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Updated: Aug 9, 2026

Establishment of the Dual Humanized TK-NOG Mouse Model for HIV-associated Liver Pathogenesis
Published on: September 11, 2019
HIV/hepatitis C virus-coinfected patients with normal alanine aminotransferase levels
Stevan A Gonzalez1, Ruei-Che Liu, Brian R Edlin
1Center for the Study of Hepatitis C and Division of Gastroenterology and Hepatology, Department of Medicine, Weill Medical College of Columbia University, 525 East 68th Street, New York, NY 10021, USA.
Background And Aims:
The significance of normal alanine aminotransferase (ALT) levels in patients with HIV/hepatitis C virus (HCV) coinfection is not well understood.
Methods:
We performed a cross-sectional retrospective analysis on consecutive HIV/HCV-coinfected patients (n = 89) who underwent a liver biopsy during a 2-year period. Similar data were also collected on HCV-monoinfected patients (n = 117).
Results:
Mean ALT levels and the percentage of patients with normal ALT (< or =40 U/L) levels were similar in HIV/HCV-coinfected (mean +/- SD, 81.7 +/- 56.1 U/L; 21%) and HCV-monoinfected patients (97.3 +/- 100.7 U/L; 18%; P = 0.19 and 0.54, respectively). Coinfected patients, however, had significantly advanced necroinflammation (P= 0.001) and fibrosis (P = 0.02) compared with monoinfected patients. The percentage of patients with advanced necroinflammation (grades 3 or 4) was lower in HCV-monoinfected patients with normal ALT levels compared with those with elevated ALT (5% vs 20%, respectively). In contrast, the percentage of coinfected patients with advanced necroinflammation was similar whether the patient had normal or elevated ALT levels (32% vs 37%, respectively).
Conclusions:
In coinfected patients, normal ALT levels are not an indicator of mild necroinflammation and may not portend a more benign disease course.
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