Clinical impact of normal alanine aminotransferase on direct‐acting antiviral outcome in patients with chronic hepatitis C virus infection
Background and Aims This study aimed to clarify the clinical picture of hepatitis C virus (HCV) carriers with normal alanine aminotransferase (CNALT) and those with ALT elevation (non‐CNALT) under direct‐acting antivirals (DAAs). Methods We enrolled 1002 patients with HCV (427 men, median age: 69 ye...
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| Format: | Article |
| Language: | English |
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Wiley
2020-08-01
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| Series: | JGH Open |
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| Online Access: | https://doi.org/10.1002/jgh3.12296 |
| _version_ | 1818461900044763136 |
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| author | Satoru Joshita Ayumi Sugiura Takeji Umemura Tomoo Yamazaki Naoyuki Fujimori Akihiro Matsumoto Yoko Usami Eiji Tanaka |
| author_facet | Satoru Joshita Ayumi Sugiura Takeji Umemura Tomoo Yamazaki Naoyuki Fujimori Akihiro Matsumoto Yoko Usami Eiji Tanaka |
| author_sort | Satoru Joshita |
| collection | DOAJ |
| description | Background and Aims This study aimed to clarify the clinical picture of hepatitis C virus (HCV) carriers with normal alanine aminotransferase (CNALT) and those with ALT elevation (non‐CNALT) under direct‐acting antivirals (DAAs). Methods We enrolled 1002 patients with HCV (427 men, median age: 69 years) who had received DAAs for comparisons between CNALT (ALT ≤33 U/L in males and ≤25 U/L in females; n = 374) and non‐CNALT (n = 628) groups. Results CNALT patients displayed a higher platelet count (PLT) (170 000 vs 146 000/μL, P < 0.0001) and albumin (4.1 vs 4.1 g/dL, P = 0.0006) but lower AST (25 vs 51 U/L, P < 0.0001), alpha fetoprotein (3.2 vs 5.4 ng/mL, P < 0.0001), and liver fibrosis marker scores (all P < 0.0001). The sustained virologic response rate was comparable between the CNALT and non‐CNALT groups (97.8 vs 95.3%, P = 0.106). The cumulative incidence of hepatocellular carcinoma (HCC) after DAA treatment was comparable between the CNALT and non‐CNALT groups (P = 0.117, log‐rank test). In CNALT patients with HCC history, PLT ≥150 000/μL was an independent risk factor of HCC recurrence (P = 0.019). In non‐CNALT patients without HCC history, male gender (P = 0.021) and albumin <4.0 g/dL (P = 0.007) were independent risk factors, while PLT < 150 000/μL (P = 0.081) was a marginal risk factor of HCC occurrence. Conclusion CNALT patients displayed a milder degree of liver fibrosis. Combinations of CNALT and PLT status might be useful as markers for HCC occurrence or recurrence surveillance. |
| first_indexed | 2024-12-14T23:53:29Z |
| format | Article |
| id | doaj.art-3e3161830fe6499daac9108a04669ec5 |
| institution | Directory Open Access Journal |
| issn | 2397-9070 |
| language | English |
| last_indexed | 2024-12-14T23:53:29Z |
| publishDate | 2020-08-01 |
| publisher | Wiley |
| record_format | Article |
| series | JGH Open |
| spelling | doaj.art-3e3161830fe6499daac9108a04669ec52022-12-21T22:43:11ZengWileyJGH Open2397-90702020-08-014457458110.1002/jgh3.12296Clinical impact of normal alanine aminotransferase on direct‐acting antiviral outcome in patients with chronic hepatitis C virus infectionSatoru Joshita0Ayumi Sugiura1Takeji Umemura2Tomoo Yamazaki3Naoyuki Fujimori4Akihiro Matsumoto5Yoko Usami6Eiji Tanaka7Department of Medicine, Division of Gastroenterology and Hepatology Shinshu University School of Medicine Matsumoto JapanDepartment of Medicine, Division of Gastroenterology and Hepatology Shinshu University School of Medicine Matsumoto JapanDepartment of Medicine, Division of Gastroenterology and Hepatology Shinshu University School of Medicine Matsumoto