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World J Gastroenterol. Apr 14, 2013; 19(14): 2256-2261
Published online Apr 14, 2013. doi: 10.3748/wjg.v19.i14.2256
Published online Apr 14, 2013. doi: 10.3748/wjg.v19.i14.2256
Disease progression in chronic hepatitis C patients with normal alanine aminotransferase levels
Dong Hyun Sinn, Department of Internal Medicine, Sanggye Paik Hospital, Inje University School of Medicine, Seoul 139-707, South Korea
Geum-Youn Gwak, Jae-uk Shin, Moon Seok Choi, Joon Hyeok Lee, Kwang Cheol Koh, Seung Woon Paik, Byung Chul Yoo, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 135-710, South Korea
Author contributions: Sinn DH and Gwak GY designed the research, analyzed the data, and wrote the paper; Shin J, Choi MS, Lee JH, Koh KC, Paik SW and Yoo BC provided data and critically revised the paper; all authors approved the final version of the paper.
Correspondence to: Geum-Youn Gwak, MD, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Gangnam-Gu, Seoul 135-710, South Korea. gy.gwak@samsung.com
Telephone: +82-2-34103409 Fax: +82-2-34103849
Received: December 1, 2012
Revised: January 18, 2013
Accepted: February 5, 2013
Published online: April 14, 2013
Revised: January 18, 2013
Accepted: February 5, 2013
Published online: April 14, 2013
Core Tip
Core tip: Recent studies have indicated that the upper limit of normal for the serum alanine aminotransferase (ALT) level should be lowered. However, outcome studies based on the development of adverse events during long-term follow-up are limited. In this present study, among patients infected with chronic hepatitis C virus who had normal ALT levels, the risk of disease progression differed between patients with “high-normal” and “low-normal” ALT levels, even within the currently accepted normal levels. This finding suggests that lowering the normal threshold of ALT levels may be necessary to better identify patients who are at increased risk for disease progression.