Hepatitis B viral factors in HBeAg-Negative carriers with persistently normal serum alanine aminotransferase levels

Authors

  • Chih-Lin Lin,

    1. Department of Gastroenterology, Ren-Ai branch, Taipei City Hospital, Taipei 100, Taiwan
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    • These authors contributed equally to this work.

  • Li-Ying Liao,

    1. Department of Gastroenterology, Ren-Ai branch, Taipei City Hospital, Taipei 100, Taiwan
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    • These authors contributed equally to this work.

  • Chun-Jen Liu,

    1. Department of Internal Medicine, National Taiwan University Hospital, Taipei 100, Taiwan
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  • Ming-Whei Yu,

    1. Department of Public Health and Graduate Institute of Epidemiology, Taipei, Taiwan
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  • Pei-Jer Chen,

    1. Department of Internal Medicine, National Taiwan University Hospital, Taipei 100, Taiwan
    2. Graduate Institute of Clinical Medicine, Taipei, Taiwan
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  • Ming-Yang Lai,

    1. Department of Internal Medicine, National Taiwan University Hospital, Taipei 100, Taiwan
    2. Graduate Institute of Clinical Medicine, Taipei, Taiwan
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  • Ding-Shinn Chen,

    1. Department of Internal Medicine, National Taiwan University Hospital, Taipei 100, Taiwan
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  • Jia-Horng Kao

    Corresponding author
    1. Department of Internal Medicine, National Taiwan University Hospital, Taipei 100, Taiwan
    2. Graduate Institute of Clinical Medicine, Taipei, Taiwan
    3. Hepatitis Research Center, Taipei, Taiwan
    4. Department of Medical Research, Taipei, Taiwan
    • Director and Professor, Hepatitis Research Center and Graduate Institute of Clinical Medicine, Taipei 100, Taiwan
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    • These authors contributed equally to this work.

    • fax: (886) 2-23825962


  • Potential conflict of interest: Nothing to report.

Abstract

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. (HEPATOLOGY 2007;45:1193–1198.)

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