Hepatitis C virus with normal transaminase levels

Approximately 30% of patients with chronic HCV infection show persistently normal alanine aminotransferase ( PNALT) levels. The majority of these patients have some degree of histological liver damage. Controversies still exist regarding the definition of 'persistent' alanine aminotransferase ( ALT) normality, and the natural history and optimal management of chronic hepatitis C with normal ALT. Although patients with HCV infection and normal ALT have been historically excluded from antiviral treatment, with the advent of the new treatment with PEG-interferon plus ribavirin, it has been suggested that the issue of whether or not to treat subjects with PNALT should be re-evaluated, and that antiviral treatment should be useful at least in selected subsets of patients. Copyright (c) 2007 S. Karger AG, Basel