Serum alanine aminotransferase in hepatitis C screening of patients on hemodialysis

Sammy Saab, Paul Martin, Maria Brezina, Gary Gitnick, Hal F. Yee

Research output: Contribution to journalArticle

66 Citations (Scopus)

Abstract

It is recommended that patients on hemodialysis (HD) therapy undergo regular screening for hepatitis C virus (HCV) infection by using alanine aminotransferase (ALT) values. However, the utility of using ALT values in this setting is unknown. The aim of this prospective study at the University of California Los Angeles Hepatitis Screening Program is to determine the sensitivity, specificity, and predictive values of an elevated ALT level for the diagnosis of HCV infection in HD patients. We screened 2,440 HD patients from 39 dialysis centers for viral infection by using hepatitis antibody serological testing and ALT values. We found the sensitivity and specificity of a newly elevated ALT level for acute HCV infection to be 83% and 90%, respectively. According to Bayes' theorem, the positive predictive value was 4% and the positive likelihood ratio was 8.74. For chronic HCV infection, the sensitivity of a newly elevated aminotransferase level was 21%, and specificity was 91%. The positive predictive value was 16% (according to Bayes' theorem), and the positive likelihood ratio was 2.47. The negative predictive value of a newly elevated aminotransferase value was 99% for acute HCV infection and 94% for chronic HCV infection. Our results indicate that although a newly elevated aminotransferase level is sensitive and specific for acute HCV infection, its positive predictive value is inadequate. A newly elevated aminotransferase level was neither sensitive nor positively predictive of chronic infection. Therefore, an elevated ALT level is an ineffective method for screening for HCV infection in HD patients.

Original languageEnglish
Pages (from-to)308-315
Number of pages8
JournalAmerican Journal of Kidney Diseases
Volume37
Issue number2
StatePublished - Feb 14 2001
Externally publishedYes

Fingerprint

Virus Diseases
Hepatitis C
Alanine Transaminase
Renal Dialysis
Hepacivirus
Serum
Transaminases
Bayes Theorem
Chronic Hepatitis C
Hepatitis Antibodies
Sensitivity and Specificity
Los Angeles
Hepatitis
Dialysis
Prospective Studies
Infection

Keywords

  • Hemodialysis (HD)
  • Hepatitis C
  • Screening

ASJC Scopus subject areas

  • Nephrology

Cite this

Serum alanine aminotransferase in hepatitis C screening of patients on hemodialysis. / Saab, Sammy; Martin, Paul; Brezina, Maria; Gitnick, Gary; Yee, Hal F.

In: American Journal of Kidney Diseases, Vol. 37, No. 2, 14.02.2001, p. 308-315.

Research output: Contribution to journalArticle

Saab, Sammy ; Martin, Paul ; Brezina, Maria ; Gitnick, Gary ; Yee, Hal F. / Serum alanine aminotransferase in hepatitis C screening of patients on hemodialysis. In: American Journal of Kidney Diseases. 2001 ; Vol. 37, No. 2. pp. 308-315.
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