Help
Subscribe


Submit Videos to GastroHep Read For FREE - Our full range of review articles
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy Profile of Guido Tytgat Profile of Pete Peterson Profile of Peter Cotton Profile of Roy Pounder

Home

News  
Journals
Review Articles
Slide Atlas
Video Clips
Online Books
Advanced Digestive Endoscopy
Classical Cases
Conference Diary
PubMed
International GH Links
USA GH Links
National GH Links
National GI Societies
Other Useful Links




Emails on Gastroenterology and Hepatology
the National AIDS Treatment Advocacy Project
Visit the gastroenterology section of the EUMS

News

ALT increase is a marker of fibrosis in Hep B

The most recent issue of the Clinical Gastroenterology & Hepatology evaluates histologic changes in liver tissue from patients with chronic Hepatitis B and minimal increases in levels of alanine aminotransferase.

News image

The level of alanine aminotransferase (ALT) is a marker of hepatitis B severity and response to treatment.

However, measurements of ALT level may be of limited use during the immune clearance phase of chronic hepatitis B and can be affected by age, weight, and concomitant liver disease.

Dr Mindie Nguyen and colleagues from California, USA performed a literature review to determine the proportion of chronic hepatitis B patients with ALT levels of 1- to 2-fold the upper limit of normal who also had significant underlying liver fibrosis.

The team performed a Medline search of original articles published before 2012, and their references.

The researchers also searched abstracts from the 2010 and 2011 annual meetings of the American Association for the Study of Liver Diseases and the 2011 and 2012 Digestive Disease Weeks.

48% of patients had stage 2 or higher fibrosis
Clinical Gastroenterology & Hepatology

Studies were included that had 20 or more consecutive treatment-naive chronic hepatitis B patients with 6 months or more of follow-up evaluation, histologic data, and levels of ALT 1- to 2-fold the upper limit of normal.

The team evaluated 8 articles and 1 abstract, comprising 683 patients.

Based on random-effects modeling, the researchers found that 48% of patients had stage 2 or higher fibrosis.

In a sensitivity analysis, exclusion of the study that caused the greatest deflection of the pooled estimate produced a revised estimate of 43%.

A subgroup of hepatitis B e antigen–positive and hepatitis B e antigen–negative patients showed similar rates of fibrosis.

Dr Nguyen's team concludes, "Despite heterogeneity in the literature, a substantial proportion of patients with slight increases in ALT level have significant fibrosis."

"Given the possibility of advanced liver disease, the threshold for antiviral treatment must be individualized."

"Further studies are needed to investigate patients with modest increases in ALT level."

Clin Gastroenterol Hepatol 2014: 12(8): 1262–1266
29 July 2014

Go to top of page Email this page Email this page to a colleague

 27 May 2015

Advanced search
 27 May 2015 
Vegetables and fruit and IBD
 27 May 2015 
Radiofrequency ablation for treatment of GERD
 27 May 2015 
Management of constipation and IBS
 26 May 2015 
Antimicrobials for intraabdominal infection
 26 May 2015 
Calcium channel blockers and GI bleeds
 26 May 2015 

Risk factors for celiac disease

 25 May 2015 
Colorectal cancer screening
 25 May 2015 
Saccharomyces boulardii and H. pylori
 25 May 2015 
Risk of GI bleeds with NSAIDs
 22 May 2015 
Colonoscopy screening for colorectal cancer
 22 May 2015 
Treatment with anti-integrin antibodies in IBD
 22 May 2015 
Care of patients with GERD
 21 May 2015 
Lymphoma in IBD
 21 May 2015 
Serrated polyps and colorectal cancer
 21 May 2015 
Imaging for hepatocellular carcinoma
 20 May 2015 
Surveillance in long-segment Barrett's
 20 May 2015 
Pancreatic neuroendocrine tumors
 20 May 2015 
Refractory metastatic colorectal cancer
 19 May 2015 
Metabolic syndrome and Barrett's
 19 May 2015 
PPIs and cryptogenic liver abscess
 19 May 2015 
Anti-integrin antibodies in IBD
 18 May 2015 
ESPGHAN celiac guidelines
 18 May 2015 
HLA haplotypes and primary sclerosing cholangitis
 18 May 2015 
Safety of PPI
 15 May 2015 
Microscopic colitis risk with PPIs/NSAIDs
 15 May 2015 
Management of nonhospitalized ulcerative colitis
 15 May 2015 
Diabetes and infections in IBD with immunomodulation
 14 May 2015 
Radiation exposure during ERCP
 14 May 2015 
Diagnosis of spontaneous bacterial peritonitis
 14 May 2015 
Mortality in US patients with cirrhosis
 13 May 2015 
Predictors of IBD
 13 May 2015 
Psychological distress and liver disease mortality
 13 May 2015 
Hypnotherapy in IBS/IBD
 12 May 2015 
Bleeding in NSAID users with H.pylori
 12 May 2015 
Capsule colonoscopy detects colorectal polyps
 12 May 2015 
Anti-TNF biologics in acute severe ulcerative colitis
 11 May 2015 
Management of Barrett's esophagus
 11 May 2015 
Marker to detect recurrence of Crohn's
 11 May 2015 
Thalidomide for IBD
 08 May 2015 
Surveillance colonoscopy in colorectal cancer
 08 May 2015 
HCV treatment with compensated cirrhosis
 08 May 2015 
Medical management of Crohn's
 07 May 2015 
Surgical complications in ulcerative colitis
 07 May 2015 
Combination therapy for noncirrhostic patients
 07 May 2015 
Anxiety and new-onset dyspepsia
 06 May 2015 
PPIs and spontaneous bacterial peritonitis
 06 May 2015 
Infant feeding and celiac disease
 06 May 2015 
Preventing recurrent C. diff infection
 05 May 2015 
Fatigue in primary sclerosing cholangitis
 05 May 2015 
Annual CT scans after esophagectomy for cancer
 05 May 2015 
Prevalence of eosinophilic esophagitis
 04 May 2015 
Stress resilience and peptic ulcer disease
 04 May 2015 
Endoscope storage and microbial colonization
 04 May 2015 
Menarche and NAFLD
 01 May 2015 
Sleep and physical activity measured in Crohn's
 01 May 2015 
NAFLD progression from steatosis to fibrosing-steatohepatitis
 01 May 2015 
Dietary supplement hepatotoxicity
 30 April 2015 
Risk factors for primary sclerosing cholangitis
 30 April 2015 
Neoadjuvant chemoradiotherapy for esophageal cancer
 30 April 2015 
Botulinum toxin A for the treatment of obesity

Blackwell Publishing


GastroHep.com is a Blackwell Publishing registered trademark
© 2015 Wiley-Blackwell and GastroHep.com and contributors
Privacy Statement
Disclaimer
About Us