Abstract:
AIM:To investigate the accuracy of serum alanine aminotransferase (ALT) in diagnosing lamivudine resistance and factors that contributed to abnormal serum ALT. METHODS:This was a retrospective study of chronic hepatitis B patients on lamivudine therapy who were followed for 3-mo with liver function tests and hepatitis B virus (HBV) DNA measurement. Lamivudine resistance was defined as HBV DNA ≥ 1 log from nadir on at least 2 occasions, confirmed by genotyping. Serum ALT levels in patients with lamivudine resistance were compared to serum ALT levels in those without lamivudine resistance. RESULTS:There were 111 patients with and 117 without lamivudine resistance. The area under the receiver operating characteristic of serum ALT to diagnose lamivudine resistance was 0.645 ± 0.037. Serum ALT > 42.5 U/L gave the best diagnostic accuracy with sensitivity = 61%, specificity = 60%, positive predictive value = 60%, negative predictive value = 61%, positive likelihood ratio = 1.53 and negative likelihood ratio = 0.65 for predicting lamivudine resistance, missing 39% of resistant patients. Using other serum ALT cutoffs, diagnostic accuracy was lower. By multivariate analysis, baseline abnormal serum ALT was associated with abnormal ALT during resistance (OR = 5.98, P = 0.003), and males were associated with serum ALT flares during resistance (OR = 8.9, P = 0.016). CONCLUSION:Serum ALT is inadequate for diagnosing lamivudine resistance and has implications where viral resistance testing is suboptimal and for reimbursement of rescue therapy.
journal_name
World J Gastroenteroljournal_title
World journal of gastroenterologyauthors
Lim LG,Aung MO,Seet BL,Tan C,Dan YY,Lee YM,Sutedja DS,Fernandes M,Lee GH,Koay E,Lim SGdoi
10.3748/wjg.v16.i37.4691subject
Has Abstractpub_date
2010-10-07 00:00:00pages
4691-6issue
37eissn
1007-9327issn
2219-2840journal_volume
16pub_type
杂志文章abstract:AIM:To investigate the existence and clinical significance of hepatitis C virus (HCV) RNA in the serum and peripheral blood mononuclear cells (PBMC) of patients with hepatitis C. METHODS:HCV RNA was detected by nested polymerase chain reaction (Nested PCR) in serum and in PBMC of 46 patients with acute hepatitis C (AH...
journal_title:World journal of gastroenterology
pub_type: 杂志文章
doi:10.3748/wjg.v3.i2.108
更新日期:1997-06-15 00:00:00
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journal_title:World journal of gastroenterology
pub_type: 杂志文章,评审
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journal_title:World journal of gastroenterology
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pub_type: 临床试验,杂志文章
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更新日期:2014-08-14 00:00:00
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更新日期:2020-06-28 00:00:00
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更新日期:2006-10-21 00:00:00
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更新日期:2006-07-14 00:00:00
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pub_type: 杂志文章,评审
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更新日期:2013-08-14 00:00:00
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更新日期:2006-01-28 00:00:00
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pub_type: 杂志文章,随机对照试验
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更新日期:2017-08-28 00:00:00
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journal_title:World journal of gastroenterology
pub_type: 杂志文章
doi:10.3748/wjg.v12.i8.1255
更新日期:2006-02-28 00:00:00
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更新日期:2003-03-01 00:00:00
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pub_type: 杂志文章,评审
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journal_title:World journal of gastroenterology
pub_type: 杂志文章,meta分析,评审
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更新日期:2011-07-14 00:00:00
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pub_type: 杂志文章,随机对照试验
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更新日期:2012-06-07 00:00:00
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journal_title:World journal of gastroenterology
pub_type: 杂志文章
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更新日期:2003-11-01 00:00:00
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更新日期:2007-02-14 00:00:00
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journal_title:World journal of gastroenterology
pub_type: 杂志文章
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更新日期:2004-11-01 00:00:00
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journal_title:World journal of gastroenterology
pub_type: 杂志文章
doi:10.3748/wjg.v17.i25.3035
更新日期:2011-07-07 00:00:00
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journal_title:World journal of gastroenterology
pub_type: 杂志文章
doi:10.3748/wjg.v20.i38.13728
更新日期:2014-10-14 00:00:00
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journal_title:World journal of gastroenterology
pub_type: 杂志文章
doi:10.3748/wjg.v17.i3.322
更新日期:2011-01-21 00:00:00
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journal_title:World journal of gastroenterology
pub_type: 杂志文章
doi:10.3748/wjg.v22.i34.7767
更新日期:2016-09-14 00:00:00
abstract::The risk factors for hepatocellular carcinoma (HCC) development have been established, and include chronic hepatitis B and C, heavy alcohol consumption, and aflatoxins. In fact, 5%-30% of patients with HCC still lack a readily identifiable risk factor. It has been reported that the majority of ''cryptogenic'' HCC may ...
journal_title:World journal of gastroenterology
pub_type: 杂志文章,评审
doi:10.3748/wjg.v16.i46.5801
更新日期:2010-12-14 00:00:00
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journal_title:World journal of gastroenterology
pub_type: 杂志文章
doi:10.3748/wjg.v12.i29.4745
更新日期:2006-08-07 00:00:00