Abstract
Approximately 30% of patients with chronic HCV infection show persistently normal alanine aminotransferase levels (PNAL). The prevalence of HCV carriers with normal liver seems to be very low (less than 15-20%). Liver disease is usually minimal/mild and fibrosis is generally absent or minimal, although the association of normal alanine aminotransferase (ALT) with cirrhosis or with liver cancer has been reported. In all studies, liver histology was, on average, significantly less severe in subjects with PNAL than with abnormal ALT. Although the majority of data seem to show that HCV carriers with normal ALT have mild and stable disease, with a favourable prognosis, several studies reported a significant progression of fibrosis in approximately 20-30% of the patients with ALT normality, and the development of HCC in some cases has been described, despite persistent ALT normality. Sudden worsening of disease with ALT increase and histological deterioration has been described after up to 15 years of follow-up, in particular in patients harboring genotype 2. As to antiviral treatment, it has been clearly stated that it no longer seems reasonable to affirm that sustained response rates for patients with normal ALT levels are any different than those for patients with elevated ALT levels when the combination of pegylated interferon (IFN) and ribavirin is used. The issue at hand is whether or not patients with mild disease should be treated. There are numerous other factors which impact on this decision, including genotype, histology, patients motivation, symptoms, co-morbid illness, and the age of the patient.
Keywords: Alnine aminotransferase, hepatocellular carcinoma, chronic hepatitis C, ribavirin, Interferon
Mini-Reviews in Medicinal Chemistry
Title: Antiviral Treatment of HCV Carriers with Persistently Normal ALT Levels
Volume: 8 Issue: 2
Author(s): Claudio Puoti, Lia Bellis, Alessandra Galossi, Riccardo Guarisco, Sabino Nicodemo, Lucia Spilabotti and Orlando Dell' Unto
Affiliation:
Keywords: Alnine aminotransferase, hepatocellular carcinoma, chronic hepatitis C, ribavirin, Interferon
Abstract: Approximately 30% of patients with chronic HCV infection show persistently normal alanine aminotransferase levels (PNAL). The prevalence of HCV carriers with normal liver seems to be very low (less than 15-20%). Liver disease is usually minimal/mild and fibrosis is generally absent or minimal, although the association of normal alanine aminotransferase (ALT) with cirrhosis or with liver cancer has been reported. In all studies, liver histology was, on average, significantly less severe in subjects with PNAL than with abnormal ALT. Although the majority of data seem to show that HCV carriers with normal ALT have mild and stable disease, with a favourable prognosis, several studies reported a significant progression of fibrosis in approximately 20-30% of the patients with ALT normality, and the development of HCC in some cases has been described, despite persistent ALT normality. Sudden worsening of disease with ALT increase and histological deterioration has been described after up to 15 years of follow-up, in particular in patients harboring genotype 2. As to antiviral treatment, it has been clearly stated that it no longer seems reasonable to affirm that sustained response rates for patients with normal ALT levels are any different than those for patients with elevated ALT levels when the combination of pegylated interferon (IFN) and ribavirin is used. The issue at hand is whether or not patients with mild disease should be treated. There are numerous other factors which impact on this decision, including genotype, histology, patients motivation, symptoms, co-morbid illness, and the age of the patient.
