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Hepatitis B viral factors in HBeAg‐Negative carriers with persistently normal serum alanine aminotransferase levels
Author(s) -
Lin ChihLin,
Liao LiYing,
Liu ChunJen,
Yu MingWhei,
Chen PeiJer,
Lai MingYang,
Chen DingShinn,
Kao JiaHorng
Publication year - 2007
Publication title -
hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.488
H-Index - 361
eISSN - 1527-3350
pISSN - 0270-9139
DOI - 10.1002/hep.21585
Subject(s) - medicine , odds ratio , confidence interval , gastroenterology , hbeag , alanine aminotransferase , hepatitis b , liver disease , hepatology , basal (medicine) , viral hepatitis , immunology , hepatitis b virus , hbsag , virus , insulin
Chronic hepatitis B patients with high‐normal serum ALT (levels of 0.5‐1× upper limit of normal) are still at risk of liver disease progression. We thus investigated the correlation between serum ALT level and hepatitis B viral factors in HBeAg‐negative carriers with persistently normal serum ALT level (PNALT). Baseline clinical and virological features of 414 HBeAg‐negative carriers, including 176 (42.5%) with low‐normal ALT (levels of less than 0.5× upper limit of normal) and 238 (57.5%) with high‐normal ALT, were compared. Compared with HBV carriers with low‐normal ALT, those with high‐normal ALT were older (41 vs. 37 years, P < 0.001) and had a greater frequency of serum HBV DNA level >104 copies/ml (63.4% vs. 47.5%, P < 0.001) as well as a higher prevalence of basal core promoter T1762/A1764 mutant (36.5% vs. 24.2%, P = 0.01). Multivariate analysis showed that factors associated with a high‐normal serum ALT level included male sex [odds ratio (OR), 1.82; 95% confidence interval (CI), 1.10‐3.01, P = 0.019], increasing age (OR, <30 years: 1, reference; 30‐39 years: 2.43, 95% CI, 1.18‐5.03, P = 0.016; 40‐49 years: 4.22, 95% CI, 1.99‐8.93, P < 0.001; ≥50 years: 4.06, 95% CI, 1.69‐9.78, P = 0.002) and serum HBV DNA level >104 copies/ml (OR, 1.83; 95% CI, 1.07‐3.13, P = 0.027). Conclusion: HBeAg‐negative patients with persistently normal ALT are not a homogenous group, and those with high‐normal ALT share some of the characteristics that have been associated with adverse long‐term outcomes. (H EPATOLOGY 2007;45:1193–1198.)