Detectable serum hepatitis C virus (HCV) RNA in HCV patients with persistently normal alanine transaminase (PNALT) is associated with significant liver damage.
In this study, researchers from the United States compared the histological progression of fibrosis in patients with PNALT and elevated alanine transaminase (ALT).
The research team included 40 patients with PNALT (group 1) and 41 patients with elevated ALT (group 2) in the study. Patients had fibrosis of F0 to F2.
The median time to second liver biopsies was 6.3 years.
|Progression of fibrosis:|
- group 1 = 23%
- group 2 = 42%
|Journal of Hepatology|
The research team found that 23% of patients in group 1 and 42% in group 2 had progression of fibrosis.
Overall, there was a trend towards a significantly higher cumulative probability of fibrosis progression in group 2.
In patients with initial F0 to F1 fibrosis, there was a significant difference in cumulative probability of fibrosis progression between the 2 groups. Probabilities for groups 1 and 2 were 23% and 43%, respectively.
Dr Chee-Kin Hui's team concluded, "Anti-HCV patients with PNALT with an initial fibrosis of F0 or F1 were less likely to develop progression of fibrosis than those with elevated ALT".
However, "Patients with PNALT may have histologically and clinically progressive disease."