How to distinguish normal liver from chronic hepatitis in anti-HCV positive individuals with normal alanine aminotranferase levels

RESUMO

The aim of this study was to characterize the biochemical, virological and histological profile of patients with HCV infection and persistently normal alanine aminotransferase levels (PNALT) in order to discriminate between normal liver and chronic hepatitis. Twenty eight anti-HCV positive patients with PNALT were studied. Twelve (42.9) patients showed normal liver while 16 (57.1) had chronic hepatitis. In patients with normal liver, the mean of ALT level differed from patients with chronic hepatitis (16.3 IU/L versus 25.6 IU/L, p 0.000089). By considering different ALT values as upper normal limit, sensitivity, specificity, positive and negative predictive values were calculated and the value of 18 IU/l showed 88, 90, 94 and 82, respectively, in predicting chronic hepatitis. In conclusion, patients with normal liver had lower ALT levels than those with chronic hepatitis and by establishing 18 IU/L as a new upper limit of normal ALT value, it was possible to differentiate normal liver from chronic hepatitis in HCV patients with PNALT (AU)#S