Русский
Alanine aminotransferase activity and its clinical significance in patients with chronic hepatitis B
Voznesensky S.L., Kozhevnikova G.М., Golub V.P.
Peoples’ Friendship University of Russia, Moscow
Objective. To identify the clinical significance of the level of ALT activity in patients with CHB.
Subjects and methods. During the investigation, more than 250,000 patients were tested for serum hepatitis B surface antigen (HBsAg). ALT activity was identified in the persons who had been found to have HBsAg. Qualitative and quantitative assessments of HBV DNA were made in HBsAg-positive individuals. Groups of patients with different ALT activities and viral load were studied. Non-invasive assessment of liver fibrosis was carried out in CHB patients with normal ALT activity.
Results. The prevalence of HBsAg in the Moscow Region amounted to 4.1%. Serum HBV DNA was detected in 63.3% of the HBsAg-positive examinees and a high viral load was found in 20.0%. High ALT levels were observed more often in males and patients older than 30 years. The combination of ALT activity> 2 N and viremia ≥ 20,000 IU/ml suggests that the course of CHB is active and requires etiotropic therapy. Normal ALT activity levels and viremia < 20,000 IU/ml do not rule out the active course of CHB in HBsAg-positive patients.
Literature
1. [State report ≪On the state sanitary and epidemiological wellbeing of the population in the Russian Federation in 2015≫]. Moscow: Federal’naja sluzhba po nadzoru v sfere zashhity prav potrebitelej i blagopoluchija cheloveka, 2016. 200 p. (In Russ.) 2. Mukomolov S.L., Levakova I.A. [Epidemiological characteristic of chronic viral hepatitis in the Russian Federation in 1999–2009]. Infekcija i immunitet 2011; 1(3): 255–62. (In Russ.) 3. Abdurahmanov D.T. Hronicheskij gepatit В i D [Chronic hepatitis B and D]. Moscow: GJeOTAR-Media, 2010. 288 р. (In Russ.) 4. Azam F., Koulaouzidis A. Hepatitis В virus and hepatocarcinogenesis. Ann Hepatol. 2008; 7(2): 125–9. 5. Isakov V.A., Pokrovskу V.V. [Russia on the verge of an epidemic of hepatitis B. Problems and perspectives of the global fight against the virus]. Praktika pediatra 2006; (9): 17–9. (In Russ.) 6. Liu T.T., Fang Y., Xiong H., Chen T.Y., Ni Z.P., Luo J.F. A case-control study of the relationship between hepatitis B virus DNA level and risk of hepatocellular carcinoma in Qidong, China. World J. Gastroenterol. 2008; 14(19): 3059–63. 7. Keef E.B., Dieterich D.T., Han S.B., Jacobson I.M., Martin P., Schiff E.R., Tobias H. A treatment algorithm for the management of chronic hepatitis b virus infection in the United States. Clin. Gastroentorol. Hepatol. 2006; 4(8): 1–27. 8. Klinker H. Management of hepatitis B/C in patients with HIV-infection. MMW Fortschr Med. 2011; 153(18): 56–7, 59. 9. Sulkowski M.S. Viral hepatitis and HIV coinfection. J. Hepatol. 2008; 48: 353–67. 10. Maevskaja M.V. [Chronic viral hepatitis and alcohol]. Farmateka 2006; (9): 1–5. (In Russ.) 11. Nguyen M.H., Trinh H., Garcia R.T., Ahmed A., Keeffe E.B. Significant histologic disease in HBV-infected patients with normal to minimally elevated ALT levels at initial evalution. Hepatology 2005; 42: 593A. 12. Yang Y.H., Xie Q., Wang H., Xie Q., Wang H. Viral factors influencing histological changes of HBeAg-negative chronic hepatitis B patients with persistently normal serum ALT levels. Zhonghua Gan Zang Bing Za Zhi 2009; 17(6): 434–9. 13. Shut’ko S.A. [The clinical significance of dynamic determination of viral load in patients with various embodiments of HBV-chronic infection]. Cand. Med. Diss. Moscow, 2009. (In Russ.) 14. Zacharakis G., Koskinas J., Kotsiou S., Pouliou E., Papoutselis M., Tzara F., Vafeiadis N., Maltezos E., Archimandritis A., Papoutselis K. Natural history of chronic hepatitis B virus: a cohort study with up to 12 years’ follow-up in northern Greece. J. Med. Virol. 2005; 77(2): 173–9.
About the Autors
For correspondence: Sergey L. Voznesenskiy, voznesenskiy_sl@pfur.ru
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