Metabolic factors are associated with serum alanine aminotransferase levels in patients with chronic hepatitis C

Kobayashi, Yumi; Kawaguchi, Yasunori; Mizuta, Toshihiko; Kuwashiro, Takuya; Oeda, Satoshi; Oza, Noriko; Takahashi, Kazuhiro; Iwane, Shinji; Eguchi, Yuichiro; Anzai, Keizo; Ozaki, Iwata; Fujimoto, Kazuma

doi:10.1007/s00535-010-0338-x

Cited by 14 publications

(11 citation statements)

References 42 publications

(61 reference statements)

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“…However, subjects with ALT between 40-80 IU/L showed the lowest HCV clearance rate (13.8 %). A discrepancy between ALT level and HCV infection status has also been reported in other studies [9,12,16,28], suggesting that the ALT level might not be a reliable measure for HCV infection status and disease progression.…”

Section: Correlates Of Hcv Clearancementioning

confidence: 71%

Hepatitis B virus and hepatitis C virus infection among HIV-1-infected injection drug users in Dali, China: prevalence and infection status in a cross-sectional study

et al. 2015

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To assess the prevalence of hepatitis B virus (HBV) and hepatitis C virus (HCV) infection and to investigate their mutual influences on infection status among human immunodeficiency virus type 1 (HIV-1)-seropositive injection drug users (IDUs). A cross-sectional study was conducted among HIV infected IDUs in Dali, China. The participants were tested for serological markers of HBV and HCV infection, alanine transaminase (ALT) activity and CD4(+) T cell count. HCV genotype was determined by sequencing. Of 529 patients, 498 (94.1 %) HIV infected IDUs agreed to participate. The overall prevalence of HCV infection (anti-HCV antibody positive) and spontaneous HCV clearance were 90.8 % (452/498) and 21.5 % (97/452), respectively. Of 411 subjects who had not received HBV vaccine, 296 (72.0 %) were positive for antibody against HBV core antigen (HBcAb), while 274 (66.7 %) were positive for both HCV antibody and HBcAb. HBV antigens were detected in 52 of the HBV-infected subjects (17.6 %). HCV clearance was associated with HBV antigenemia (p = 0.0002) and higher CD4(+) T cell count (p = 0.0294). Resolved HBV infection was associated with HCV genotype 3 (p = 0.0365). HBV and HCV infection are highly prevalent and mutually influence infection status in HIV-1 infected IDUs in Dali, China.

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Section: Correlates Of Hcv Clearancementioning

confidence: 71%

Hepatitis B virus and hepatitis C virus infection among HIV-1-infected injection drug users in Dali, China: prevalence and infection status in a cross-sectional study

et al. 2015

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“…In our study, inflammatory activity of moderate to high intensity was present in similar proportions, 65.2 and 68.3%, of the HCV genotype non-3 and genotype 3 groups, respectively. Kobayashi et al [26] evaluated the clinical and histological statuses and virological characteristics of 256 patients chronically infected with HCV genotypes 1 and 2 to identify the factors associated with ALT serum levels. ALT activity in the liver has been widely used as a marker of liver inflammation.…”

Section: Discussionmentioning

confidence: 99%

“…ALT activity in the liver has been widely used as a marker of liver inflammation. Elevated ALT levels in the serum of the patients evaluated by Kobayashi et al [26] were strongly associated with severe hepatic inflammation and male gender, and they were also associated with higher HOMA-IR index values, low HDL levels, and a higher degree of hepatic steatosis. The authors hypothesized that specific metabolic factors may originate from the host rather than from the virus.…”

Section: Discussionmentioning

confidence: 99%

Genetic variation in the microsomal triglyceride transfer protein (−493G/T) is associated with hepatic steatosis in patients infected with hepatitis C virus

et al. 2017

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BackgroundIn chronic hepatitis C, the fibrosis progression rates are extremely variable and can be influenced by factors associated with the host, virus and environment. Among the associated metabolic factors, hepatic steatosis is characterized by an accumulation of triglycerides in hepatocytes. In the host, genetic determinants of hepatic steatosis are observed, such as single-nucleotide polymorphisms (SNPs) in the microsomal triglyceride transfer protein (MTTP) gene. The MTTP -493G/T SNP appears to play an important role in the regulation of gene expression and influences the plasma concentration of circulating low-density lipoprotein (LDL). The present study investigated the influence of this SNP in the development of hepatic steatosis in patients with chronic hepatitis C and evaluated the association of hepatic steatosis with certain characteristics of these patients and the hepatitis C virus (HCV).MethodsTwo hundred thirty-nine patients with chronic hepatitis C were genotyped for the MTTP -493G⁄T SNP by a polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) assay. The association between hepatic steatosis and selected characteristics of the patient and virus was evaluated using bivariate and multivariate analyses.ResultsThe most prevalent MTTP -493G/T genotype was GG (46%) followed by GT (43.5%) and TT (10.5%). Multivariate analysis of the total cohort revealed associations between the presence of hepatic steatosis and inflammatory activity of moderate to high intensity (P < 0.001), advanced age (P = 0.010), elevated gamma glutamyl transpeptidase (GGT) levels (P = 0.010) and low LDL levels (P = 0.022). Hepatic steatosis was also associated with the TT/GT genotype of the MTTP -493G⁄T SNP in patients infected with HCV genotype 3 (P < 0.001).ConclusionsIn chronic hepatitis C patients infected with HCV genotype 3 and with the TT/GT genotype of the MTTP -493G/T SNP, a significant increase in hepatic steatosis was observed, which may indicate that this SNP has a significant influence on the accumulation of triglycerides in hepatocytes. Furthermore, associations were observed between hepatic steatosis and inflammatory activity of moderate to high intensity, advanced age, elevated GGT and low LDL levels.

