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Evidence summaries

Correlation of Serum Alt Concentration and Histological Improvement in Patients with Hepatitis C after Treatment with Interferon Alfa

Serum ALT concentration does probably not always reflect liver histology accurately after interferon alpha treatment and may underestimate histological improvement. Level of evidence: "C"

A systematic review 1 including 15 studies with a total of 1 546 subjects (quantitative histological assessment) and 42 studies for qualitative assessment), was abstracted in DARE.

Results for quantitative assessment: For patients who underwent a second liver biopsy at the end of treatment (9 studies, n=201), 28% had improved histology, whilst for 5% the histology deteriorated. The sensitivity and specificity of the ALT for determining histological change were 70% (95% CI 56% to 81%) and 66% (95% CI 56% to 75%). As many as 17% (95% CI 9% to 30%) of patients with abnormal ALT at the end of therapy may have improved histology.

    References

    • Bonis PA, Ioannidis JP, Cappelleri JC, Kaplan MM, Lau J. Correlation of biochemical response to interferon alfa with histological improvement in hepatitis C: a meta-analysis of diagnostic test characteristics. Hepatology 1997 Oct;26(4):1035-44. [PubMed] [DARE]

Primary/Secondary Keywords