Incidence of Hepatitis C in Patients with Chronic Elevations of Aminotransferases

Abstract

Background: We undertook a study to determine the incidence of hepatitis C in patients with persistent elevations of aminotransferases, either alanine aminotransferase (ALT) or aspartate aminotransferase (AST).

Methods: We conducted a retrospective review of medical records at the Family Practice Center from 1992 to 1993. Patients in whom aminotransferase levels were elevated 1.5 times normal for at least 6 months were eligible for the study. Sixty patients met our eligibility criteria. Patients were tested for hepatitis B and C and other possible causes of elevated aminotransferase levels.

Results: Of these 60 patients, 35 (58 percent) tested positive for hepatitis C virus by first-generation enzyme-linked immunosorbent assay (ELISA-I); 30 had positive results confirmed by second-generation recombinant immunoblot assay (RIBA-II). The other 5 patients were lost to follow-up, and their status was not confirmed. Of the 30 patients with a positive RIBA-II, 14 had liver biopsies showing chronic persistent hepatitis or chronic active hepatitis, both consistent with hepatitis C infection. Of the 60 patients, 2 (3 percent) had hepatitis B. None had active hepatitis B coexisting with hepatitis C.

Conclusions: Our data show a much greater incidence of hepatitis C (50 percent) in our patients with chronic elevations of aminotransferase levels compared with data reported from previous studies.