慢性乙型肝炎（CHB）的临床过程呈现在亚裔患者ALT正常。

StephenW

J Viral Hepat. 2015 Jan 22. doi: 10.1111/jvh.12388. [Epub ahead of print]
Clinical course of chronic hepatitis B (CHB) presented with normal ALT in Asian American patients.Nguyen K1, Pan C, Xia V, Hu J, Hu KQ.
Author information

• 1Division of GI/Hepatology, School of Medicine, University of California, Irvine, Orange, CA, USA.
  

AbstractThe clinical course for chronic hepatitis B (CHB) patients with normal ALT and with or without minimal histologic activity remains unclear. We assessed frequency, amplitude, disease activities, and associated factors of ALT and/or AST flares in this subpopulation. Forty-seven consecutive treatment naïve Asian patients with CHB were enrolled from two liver clinics between December 2003 and January 2013, who had normal baseline ALT by routine clinical biochemical testing performed 6 weeks before or after the liver biopsy. We defined a flare as elevation of ALT/AST above the upper limit of normal of ALT/AST. The mean follow-up was 37.6 (CI = 12, 88) months, and the mean age at entry into the study was 43.3 (CI = 19, 65); 22/47 (46.8%) were males; 15/45 (33.3%), HBeAg+; 68.1% had stage 0-1 fibrosis; 63.8% had grade 0-1 inflammation. During follow-up, 13/47 (27.7%) cases developed ALT flare at least once in a mean of 13.5 (CI = 2, 43) months after liver biopsy; ALT flare was not associated with baseline ALT level, fibrosis stage, inflammation grade, hepatitis B virus (HBV) DNA load, HBeAg status, HBV genotype, HBV precore and basal core promoter mutations. 11/13 (84/6%) of ALT flares resolved during follow-up. 13/13 (100%) of ALT flares met AASLD treatment criteria, but only 6/13 (46.2%) were on HBV treatment. Serum ALT and/or AST flares occur frequently in CHB carriers who initially presented with normal ALT during pretreatment period. Thus, regular follow-up is warranted despite status of ALT/AST. No clinical factors were found to be associated with ALT flares.

StephenW

Ĵ病毒Hepat。 2015年22月DOI：10.1111/ jvh.12388。 [打印EPUB提前]
慢性乙型肝炎（CHB）的临床过程呈现在亚裔患者ALT正常。
阮K1，潘C，夏V，胡Ĵ，胡KQ。
作者信息

    1区GI/肝病，医学院，加州大学尔湾分校，橙大学，CA，USA的。

抽象

病程慢性乙型肝炎（CHB）患者的ALT正常及有无最小组织学活动仍不清楚。我们评估的频率，振幅，疾病的活动，并且在此亚群ALT和/或AST耀斑相关因素。四十七例患者治疗天真CHB亚洲招收两个肝脏诊所2003年1月和2013年1月，谁曾正常基线ALT常规临床生化检验前6个月，或肝活检后进行的。我们定义一个火炬作为ALT / AST高于正常ALT / AST的上限的高程。平均随访时间为37.6（CI=12，88）个月，平均年龄在进入研究为43.3（CI=19，65）; 47分之22（46.8％）为男性; 15/45（33.3％），e抗原+; 68.1％有阶段0-1纤维化; 63.8％有0-1级炎症。在随访期间，四十七分之十三（27.7％）例，平均13.5发达ALT耀斑至少一次（CI=2，43）肝活检后个月; ALT耀斑没有与基线ALT水平，纤维化分期，分级炎，乙型肝炎病毒（HBV）DNA载量，HBeAg状态，HBV基因型，HBV前C区和基底核心启动子突变有关。 11/13随访期间解决ALT耀斑（84/6％）。 ALT耀斑13/13（100％）AASLD满足治疗标准，但只有6/13（46.2％）是乙肝病毒的治疗。血清ALT和/或AST耀斑频繁出现在预处理期最初表现为正常ALT谁CHB载体。因此，定期随访是必要的，尽管ALT/ AST的状态。未发现临床因素与ALT耀斑有关。

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