- Chronic Hepatitis C With Normal
Serum Enzymes Responds to
WESTPORT, CT (Reuters Health) Dec 07 - Hepatitis
C-infected patients with persistently normal serum interferon
respond to interferon therapy as well as do similar patients with
elevated alanine aminotransferase, according to a report in the
December issue of the Journal of Infectious Diseases.
Popular opinion suggests that hepatitis C virus (HCV) infection
accompanied by normal alanine aminotransferase levels is
relatively benign, the authors explain, but liver biopsies reveal
cirrhosis in as many as 10% of such patients.
Dr. Mitchell L. Shiffman and colleagues, from the Medical
College of Virginia Commonwealth University in Richmond,
compared the effects of interferon treatment in HCV-infected
patients with elevated (58 patients) or persistently normal (37
patients) alanine aminotransferase levels.
Not surprisingly, hepatic inflammation and fibrosis, as well as
advanced liver disease, were significantly less common in the
patients with normal serum alanine aminotransferase levels, the
Nevertheless, responses to interferon therapy (as measured by
serum levels of HCV RNA) were not statistically different for the
two groups of patients, the authors report. After 3 months of
treatment, about 38% of both groups of patients were HCV
RNA-negative. By 18 months after the end of treatment,
however, only 9.5% of treated patients had a sustained virologic
Also, 30% of the normal alanine aminotransferase patients
experienced a rise in serum alanine aminotransferase during the
study, as did 34% of the group with already elevated serum
alanine aminotransferase levels, the investigators say.
"Persons with persistently normal serum alanine aminotransferase
levels respond to interferon therapy, as do those with elevated
alanine aminotransferase levels," the authors conclude. "Thus, we
recommend that patients with chronic HCV infection and
persistently normal alanine aminotransferase levels undergo liver
biopsy and be offered treatment, if liver histology is thought to
warrant this option."
J Infect Dis 2000;182:1595-1601.