Clinical Features of Hepatitis C Virus Carriers With Persistently Normal Alanine Aminotransferase Levels

Hepatitis C virus (HCV) infection causes chronic hepatitis, which frequently leads to hepatic ibrosis and hepatocellular carcinoma (HCC). Alanine aminotransferase (ALT) is a iomarker of hepatocyte injury and is associated with the progression of hepatic fibrosis. dvanced hepatic fibrosis also predisposes HCV carriers to a risk of HCC. In contrast,some cases with persistent HCV infection have normal ALT levels that persist for a long ime, and these HCV carriers have no or mild hepatitis and hepatic fibrosis. These HCV arriers are defined as persistent normal ALT (PnALT) cases and their risk of HCC is low ompared to HCV carriers with abnormal ALT. However, there are various definitions of normal ALT and PnALT, and advanced hepatic fibrosis may be missed without a liver biopsy. n addition, there is also a risk of ALT elevation in HCV carriers with PnALT, which ncreases the risk of progression to hepatic fibrosis and HCC. Most HCV carriers with nALT have asymptomatic or nonspecific symptoms. HCV carriers with PnALT are also onsidered to be responsive to interferon-based treatment. Thus, assessment of hepatic ibrosis is important in HCV carriers, and the eradication of HCV infection is more likely n HCV carriers with evidence of hepatic fibrosis, regardless of their ALT levels.