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BibTex format

@article{Flower:2023:10.1097/CLD.0000000000000055,
author = {Flower, B and Nguyen, Thi Ngoc P and McCabe, L and Le, Ngoc C and Vo, Thi T and Thi, Kim HV and Dang, Trong T and Rahman, M and Thwaites, G and Walker, AS and Hung, LM and Vinh, Chau NV and Cooke, GS and Day, JN},
doi = {10.1097/CLD.0000000000000055},
journal = {Clin Liver Dis (Hoboken)},
pages = {138--142},
title = {Rise in alanine aminotransferase after HCV treatment is a highly sensitive screen for treatment failure.},
url = {http://dx.doi.org/10.1097/CLD.0000000000000055},
volume = {21},
year = {2023}
}
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TY  - JOUR
AB  - Nucleic acid testing to confirm sustained virological response (SVR) after HCV therapy is technical, often expensive, and frequently unavailable where disease prevalence is highest. Alternative surrogate biomarkers merit evaluation. In a short-treatment trial in Vietnam (SEARCH-1; n = 52) we analysed how changes in alanine transaminase (ΔALT) and aspartate transaminase (ΔAST), from end of treatment (EOT) to EOT + 12 weeks, related to SVR, defined as HCV RNA < lower limit of quantification 12 weeks after EOT. In a separate UK trial (STOPHCV1; n = 202), we then tested the hypothesis that any elevation in ALT or AST between EOT and EOT12 is a sensitive screen for treatment failure. In SEARCH-1, among 48 individuals with data, 13 failed to achieve SVR. Median ΔALT and ΔAST were negative in cured patients but elevated when treatment failed [median ΔALT (IQR): -2 IU/L (-6, +2)] versus +17 IU/L (+7.5, +38) (p< 0.001). Amongst treatment failures, 12/13 had increase in ALT and 13/13 had increase in AST after EOT, compared with 12/35 in those cured. In STOPHCV1, 196/202 patients had evaluable data, of which 57 did not achieve SVR. A rise in ALT after EOT was 100% sensitive (95% C.I. [93.7 - 100%]) and 51% specific (42.4 - 59.7%) for detecting treatment failure. ΔAST >0 IU/L was 98.1% (89.9 - 99.9%) sensitive and 35.8% (27.3 - 45.1%) specific. A rise in ALT or AST after HCV therapy is a highly sensitive screen for treatment failure in mild liver disease. This finding could reduce costs and complexity of managing HCV.
AU  - Flower,B
AU  - Nguyen,Thi Ngoc P
AU  - McCabe,L
AU  - Le,Ngoc C
AU  - Vo,Thi T
AU  - Thi,Kim HV
AU  - Dang,Trong T
AU  - Rahman,M
AU  - Thwaites,G
AU  - Walker,AS
AU  - Hung,LM
AU  - Vinh,Chau NV
AU  - Cooke,GS
AU  - Day,JN
DO  - 10.1097/CLD.0000000000000055
EP  - 142
PY  - 2023///
SN  - 2046-2484
SP  - 138
TI  - Rise in alanine aminotransferase after HCV treatment is a highly sensitive screen for treatment failure.
T2  - Clin Liver Dis (Hoboken)
UR  - http://dx.doi.org/10.1097/CLD.0000000000000055
UR  - https://www.ncbi.nlm.nih.gov/pubmed/37274950
VL  - 21
ER  -
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