JapanDepartment of Medicine, Division of Gastroenterology and Hepatology Shinshu University School of Medicine Matsumoto JapanDepartment of Medicine, Division of Gastroenterology and Hepatology Shinshu University School of Medicine Matsumoto JapanDepartment of Medicine, Division of Gastroenterology and Hepatology Shinshu University School of Medicine Matsumoto JapanDepartment of Laboratory Medicine Shinshu University Hospital Matsumoto JapanDepartment of Medicine, Division of Gastroenterology and Hepatology Shinshu University School of Medicine Matsumoto JapanBackground and Aims This study aimed to clarify the clinical picture of hepatitis C virus (HCV) carriers with normal alanine aminotransferase (CNALT) and those with ALT elevation (non‐CNALT) under direct‐acting antivirals (DAAs). Methods We enrolled 1002 patients with HCV (427 men, median age: 69 years) who had received DAAs for comparisons between CNALT (ALT ≤33 U/L in males and ≤25 U/L in females; n = 374) and non‐CNALT (n = 628) groups. Results CNALT patients displayed a higher platelet count (PLT) (170 000 vs 146 000/μL, P < 0.0001) and albumin (4.1 vs 4.1 g/dL, P = 0.0006) but lower AST (25 vs 51 U/L, P < 0.0001), alpha fetoprotein (3.2 vs 5.4 ng/mL, P < 0.0001), and liver fibrosis marker scores (all P < 0.0001). The sustained virologic response rate was comparable between the CNALT and non‐CNALT groups (97.8 vs 95.3%, P = 0.106). The cumulative incidence of hepatocellular carcinoma (HCC) after DAA treatment was comparable between the CNALT and non‐CNALT groups (P = 0.117, log‐rank test). In CNALT patients with HCC history, PLT ≥150 000/μL was an independent risk factor of HCC recurrence (P = 0.019). In non‐CNALT patients without HCC history, male gender (P = 0.021) and albumin <4.0 g/dL (P = 0.007) were independent risk factors, while PLT < 150 000/μL (P = 0.081) was a marginal risk factor of HCC occurrence. Conclusion CNALT patients displayed a milder degree of liver fibrosis. Combinations of CNALT and PLT status might be useful as markers for HCC occurrence or recurrence surveillance.https://doi.org/10.1002/jgh3.12296direct‐acting antiviralhepatitis C virus carrier with normal alanine aminotransferasehepatitis C virushepatocellular carcinoma |
| spellingShingle | Satoru Joshita Ayumi Sugiura Takeji Umemura Tomoo Yamazaki Naoyuki Fujimori Akihiro Matsumoto Yoko Usami Eiji Tanaka Clinical impact of normal alanine aminotransferase on direct‐acting antiviral outcome in patients with chronic hepatitis C virus infection JGH Open direct‐acting antiviral hepatitis C virus carrier with normal alanine aminotransferase hepatitis C virus hepatocellular carcinoma |
| title | Clinical impact of normal alanine aminotransferase on direct‐acting antiviral outcome in patients with chronic hepatitis C virus infection |
| title_full | Clinical impact of normal alanine aminotransferase on direct‐acting antiviral outcome in patients with chronic hepatitis C virus infection |
| title_fullStr | Clinical impact of normal alanine aminotransferase on direct‐acting antiviral outcome in patients with chronic hepatitis C virus infection |
| title_full_unstemmed | Clinical impact of normal alanine aminotransferase on direct‐acting antiviral outcome in patients with chronic hepatitis C virus infection |
| title_short | Clinical impact of normal alanine aminotransferase on direct‐acting antiviral outcome in patients with chronic hepatitis C virus infection |
| title_sort | clinical impact of normal alanine aminotransferase on direct acting antiviral outcome in patients with chronic hepatitis c virus infection |
| topic | direct‐acting antiviral hepatitis C virus carrier with normal alanine aminotransferase hepatitis C virus hepatocellular carcinoma |
| url | https://doi.org/10.1002/jgh3.12296 |
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