Guidelines for the antiviral therapy of hepatitis C virus carriers with normal serum aminotransferase based on platelet counts
Article first published online: 9 AUG 2007
Volume 38, Issue 1, pages 27–36, January 2008
How to Cite
Okanoue, T., Itoh, Y., Minami, M., Hashimoto, H., Yasui, K., Yotsuyanagi, H., Takehara, T., Kumada, T., Tanaka, E., Nishiguchi, S., Izumi, N., Sata, M., Onji, M., Yamada, G., Okita, K. and Kumada, H. (2008), Guidelines for the antiviral therapy of hepatitis C virus carriers with normal serum aminotransferase based on platelet counts. Hepatology Research, 38: 27–36. doi: 10.1111/j.1872-034X.2007.00217.x
- Issue published online: 29 AUG 2007
- Article first published online: 9 AUG 2007
- Received 6 March 2007; revision 22 May 2007; accepted 14 June 2007.
- antiviral therapy;
- chronic hepatitis C;
- hepatitis C virus carriers;
- normal serum aminotransferase;
- platelet count
Aim: We aimed to identify the candidates for antiviral therapy, among patients who are hepatitis C virus (HCV) carriers with normal serum aminotransferase (ALT), focused on the inhibition of hepatocellular carcinoma (HCC).
Methods: Four hundred and sixty-four HCV carriers with normal serum ALT and 129 HCV carriers with persistently normal ALT (PNALT) and platelet (PLT) counts ≥150 000/μL who received liver biopsies were enrolled. HCV carriers with normal serum ALT were divided into four groups according to their ALT levels (≤30 U/L or 31–40 U/L) and PLT counts (≥150 000/μL or <150 000/μL).
Results: In 129 HCV carriers with PNALT, the rate of progression of fibrosis stage was 0.05/year and no HCC was detected during the follow up for 10 years. Approximately 20% of patients with ALT ≤40 U/L and PLT counts ≥150 000/μLwere at stage F2–3; however, approximately 50% of patients with ALT ≤ 40 U/L and PLT counts <150 000/μL were at stage F2–4. An algorithm for the management of HCV carriers with normal serum ALT was advocated based on ALT and PLT counts.
Conclusion: The combination of ALT and PLT counts is useful for evaluating the fibrosis stage in HCV carriers with normal serum ALT. Most patients with PLT counts <150 000/μL are candidates for antiviral therapy, especially those with ALT levels ≥31 U/L when we focus on the inhibition of the development of HCC.