Evidence map›Paper›PMID 28752960›Full record

ArticleJournal of clinical laboratory analysis2018

After successful hepatitis C virus antiviral therapy: It looks that normal alanine aminotransferase level is not the normal.

Mohamed El Kassas, Mohamed Alboraie, Aya Mostafa, Reem Ezzat, Adel El Tahan, Shimaa Afify, Ahmed Sweedy, Ibrahim Kabbash, Gamal Esmat

Abstract read
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Article in Journal of clinical laboratory analysis, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Mohamed El KassasEndemic Medicine Department, Faculty of Medicine, Helwan University, Cairo, Egypt.ORCID http://orcid.org/0000-0002-3396-6894
Mohamed AlboraieInternal Medicine Department, Al-Azhar University, Cairo, Egypt.
Aya MostafaCommunity, Environmental, and Occupational Health Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Reem EzzatInternal Medicine Department, Faculty of Medicine, Assiut University, Assiut, Egypt.
Adel El TahanNew Cairo Viral Hepatitis Treatment Unit, Cairo, Egypt.
Shimaa AfifyNew Cairo Viral Hepatitis Treatment Unit, Cairo, Egypt.
Ahmed SweedyNew Cairo Viral Hepatitis Treatment Unit, Cairo, Egypt.
Ibrahim KabbashPublic Health and Community Medicine Department, Faculty of Medicine, Tanta University, Tanta, Egypt.
Gamal EsmatEndemic Medicine and Hepatogastroenterology Department, Faculty of Medicine, Cairo University, Cairo, Egypt.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundNormal serum alanine aminotransferase (ALT) levels differ with age, gender, and body mass index. Adjusting the upper limits of normal (ULN) for ALT needs further research in different populations. Aim of this work was to monitor the effect of successful chronic hepatitis C (CHC) treatment on the ALT levels in patients with normal pretreatment ALT.

methodsData of 1160 CHC patients with persistent pretreatment normal liver enzymes were retrospectively analyzed. Treatment response to direct acting antiviral agents (DAAs) therapy was recorded. Changes in ALT levels before and after treatment were analyzed by patients' demographic, laboratory, and radiologic characteristics. Areas under the receiver operating characteristic curve (AUROC) of ALT after treatment were used to generate a new ALT ULN.

resultsMales were 568 (49%) and females 592 (51%) with a mean age of 50.7 years. After treatment, mean (±SD) of ALT levels significantly decreased from (26.3±7.8) to (19.1±10.9). This reduction was more significant in interferon-free than interferon-based regimens. ROC curve analyses suggested a new ALT ULN cut off (26.4 IU/L) in the treated patients (sensitivity=78.6%, specificity=83.8%, AUROC=0.89. This cutoff dropped to 14.7 IU/L in cirrhotic patients (sensitivity=77.4%, specificity=44.7%, AUROC=0.612). The identified cutoffs were 16.3 IU/L (sensitivity=66.7%, specificity=47.5%, AUROC=0.499) and 15.5 IU/L (sensitivity=76.5%, specificity=51.3%, AUROC=0.576) in males and females, respectively.

conclusionThe current ALT ULN needs readjustment to identify new normal cutoffs in CHC patients. Posttreatment cutoffs differ according to gender, pretreatment liver affection, and treatment regimen.

Indexed as

HepacivirusAdultAlanine TransaminaseAntiviral AgentsFemaleHepatitis C, ChronicHumansMaleMiddle AgedRetrospective StudiesROC CurveAlanine TransaminaseAntiviral Agentsalanine aminotransferasedirect acting antiviral agentshepatitis C virusinterferonliver enzymes

Identifiers

PMID28752960
PMCPMC6817060

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.