Follow-up of mild alanine aminotransferase elevation identifies hidden hepatitis

StephenW

Br J Gen Pract. 2012 Mar;62(596):212-6.
Follow-up of mild alanine aminotransferase elevation identifies hidden hepatitis C in primary care.Helsper C, van Essen G, Frijling BD, de Wit NJ.
SourceJulius Center for Health Sciences and Primary Care, University Medical Center Utrecht, The Netherlands.

AbstractBACKGROUND: Hepatitis C (HCV) and hepatitis B (HBV) virus infection can lead to serious complications if left untreated, but often remain undetected in primary care. Mild alanine aminotransferase (ALT) elevations (30-100 IU/l) are commonly found and could be associated  with viral hepatitis; unfortunately, these findings frequently remain without follow-up.
AIM: To determine if and how mild ALT elevation can be used to identify hidden HCV and HBV infection in primary care.
DESIGN AND SETTING: Primary care patients referred  for liver enzyme testing were selected by a large primary care Diagnostic Centre (Saltro).
METHOD: First, 750 anonymous samples were collected in three categories of ALT elevation (30-50 IU/l, 50-70 IU/l, and 70-100 IU/l) and tested for HCV and HBV. Second,  the national prevalence of each ALT elevation was estimated by analysing all annual ALT tests performed at Saltro.
RESULTS: HCV prevalence was 1.6% and 1.2% in patients with an ALT of 50-70 IU/l and 70-100 IU/l respectively. In patients with an ALT of 30-50  IU/l, HCV prevalence was normal (≤0.1%). HBV prevalence was normal (≤0.4%) in all groups. The estimated number of ALT tests performed nationally each year in primary care was 1.1 million. An ALT of 30-50 IU/l was found in 21.1%, an ALT of 50-70 IU/l in 5.6%, and 2.6% had  an ALT of 70-100 IU/l.
CONCLUSION: In primary care patients with an ALT level of 50-100 IU/l, HCV prevalence is tenfold the population prevalence, whereas HBV prevalence is not elevated. Therefore, diagnostic follow-up for HCV is indicated in these patients,  even when other explanations for ALT elevation are present.

StephenW

BR J根Pract。 20120362（596）:212-6。
后续标识隐藏在初级保健中的C型肝炎轻度谷丙转氨酶高程。
helsper，面包车埃森Ğ，Frijling屋宇署，de Wit先生新泽西州。
源

朱利叶斯·健康科学和初级保健，大学医学中心的荷兰乌得勒支中心。
抽象
背景：

丙型肝炎（HCV）和乙肝病毒（HBV）病毒感染可导致严重的并发症，如果不及时治疗，但往往停留在初级保健未被发现。轻度谷丙转氨酶（ALT）升高（30-100 IU / L）是常见的，可以与病毒性肝炎相关，不幸的是，这些研究结果经常不跟进。
目的：

以确定是否以及如何轻度ALT升高，可用于识别隐藏在初级保健丙型肝炎和乙型肝炎病毒感染。
设计及地点：

初级护理患者的肝酶测试，选择一个大的基层医疗诊断中心（Saltro“）。
方法：

首先，750匿名样本被收集在三个类别的ALT升高（30-50 IU / L，50〜70 IU / L，和70-100 IU/ L）和丙型肝炎病毒和乙肝病毒检测。其次，每个ALT升高的国家患病率估计在Saltro完成所有年度ALT测试分析。
结果：

丙型肝炎病毒的患病率为1.6％和1.2％，在50-70 IU/ L和70-100 IU/ L，ALT患者。在30-50 IU/ L，ALT患者，丙型肝炎患病率为正常（≤0.1％）。 HBV患病率为正常（≤0.4％），各组。估计数的ALT测试执行国家每年在初级保健为1.1万。 30-50 IU/ L，ALT被发现在21.1％，ALT50-70 IU/升5.6％，2.6％有70-100 IU / L，ALT。
结论：

初级保健病人在50-100 IU / L，ALT水平，HCV感染率是十倍的患病人群，而乙肝患病率不升高。因此，诊断丙型肝炎病毒的后续行动表示在这些患者中，即使其他ALT升高的解释是存在。

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