|
|
|
|
|
 HTML
PDF |
|
Assy N, Beniashvili Z, Djibre A, Nasser G, Grosovski M, Nseir W.Lower baseline ALT cut-off values and HBV DNA levels better differentiate HBeAg(-) chronic hepatitis B patients from inactive chronic carriers.
World J Gastroenterol 2009 June;15(24):3025-3031
Lower baseline ALT cut-off values and HBV DNA levels better differentiate HBeAg(-) chronic hepatitis B patients from inactive chronic carriers
Assy N, Beniashvili Z, Djibre A, Nasser G, Grosovski M, Nseir W.
Liver Unit, Ziv Medical Center, Zefat 13100, Israel. assy.n@ziv.health.gov.il
AIM: To determine whether new cut-off values for alanine aminotransferase (ALT) and baseline hepatitis B virus (HBV) DNA levels better differentiate HBeAg(-) chronic hepatitis B (CHB) patients from inactive chronic carriers. METHODS: Ninety-one patients [32 HBeAg(+) CHB, 19 inactive carriers and 40 HBeAg(-) CHB] were followed up for 2 years and were tested for HBV DNA levels by a PCR-based assay. ALT was tested twice during the last 6 mo using new cut-off values: ULN (upper limit of normal) 30 IU/L for males, 19 IU/L for females. Diagnostic accuracy, sensitivity, specificity, positive and negative predictive values were calculated by discriminant analysis. RESULTS: When using the revised ALT cut-off values, the lowest optimal HBV DNA level that differentiated HBeAg(-) CHB patients from inactive carriers was 50?000 copies/mL. The diagnostic accuracy of HBV DNA to determine inactive carriers with a cut-off of 50?000 copies/mL was similar to the previously recommended cut-off of 100?000 copies/mL (91%). HBV DNA levels were lower than the cut-off value in 95% of inactive carriers and in 28% of HBeAg(-) CHB patients. With ALT < 30 IU/L in men and < 19 IU/L in women and HBV DNA levels < 100?000 copies/mL, the risk of CHB is 5%. On the other hand, if ALT values were > 30 IU in men and > 19 IU in women and baseline HBV DNA levels were > 100?000 copies/mL, the risk is 86%. CONCLUSION: New cut-off values for ALT together with HBV DNA levels proposed by AASLD (American Association for the Study of Liver Diseases) and NIH (National Institute of Health) consensus seem appropriate to characterize inactive carriers. |
|
|
|
The WJG Press, Room 1066, Yishou Garden ,
No. 58, North Langxinzhuang Road,
PO Box 2345, Beijing 100023, China
Fax: +86-10-85381893
Telephone: +86-10-85381892
E-mail: wjg@wjgnet.com
http: // www.wjgnet.com
Copyright 2004-2007 by The WJG Press and Beijing Baishideng BioMed Technology Co., Ltd.
| |
Editorial Board
