— Christine M. Kukka, Project Manager, HBV Advocate
Recently, liver experts lowered what is considered to be “healthy” levels of alanine aminotransferase (ALT) from about 50 international units per liter (IU/L) to 30 IU/L for males and 19 IU/L for women. ALT levels increase when liver cells are damaged by infections such as hepatitis B.
The lower ALT levels have been slow to catch on, many doctors and clinics still use the 50 IU/L benchmark before initiating treatment or more frequent monitoring of hepatitis B patients.
However, a new study by researchers at the University of Southern California in Los Angeles find that the new, lower “healthy” ALT levels are more accurate in identifying patients with active hepatitis B infection.
According to the report published in the February issue of the journal of Digestive Diseases and Sciences, doctors followed 198 Asian-Americans who had never been treated over 21 months. They compared the diagnostic accuracy of using the higher and lower “healthy” ALT levels.
If they had used the higher ALT levels, doctors would have missed liver problems in about 36.6% of the patients. When some of these “missed” patients had liver biopsies, doctors found moderate to severe fibrosis that required treatment.
Using the new, lower ALT levels enabled the doctors to more accurately assess liver health and HBV infection stage in more than 28% of their patients. “Compared with conventional ALT criteria, (the current, lower) ALT criteria is more sensitive in identifying chronic hepatitis B patients in active (infection) phases,” they wrote.
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