A. Rossini et al., VIROLOGICAL CHARACTERIZATION AND LIVER HISTOLOGY IN HCV POSITIVE SUBJECTS WITH NORMAL AND ELEVATED ALT LEVELS, Liver, 17(3), 1997, pp. 133-138
We analyzed HCV genotype and RNA titer in 36 chronically infected subj
ects, 20 with persistently normal or near-normal alanine aminotransfer
ase (ALT) activity and 16 with raised ALT activity. All subjects under
went liver biopsy and evaluation of the histological activity index (H
AI) by both Knodell's and Ishak's scoring systems. Genotype 2 was dete
cted in most subjects with normal ALT activity, whereas genotype 1 was
more frequent among subjects with raised ALT activity. HCV-RNA titer
was higher in subjects with increased ALT. Histological evidence of ch
ronic hepatitis was documented in all cases, but higher scores for gra
ding and for staging were associated with increased ALT activity. HCV
genotype had no statistical relationship with RNA titer or with liver
histology. In logistic regression analysis, viral genotype, RNA titer
and histological scores for grading and staging were correlated indepe
ndently with the ALT profile, The evidence of chronic hepatitis in all
subjects with persistently normal ALT activity suggests that healthy
HCV carriage is a rare event.