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Viral and metabolic factors influencing alanine aminotransferase activity in patients with chronic hepatitis C.

Abstract：

BACKGROUND/AIMS:In chronic hepatitis C, disease progression and clinical manifestations are heterogenous. To clarify the role and interactions of viral and host factors in inducing liver cell injury, we examined the associations of several virological and metabolic variables with serum alanine aminotransferase levels. METHODS:Patients with chronic hepatitis C enrolled in three phase III clinical trials of peginterferon alfa-2a (40KD) plus ribavirin (two studies analysing 'elevated' and one persistently 'normal' alanine aminotransferase) were included. RESULTS:Multivariate analyses of 2,881 patients before treatment and of 1,403 patients with a sustained virological response indicated that gender, viral factors (genotype, HCV RNA titer) and indicators of metabolic syndrome (body mass index, blood pressure, blood glucose, cholesterol and triglyceride concentration) were associated with alanine aminotransferase levels. In addition, hepatitis C virus infection influenced serum lipids concentration according to a genotype-specific effect. CONCLUSIONS:Heterogeneity in alanine aminotransferase levels in patients with chronic hepatitis C partially depends on the degree of derangement of fat and carbohydrate metabolism. As this is the result of an interaction of chronic hepatitis C infection with the patient's individual characteristics, treatment decisions should not be based on alanine aminotransferase level alone but rather on global evaluation of the patient.

journal_name

J Hepatol

journal_title

Journal of hepatology

authors

Prati D,Shiffman ML,Diago M,Gane E,Rajender Reddy K,Pockros P,Farci P,O'Brien CB,Lardelli P,Blotner S,Zeuzem S

doi

10.1016/j.jhep.2006.01.004

subject

Has Abstract

pub_date

2006-04-01 00:00:00

pages

679-85

issue

4

eissn

0168-8278

issn

1600-0641

pii

S0168-8278(06)00014-6

journal_volume

44

pub_type

杂志文章

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