This study was aimed to evaluate demographic, clinical, patients with normal ALT levels, and available data are conflicting.
histological, and virological characteristics of 46 hepatitis C virus (HCV) carriers with persistently normal alanine trans-
The aim of this study was to evaluate demographic characteristics, liver histology, HCV genotype distribution, and se-aminase (ALT) levels and to compare the results with those obtained in a group of 52 HCV-RNA-positive patients with rum HCV-RNA titers in a group of HCV-RNA-positive subjects with persistently normal ALT levels (PNAL), and to elevated ALT levels. Subjects with normal ALT were more often females (P õ .001), were more likely to be asymptomatic ascertain whether clinical and histological features might correlate with virological parameters of HCV infection. The re-(P õ .001), and have a lower incidence of risk factors for HCV transmission (P õ .01). All patients with normal ALT sults were compared with those obtained in a group of patients with HCV-related chronic liver disease (CLD) and had significant histological liver damage. The mean grading and staging did not differ between patients with normal and elevated aminotransferase levels, seen at our Liver Unit during the same period. those with raised ALT concentrations. Moderate to severe hepatitis was more frequently found among subjects with PATIENTS AND METHODS normal than with elevated ALT. HCV genotype 2a was far more common in subjects with normal (43%) than with abnor-Patients. Ninety-eight consecutive anti-HCV-positive outpatients referred to our Liver Unit were studied. Patients with hepatitis mal ALT levels (6%; P õ .002), genotype 1b being more B surface antigen positivity, previous interferon treatment, serum frequent in these latter (50% vs. 17%; P õ .001). Patients HCV-RNA negativity, history of heavy alcohol abuse, low platelet with normal ALT levels had similar serum HCV-RNA titers count (õ100,000), hepatocellular carcinoma, and abnormal ferritin than subjects with raised ALT. Neither HCV genotype distrilevels were excluded from this study. According to their aminotransbution nor viral load correlated with the severity of liver ferase levels, these subjects were categorized into two groups: perdamage. We conclude that significant liver disease may occur sons with PNAL (group A) and patients with abnormal ALT values irrespective of clinical symptoms, ALT levels, HCV genotypes, (group B). Group A consisted of 46 subjects (16 males; mean age, and viral load. (HEPATOLOGY 1997;26:1393-1398.) 44.8 { 13.8 years; range, 19-76 years) fulfilling the following criteria: 1) serum HCV-RNA positivity by reverse-transcription polymerase chain reaction; 2) normal serum ALT concentrations (õ40 IU/ Abbreviations: HCV, hepatitis C virus; ALT, alanine transaminase; PNAL, persistently normal ALT levels; CLD, chronic liver disease.
(4 cases), and occasional laboratory check-up (5 cases). All study