Harran Üniversitesi Tıp Fakültesi Dergisi
Yazarlar: Hasan KARSEN, Azize Sezin SEYHANOĞLU, Emine Ayca GÜLER
Konular:Tıp
Anahtar Kelimeler:Chronic Hepatitis B,Remission,Alanine Transaminase
Özet: Aim: Our aim is to investigate the reason for persistent ALT elevation in chronic Hepatitis B (CHB) patients entering into remission with antiviral treatment. Material Method: 10 patients with persistent ALT elevation were included in the study and their pre-treatment HBV-DNA values, serological tests, ALT, AST titers, liver fibrosis degree, ultrasonography (USG) and antiviral medicines they were taking were analyzed. While the time passed since the beginning of the treatment in these patients was evaluated, their HBVDNA, serology, bio-chemical tests, other liver functions tests, serum cholesterol and triglyceride levels, liver USG, autoimmune tests and possible other hepatitis reasons were searched again. Results: At the beginning of the treatment, HBV-DNA values of the 10 patients, all of whom were male, were between 104 -108 copy/ml and 5 of the patients had HBeAg seroconversion. Considering virological response with treatment, HBV-DNA was 244 IU/ml in only one of the patients whereas it was negative in the rest and HBeAg seroconversion occurred in all the patients. It was realized that there was an increase in ALT values of five patients compared to pretreatment; ALT value remained the same in one of the patients and ALT values of the remaining four patients did not decrease to normal despite a decline. When liver USG was analyzed, no other pathology was determined except for the grade I hepatosteatosis in two patients. Other viral hepatitis agents and autoimmune hepatitis markers were negative, and liver functions tests and alphafetoprotein (AFP) were normal. In the patients’ stories, there was no reference to quitting medicines, alcohol and drug use or taking other medicines that could be a cause. Considering the antiviral medicines the patients took, it was observed that four of the patients took entecavir, four of them took tenofovir, one took entecavir + tenofovir, one took telbivudin and one took PegInterferon. Conclusion: ALT elevation of CHB patients may continue even if they are virologically and serologically in remission with treatment. This situation faces us as a problem which has no precisely known reason and needs highlighting.