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What is the reason of elevated alanine aminotransferase level in HBeAg negative patients with low viremia: NAFLD or chronic hepatitis?
- Source :
-
Annals of hepatology [Ann Hepatol] 2007 Apr-Jun; Vol. 6 (2), pp. 92-6. - Publication Year :
- 2007
-
Abstract
- Background and Study Aims: Increased alanine aminotransferase (ALT) levels with negative hepatitis B virus (HBV) DNA by hybridization is a common problem in Turkey where is a mild endemic region. We aimed to evaluate the causes of elevated ALT levels in patients who are negative for hepatitis B e antigen (HBeAg) and HBV DNA (by hybridization) for at least 6 months.<br />Patients-Methods: Forty-nine patients were enrolled in this study. Histological changes [histological activity index (HAI), and the extent of fibrosis] were assessed according to the Knodell scoring system and steatosis were graded by Brunt's classification for NAFLD in all patients.<br />Results: A mean age of the patients was 34.9 +/- 12.1 years (16-70). 43 (87.8%) of them were male. Mean ALT level was 95 +/- 39.7 IU/L (50- 258). Hyperglycemia (>100 mg/dL) and hyperlipidemia were found in 12 and 24 patients, respectively. Hepatic steatosis (7 patients grade 1; 5 patients grade 2; and 7 patients grade 3), ground-glass hepatocyte, chronic hepatitis, and Wilson disease were found in liver biopsy in 38.8%, 32.6%, 26.6%, 2%, respectively. Mean HAI was 6.5 +/- 3.6 (4-12) in chronic hepatitis. Seven patients (53.9%) were in stage 1 and 2 while 6 patients (46.1%) were in stage 3 and 4.<br />Conclusions: Nonalcoholic fatty liver disease is the most common cause of elevated ALT levels in HBeAg negative/HBV DNA negative patients. Chronic hepatitis B was found in 26.6% of these patients.
- Subjects :
- Adolescent
Adult
Aged
Alanine Transaminase blood
DNA, Viral blood
Fatty Liver pathology
Female
Hepatitis B virus isolation & purification
Humans
Male
Middle Aged
Up-Regulation
Viremia
Alanine Transaminase metabolism
Fatty Liver enzymology
Hepatitis B e Antigens blood
Hepatitis B, Chronic enzymology
Subjects
Details
- Language :
- English
- ISSN :
- 1665-2681
- Volume :
- 6
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Annals of hepatology
- Publication Type :
- Academic Journal
- Accession number :
- 17519831