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“…Biyokimyasal olarak sessiz KCH'li olgulara tanı koyabilmek ve tedaviyi yönlendirmek için uygun olgularda karaciğer biyopsisi yapılması yol göstericidir. HCV ile infekte kadın hastalarda erkeklere göre normal ALT düzeyine daha yüksek oranda rastlanmaktadır (24,25). Çalışmamıza alınan hastaların da %61.1'i kadındı.…”

Section: İrdelemeunclassified

Liver Histology of Patients with Hepatitis C Virus Infection and Normal Alanine Aminotransferase Levels

Aygen¹,

Denız²,

Akhan³

et al. 2012

Klimik Dergisi

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ÖzetAmaç: Bu çalışmada alanin aminotransferaz (ALT) düzeyi normal kronik hepatit C (KHC)'li hastalarda karaciğerdeki histolojik değişikliklerin değerlendirilmesi amaçlanmıştır. Yöntemler: Çok merkezli retrospektif çalışmamızda >16 yaş, ALT düzeyi normal, KHC'li 72 hasta değerlendirildi. ALT'nin en az 6 ay süresince ve en az birer ay arayla 2 veya 3 kez normal sınırlar içinde olması "normal ALT düzeyi" kabul edildi. Demografik veriler, tanı konulan yıl, 6 ay içindeki en az 2 ALT değeri, hepatit göstergeleri, hepatit C virusu (HCV) RNA ve karaciğer biyopsisi sonuçları kaydedildi. Hepatit göstergeleri farklı kitlerle test edildi. HCV RNA, ölçüm aralığı ve duyarlılığı farklı polimeraz zincir reaksiyonu kitleriyle çalışıldı. Biyopsi preparatları aynı patologca tekrar değerlendirildi. Bulgular: Hastaların yaş ortalaması 44±13 yıldı ve %61.1'i kadındı. HCV RNA değerleri 1.53x10 2 -1.13x10 8 İÜ/ml arasındaydı. ALT değerleri ortalaması 30.3±9.6 İÜ/lt bulundu. Histopatolojik olarak ortalama nekroinflamasyon derecesi 4.67±1.96 ve ortalama fibroz evresi 1.03±1.13 idi. Biyopsilerin %48.6'sında minimal aktivite, %45.8'inde hafif aktivite ve %2.8'inde orta aktivite saptandı. Portal-periportal fibroz oranı %51.4, köprüleşen fibroz oranı %6.9 ve inkomplet-komplet siroz oranı %1.4 idi. Sonuçlar: KHC'li hastalarda ALT düzeyleri hastalığın aktivitesini belirlemede zayıf bir göstergedir. Tedavi indikasyonu olan hastalar karaciğer biyopsisi açısından değerlendirilmelidir. AbstractObjective: In this study, our objective is to evaluate histological changes in livers of hepatitis C virus (HCV)-infected patients with normal alanine aminotransferase (ALT) levels. Methods: 72 patients over 16 years old, with chronic hepatitis C (CHC) and normal ALT levels were evaluated in this multicenter retrospective study. Persistently normal ALT level was defined as 2 or 3 normal ALT levels at intervals of at least 1 month during 6 months. Demographic data, year of diagnosis, at least 2 ALT values within 6 months, hepatitis markers, results of HCV RNA and the liver biopsy were all evaluated. Serological markers have been tested with different kits. HCV RNA has been studied by RT-PCR with dynamic range and sensitivity of different kits. All biopsies were evaluated again by the same pathologist. Results: The mean age was 44±13 years and 61.1% were female. HCV RNA levels were between 1.53x10 2 -1.13x10 8 IU/ml. The mean ALT levels were 30.3±9.6 IU/lt. The mean grade of necroinflammation was 4.67±1.96 and mean staging of fibrosis was 1.03±1.13. The ratios of minimal, mild and moderate activity in the liver biopsies were 48.6%, 45.3% and, 2.8%, respectively. Rate of portal-periportal fibrosis, bridging fibrosis and incomplete cirrhosis were 51.4%, 6.9%, and 1.4%, respectively. Conclusions: ALT level is a poor indicator of liver disease activity in patients with CHC. Patients with indication for treatment should be evaluated for liver biopsy.

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Metabolic factors are associated with serum alanine aminotransferase levels in patients with chronic hepatitis C

Abstract: Metabolic factors, as well as sex and hepatic inflammation, are independent risk factors for serum ALT elevation in hepatitis C virus (HCV)-infected patients. Metabolic factors may offer targets to decrease serum ALT levels.

Cited by 14 publications

References 42 publications

Hepatitis B virus and hepatitis C virus infection among HIV-1-infected injection drug users in Dali, China: prevalence and infection status in a cross-sectional study

Hepatitis B virus and hepatitis C virus infection among HIV-1-infected injection drug users in Dali, China: prevalence and infection status in a cross-sectional study

Genetic variation in the microsomal triglyceride transfer protein (−493G/T) is associated with hepatic steatosis in patients infected with hepatitis C virus

Liver Histology of Patients with Hepatitis C Virus Infection and Normal Alanine Aminotransferase Levels

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