RELATIONSHIP BETWEEN SUSTAINED ELEVATION OF SERUM ALANINE AMINOTRANSFERASE AND PROGRESSION FROM CIRRHOSIS TO HEPATOCELLULAR-CARCINOMA - COMPARISON IN PATIENTS WITH HEPATITIS-B VIRUS-ASSOCIATED AND HEPATITIS-C VIRUS-ASSOCIATED CIRRHOSIS

Most patients with hepatocellular carcinoma (HCC) in Japan have hepati tis B virus (HBV)- or hepatitis C virus (HCV)-associated cirrhosis. In the present study, the risk of HCC in patients with cirrhosis was ana lysed by the levels of serum alanine aminotransferase (ALT). One hundr ed and one (78%) of 129 patients with cirrhosis registered from April 1979 were followed at monthly intervals with the measurement of serum ALT. Of 101 patients, 38 tested positive for hepatitis B surface antig en (HBsAg) but negative for antibody to HCV (anti-HCV; HBV group), 47 tested negative for HBsAg but positive for anti-HCV (HCV group) and ni ne tested positive and seven tested negative for both. Mean serum ALT during follow-up was calculated on the basis of monthly values during the observation period that started at enrolment and ended with the de tection of HCC or at the end of March 1994. By the end of March 1994, 37 (37%) patients developed HCC; 12 were in the HBV group, 21 in the H CV group and four were in the group positive for both. Mean serum ALT during the observation period was similar in patients who developed HC C and those who did not develop HCC in the HBV group. In contrast, the value was significantly higher in patients who developed HCC than in patients who did not develop HCC in the HCV group (P < 0.05).