Export Options
About this article
Cite this article as:
Puoti Claudio, Bellis Lia, Galossi Alessandra, Guarisco Riccardo, Nicodemo Sabino, Spilabotti Lucia and Dell' Unto Orlando, Antiviral Treatment of HCV Carriers with Persistently Normal ALT Levels, Mini-Reviews in Medicinal Chemistry 2008; 8 (2) . https://dx.doi.org/10.2174/138955708783498104
DOI https://dx.doi.org/10.2174/138955708783498104 |
Print ISSN 1389-5575 |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-5607 |
Call for Papers in Thematic Issues
Bioprospecting of Natural Products as Sources of New Multitarget Therapies
According to the Convention on Biological Diversity, bioprospecting is the exploration of biodiversity and indigenous knowledge to develop commercially valuable products for pharmaceutical and other applications. Bioprospecting involves searching for useful organic compounds in plants, fungi, marine organisms, and microorganisms. Natural products traditionally constituted the primary source of more than ...read more
Computational Frontiers in Medicinal Chemistry
The thematic issue "Computational Frontiers in Medicinal Chemistry" provides a robust platform for delving into state-of-the-art computational methodologies and technologies that significantly propel advancements in medicinal chemistry. This edition seeks to amalgamate top-tier reviews spotlighting the latest trends and breakthroughs in the fusion of computational approaches, including artificial intelligence (AI) ...read more
Natural Products and Dietary Supplements in Alleviation of Metabolic, Cardiovascular, and Neurological Disorders
Metabolic disorders like diabetes, obesity, inflammation, oxidative stress, cancer etc, cardiovascular disorders like angina, myocardial infarction, congestive heart failure etc as well as neurological disorders like Alzheimer?s, Parkinson?s, Epilepsy, Depression, etc are the global burden. They covered the major segment of the diseases and disorders from which the human community ...read more
Natural Products in Drug Discovery
Natural products have always been one of the important ways of drug discovery due to their novel skeleton and diverse functional group characteristics. According to statistics, between 1981 and 2019, the FDA approved a total of 1,394 small molecule drugs for marketing, of which 930 marketed drugs originated from the ...read more
- Author Guidelines
- Graphical Abstracts
- Fabricating and Stating False Information
- Research Misconduct
- Post Publication Discussions and Corrections
- Publishing Ethics and Rectitude
- Increase Visibility of Your Article
- Archiving Policies
- Peer Review Workflow
- Order Your Article Before Print
- Promote Your Article
- Manuscript Transfer Facility
- Editorial Policies
- Allegations from Whistleblowers
Related Articles
-
Neuroimaging Features of Acquired Metabolic and Toxic Encephalopathies
Current Medical Imaging Transferrin and the Transferrin Receptor: Of Magic Bullets and Other Concerns
Inflammation & Allergy - Drug Targets (Discontinued) STAT5 and STAT5 Inhibitors in Hematological Malignancies
Anti-Cancer Agents in Medicinal Chemistry Targeted Elimination of Leukemia Stem Cells; a New Therapeutic Approach in Hemato-Oncology
Current Drug Targets Biocompatible Europium Doped Hydroxyapatite Nanoparticles as a Biological Fluorescent Probe
Current Nanoscience Activation of LINE-1 Retrotransposon Increases the Risk of Epithelial-Mesenchymal Transition and Metastasis in Epithelial Cancer
Current Molecular Medicine Follicular Immunology Environment and the Influence on In Vitro Fertilization Outcome
Current Women`s Health Reviews Targeting Cancer Stem Cell Lines as a New Treatment of Human Cancer
Recent Patents on Anti-Cancer Drug Discovery Analysis of Glycosylation and Other Post-Translational Modifications by Mass Spectrometry
Current Analytical Chemistry De Novo Design of New Inhibitor of Mutated Tyrosine-Kinase for the Myeloid Leukemia Treatment
Current Pharmaceutical Design Recent Advances in Carbon Nanotubes as Delivery Systems for Anticancer Drugs
Current Medicinal Chemistry Molecular Mechanisms Regulating Matrix Metalloproteinases
Current Topics in Medicinal Chemistry Activities of Venom Proteins and Peptides with Possible Therapeutic Applications from Bees and WASPS
Protein & Peptide Letters MicroRNAs as Critical Regulators Involved in Regulating Epithelial- Mesenchymal Transition
Current Cancer Drug Targets Small Molecules Modulating Biogenesis or Processing of microRNAs with Therapeutic Potentials
Current Medicinal Chemistry miR-203 Suppresses the Proliferation and Metastasis of Hepatocellular Carcinoma by Targeting Oncogene ADAM9 and Oncogenic Long Non-coding RNA HULC
Anti-Cancer Agents in Medicinal Chemistry Zinc, Metallothioneins and Longevity: Interrelationships with Niacin and Selenium
Current Pharmaceutical Design Marine Depsipeptides as Promising Pharmacotherapeutic Agents
Current Protein & Peptide Science The Role of Mitochondria in Cancer Induction, Progression and Changes in Metabolism
Mini-Reviews in Medicinal Chemistry Breast Cancer, a Stem Cell Disease
Current Stem Cell Research & Therapy