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Normal alanine aminotransferase protects against hepatic events in CHB patients

24 Sep 2018

In patients with chronic hepatitis B (CHB) infections on nucleos(t)ide analogue (NA) treatment, normal on-treatment alanine aminotransferase (ALT) levels are associated with lower risks of hepatic events, a recent study has shown.

Using data from the Clinical Data Analysis and Reporting System of Hong Kong, researchers evaluated serial on-treatment ALT levels of 21,182 CHB patients (mean age 51±13 years). ALT <30 and <19 U/L in males and females, respectively, were considered as normal. Composite hepatic events, including hepatocellular carcinoma, were the study outcomes.

Of the participants, 10,438 achieved normal on-treatment ALT levels within 12 months of NA treatment, while 10,745 did not. Only a minority (3.0 percent; n=627) of the patients developed the primary study outcome of composite hepatic events over a mean follow-up period of 4.0±1.7 years. Most of these were hepatocellular carcinoma (2.4 percent; n=509).

The cumulative hepatic event rates were lower in those with normal vs elevated on-treatment ALT at different time points: 3 months (4.27 percent vs 4.76 percent; p=0.083), 6 months (3.60 percent vs 5.24 percent; p<0.001), 9 months (3.44 percent vs 5.57 percent; p<0.001) and 12 months (3.51 percent vs 5.70 percent; p<0.001).

These were confirmed in fully adjusted Cox regression analyses, which showed that the risk of composite hepatic events were significantly lower in those with normal vs elevated ALT at 3 months (adjusted hazard ratio [HR], 0.61; 95 percent CI, 0.49–0.77; p<0.001), 6 months (adjusted HR, 0.55; 0.45–0.67; p<0.001), 9 months (adjusted HR, 0.54; 0.44–0.65; p<0.001) and 12 months (adjusted HR, 0.51; 0.42–0.61; p<0.001).

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Most Read Articles
31 Jul 2016
New drug applications approved by US FDA as of 15 - 31 July 2016 which includes New Molecular Entities (NMEs) and new biologics. It does not include Tentative Approvals. Supplemental approvals may have occurred since the original approval date.
Audrey Abella, 06 Jul 2017
The addition of aggressive local ablation to systemic therapy may extend overall survival (OS) in patients with unresectable colorectal cancer (CRC) with liver metastases compared with systemic therapy alone, according to a phase II trial.
06 Jul 2016
Access to primary care or insurance prior to diagnosis is associated with better outcomes in autoimmune hepatitis, according to a recent study.