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Medline ® Abstract for Reference 148

of 'Epidemiology, natural history, and diagnosis of hepatitis C in the HIV-infected patient'

Persistently normal alanine aminotransferase levels in HIV/HCV-coinfected patients: the role of steatosis.
Bani-Sadr F, Barange K, Daoud F, Jacomet C, Bicart-See A, Rosenthal E, Cacoub P, Pol S, Perronne C, Carrat F, ANRS HC02 - Ribavic Study Team
HIV Med. 2009;10(7):417.
OBJECTIVE: The frequency and significance of, and liver biopsy findings associated with, a persistently normal alanine aminotransferase (ALT) level in HIV/hepatitis C virus (HCV)-coinfected patients are poorly characterized. We analysed factors associated with persistently normal ALT levels, defined as at least three consecutive normal ALT values over a 6-month period, in a group of 381 HIV/HCV-coinfected patients.
METHODS: Patients were categorized into two groups according to ALT values: group 1, patients with persistently normal ALT levels; and group 2, patients with elevated ALT values. Possible interactions with host factors, HIV and HCV viral factors, antiretroviral treatment and histological features were examined.
RESULTS: Thirty-six patients (9.4%) had persistently normal ALT levels. None of the 36 patients had cirrhosis. Seven patients (19.4%) had a METAVIR fibrosis score of F3. In multivariate analysis, a lower mean METAVIR inflammation score [odds ratio (OR) 0.50, 95% confidence interval (CI) 0.28-0.89; P=0.017],the absence of steatosis (OR 0.43, 95% CI 0.20-0.90; P=0.026) and HCV genotype 4 infection (OR 2.81, 95% CI 1.15-6.68; P=0.023) were associated with persistently normal ALT levels.
CONCLUSION: The slower progression of chronic hepatitis in patients with persistently normal ALT levels could be related, in part, to a lower frequency of steatosis.
Groupe Hospitalier Universitaire Est, INSERM U 707, UniversitéPierre et Marie Curie, Paris, France.