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Table 9 Studies that have followed up patients from the general population after abnormal LFT

From: Should patients with abnormal liver function tests in primary care be tested for chronic viral hepatitis: cost minimisation analysis based on a comprehensively tested cohort

Author and Country Date Type of Study and population studied Analytes Used Patients enrolled Patients with abnormal LFTs (%) Prevalence of viral hepatitis in patients with abnormal LFTs Notes
McLernon DJ et al. [31] Scotland 2009 Record Linkage; laboratory database of GP tests, hospital admissions and death certificates. Bilirubin, Albumin, ALP, GGT, ALT, AST (transaminases sometimes combined). GP selected 95,977 20,827 (21.7%) 2.2% Median follow up of 3.7 years. Risk of under ascertainment.
Pendino GM et al. [35] Italy 2005 Prospective Cohort Study; general population. AST, ALT, GGT. 1,645 319 (19.4%) 17.9% High baseline rate of viral hepatitis; 5.6%.
Kim HC et al. [30] Korea 2004 Record Linkage: insurance data and death certificates. AST, ALT. 142,055 11,193 (7.9%) N/A Outcome was liver disease mortality.
Yano E et al. [16] Japan 2001 Prospective Cohort Study; "healthy" office workers. AST, ALT, GGT. 1,973 358 (18.1%) 2.7% Assumed that all liver cancer and cirrhosis was a result of viral hepatitis.
Daniel S et al. [36] USA 1999 Prospective Cohort Study; primary care population. ALT, AST raised 50% above normal on at least two occasions across a six month period. 1,124 1,124 (100%) N/A Marker was negative patients only, so infected patients excluded from analysis.
Mathiesen UL et al. [37] Sweden 1999 Prospective Cohort Study; primary care population. AST, ALT raised for at least 6 months. (ALP had to be normal). 150 150 (100%) 15.3%  
Whitehead MW et al. [39] UK 1999 Prospective Cohort Study; primary care population. AST markedly raised (10 times (>400 U/l) above the upper limit of normal.) 137 137 (100%) 2.2%  
Bellentani S et al. [34] Italy 1994 Prospective Cohort; general population. AST, ALT, GGT. 6,917 1,473 (21.3%) 2.4%  
Hultcrantz R et al. [38] Scandinavia 1986 Prospective Cohort Study; primary care population. AST, ALT moderately raised for at least 6 months.(ALP had to be below twice the upper limit of normal). 149 149 (100%) 2.7%  
  1. We also identified a relevant study by Kim and colleagues. This study prospectively followed a group of "healthy" Korean factory workers taking measurements of ALT, AST and GGT on at least two separate occasions. The full article was in Korean so we only had access to the abstract [53].
  2. ALT: Alanine aminotransferase;
  3. AST: Aspartate aminotransferase;
  4. ALP: Alkaline phosphatase;
  5. GGT: Gamma-glutamyltransferase;
  6. HBV: Hepatitis B;
  7. HCV: Hepatitis C;
  8. LFT: Liver function test.