The Distribution of Serum Alanine Aminotransferase Levels in a Blood Donor Population1

Kahn, Richard; Johnson, Gina; Aach, Richard D.; Hines, Andria; Ellis, Frank R.; Miller, William V.

doi:10.1093/oxfordjournals.aje.a113380

Cited by 33 publications

(5 citation statements)

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“…Raised ALT levels in apparently healthy individuals have been statistically correlated to at least one of the following: male sex [16][17][18], middle age [16][17][18], over weight [10,16,20], alcohol-drinking habits [18,20] and ongoing gastrointestinal symptoms [19]. The association to male sex and overweight is in congruence with our study.…”

Section: Discussionsupporting

confidence: 88%

Persistent Alanine Aminotransferase Elevation in Healthy Swedish Blood Donors - Mainly Caused by Obesity

Wejstål¹,

Hansson²,

Lindholm³

et al. 1988

Vox Sanguinis

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Five hundred consecutive healthy blood donors were tested for serum alanine aminotransferase (ALT) and 44 (8.8%) had increased levels. Donors with and without raised ALT were compared in several aspects but only weight (expressed as percentage of ideal body weight) and sex differed significantly (119.1 ± 14.5 and 106.3 ± 12.8%, respectively; p<0.001 and males 97.7 and 77.1%, respectively; p<0.01). The 44 donors with raised ALT were followed up and in 13 out of 15 donors with persistently raised ALT without obvious reason, a liver biopsy was performed. Ten donors had various degrees of liver steatosis, 2 had normal liver morphology and in 1 donor chronic hepatitis could not be ruled out. If ALT screening is introduced as a surrogate test for non-A, non-B hepatitis in Swedish blood donors, we suggest that a correction for overweight must be considered in order to minimize donor loss.

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Section: Discussionsupporting

confidence: 88%

Persistent Alanine Aminotransferase Elevation in Healthy Swedish Blood Donors - Mainly Caused by Obesity

Wejstål¹,

Hansson²,

Lindholm³

et al. 1988

Vox Sanguinis

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“…9 Further evidence has been presented that sociodemographic data of non-A, non-B virus are very similar to that of HBV and most of the donors with elevated ALT tend to possess anti-HBc and anti-HBs together. 22 In our studies, we also observed that most of the donors with an elevated ALT were positive for both antibodies. In order to eliminate this complication of transfusion, it is essential that the donor be tested for ALT.…”

Section: Discussionsupporting

confidence: 73%

Hepatitis B Virus Markers among the Blood Donors in Medina Munawara

et al. 1988

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Three hundred sixty-nine male blood donors from Medina Munawara were studied for hepatitis B virus (HBV) markers. Serologic evidence of exposure to HBV was noted in 48%. A majority of these individuals showed the presence of antibodies, and only 7.6% were documented as HBsAg carriers. The infection was usually caused by HBV subtype ay. A strong positive correlation existed between infection rate, age, and poor socioeconomic conditions. We presume that improvement in the socioeconomic conditions and timely vaccination may help in reducing the infection rate. The discovery of hepatitis B surface antigen (HBsAg) by Blumberg et al 1 led to the recognition that blood or blood products of a healthy donor could be infectious. In order to avoid post-transfusion hepatitis, sensitive methods were developed to test the blood and blood products for hepatitis B virus (HBV) markers, and the prevalence of these markers was studied in various parts of the world. In Saudi Arabia several studies have been conducted to assess the prevalence of HBsAg among the healthy population. The results of these studies show that the rate varies from 2% to 20% depending on the detection method used and the population studied. [3][4][5] HBsAg is present in about 8% to 12% of the Saudi male blood donors in the Eastern Province and Riyadh, 6-8 while 20% to 26% of Saudi males in Gizan and Khaiber areas may be termed as carriers. 4,5 As variation exists in the rates of HBV infection in different parts of the country, the present study was undertaken to determine the frequency of HBV markers in the blood donors in Medina Munawara and to find the predominant HBsAg subtype (ad or ay) among the carriers.It has been suggested that in the absence of serologic markers for HBV, unexplained elevation of alanine aminotransferase (ALT) could be due to the presence of non-A, non-B virus.9 Therefore, serum ALT levels were also determined in this study to assess the frequency of the non-A, non-B carrier state. Materials and MethodsDuring the period of October 1986 to March 1987 blood specimens were collected at the Central Blood Bank, Medina Munawara, on a random basis from 369 healthy blood donors, who were required by the Ministry of Interior to donate blood before they were issued a Saudi driver's license. Each donor completed a form to provide information pertaining to age, marital status, education, and nationality. Among the donors, 234 were Saudi nationals, while the non-Saudi group comprised 20 different nationalities. An aliquot of specimen was allowed to clot; serum was separated by centrifugation, and pending analysis, sera were stored frozen at -20°C. Estimation of ALT on these samples was carried out as early as possible, mostly within 1 week of collection.

