097:blood*; D001459:Bangladesh; D001706:Biopsy; D002648:Child; D004279:DNA, Viral / Q000097:blood; D005260:Female; D006515:Hepatitis B virus / Q000235:genetics; D019694:Hepatitis B, Chronic / Q000201:enzymology* / Q000473:pathology*; D006801:Humans; D008103:Liver Cirrhosis / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D018709:Statistics, Nonparametric; D055815:Young Adult
D004279:DNA, Viral; D000410:Alanine Transaminase