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“…3 The determination of what constitutes "normal" serum ALT levels has been controversial; this is in part because the distribution of ALT levels is influenced by such factors as gender, race, obesity, diet, and geographic region. 6,[9][10][11][12] In addition, diurnal variations in this enzyme's serum levels have been noted. 13 Despite the variations noted in the normal levels of this enzyme, the measurement of serum ALT activity has played, and continues to play, a vital role in the detection and monitoring of viral hepatitis.…”

mentioning

confidence: 99%

Dynamics of alanine aminotransferase during hepatitis C virus treatment

et al. 2003

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Studies of the kinetics of hepatitis C virus (HCV) decline during interferon (IFN)-based therapy have led to insights into treatment efficacy. However, the kinetics of serum alanine aminotransferase (ALT), an enzyme used as a surrogate of liver damage, have not been closely monitored, and it is not known if they correlate with those of HCV RNA. Here we describe the associations between ALT and HCV dynamics. We analyzed 35 patients treated daily with 10 mIU IFN-␣2b with or without ribavarin for 28 days followed by standard IFN/ ribavirin therapy. Patients exhibited 4 patterns of ALT change: (1) exponential decay of ALT, (2) transient increase in ALT followed by a decrease to pretreatment or normal levels, (3) increase in ALT to a new level, and (4) no significant change. By simultaneously modeling HCV and ALT dynamics, we successfully fit the observed changes. We found ALT decays with t 1/2 ‫؍‬ 12.7 hours. The transient increase in ALT observed in some patients suggested a mild hepatotoxic effect of IFN. However, patients with a smaller initial ALT increase achieved higher rates of viral negativity by week 72 (P ‫؍‬ .02). The week-4 ALT decline correlated with the HCV log drop (P ‫؍‬ .006) and the efficacy of therapy (P ‫؍‬ .025). In conclusion, our results suggest the use of ALT as a surrogate marker for treatment effect in patients with elevated ALT. (HEPATOLOGY 2003;38:509-517.) H epatitis C virus (HCV) is the most common cause of blood-borne viral hepatitis, 1,2 with acute HCV infection progressing to the chronic state 60% to 70% of the time. 1,3 Chronic HCV infection can lead to cirrhosis and/or hepatocellular carcinoma and is the leading cause of liver transplantation in the United States. 1,3 While treatment options have greatly improved, they are still not effective in all patients.Prior to the advent of HCV-RNA testing, alanine aminotransferase (ALT) levels served as a surrogate marker of HCV infection and liver injury. 4,5 This cytosolic enzyme functions in a transamination reaction, which is important for carbohydrate and protein metabolism. 6 With a normally functioning liver, the activity of this soluble enzyme is at low levels in the serum. With hepatic injury, ALT leaks from the liver, causing an elevation of serum ALT activity, thus serving as an indicator of hepatocellular injury. 6,7 However, the specificity and sensitivity of elevated ALT levels as a marker for hepatic injury are low. Consequently, the ALT serum level does not always correlate with the extent of hepatic injury, 8 and in fact 20% of patients infected with HCV have normal ALT values despite histologic injury on biopsy. 3 The determination of what constitutes "normal" serum ALT levels has been controversial; this is in part because the distribution of ALT levels is influenced by such factors as gender, race, obesity, diet, and geographic region. 6,[9][10][11][12] In addition, diurnal variations in this enzyme's serum levels have been noted. 13 Despite the variations noted in the normal levels of this enzyme, the measurement of ...

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The Distribution of Serum Alanine Aminotransferase Levels in a Blood Donor Population1

Cited by 33 publications

References 0 publications

Persistent Alanine Aminotransferase Elevation in Healthy Swedish Blood Donors - Mainly Caused by Obesity

Persistent Alanine Aminotransferase Elevation in Healthy Swedish Blood Donors - Mainly Caused by Obesity

Hepatitis B Virus Markers among the Blood Donors in Medina Munawara

Dynamics of alanine aminotransferase during hepatitis C virus treatment

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