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Clin Mol Hepatol > Volume 29(3); 2023 > Article
Oh and Sinn: Correspondence on Letter regarding “Is liver biopsy essential to identifying the immune tolerant phase of chronic hepatitis B?”

Correspondence

Clin Mol Hepatol. 2023; 29(3): 820-820.

Published online: May 19, 2023

DOI: https://doi.org/10.3350/cmh.2023.0135

Correspondence on Letter regarding “Is liver biopsy essential to identifying the immune tolerant phase of chronic hepatitis B?”

Joo Hyun Oh1, Dong Hyun Sinn2

Corresponding author : Dong Hyun Sinn Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Korea
Tel: +82-2-3410-3409, Fax: +82-2-3410-6983, E-mail: dh.sinn@samsung.com

Editor: Seung Up Kim, Yonsei University College of Medicine, Korea

Received April 4, 2023       Accepted April 5, 2023

Copyright © 2023 by The Korean Association for the Study of the Liver

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Keywords: Hepatitis B, chronic; Transaminases

Dear Editor,
We would like to thank Professor Emiroglu [1] for showing interest in our paper. According to the guidelines established by the American Association for the Study of Liver Disease, the upper limit of normal for alanine aminotransferase (ALT) levels in healthy adult males is reported to range between 29–33 U/L [2]. However, to accommodate for differences in repeat testing for the same sample and to improve management decisions [3], it has been recommended to update the upper limit of normal for ALT in males to 35 U/L. Therefore, we agree that “<35 U/L” would be a more appropriate reference range for guidance. We will be mindful of any small errors that could cause confusion in decision-making.

FOOTNOTES

Authors’ contribution
JHO drafted the manuscript. DHS reviewed and finalized the manuscript.
Conflicts of Interest
The authors have no conflicts to disclose.

Abbreviations

ALT
alanine aminotransferase

REFERENCES

1. Emiroglu HH. The upper limit of normal for ALT in males according to AASLD guideline. Clin Mol Hepatol 2023 May 8; doi: 10.3350/cmh.2023.0132.

2. Terrault NA, Lok ASF, McMahon BJ, Chang KM, Hwang JP, Jonas MM, et al. Update on prevention, diagnosis, and treatment of chronic hepatitis B: AASLD 2018 hepatitis B guidance. Hepatology 2018;67:1560-1599.
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3. Dutta A, Saha C, Johnson CS, Chalasani N. Variability in the upper limit of normal for serum alanine aminotransferase levels: a statewide study. Hepatology 2009;50:1957-1962.
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ORCID iDs

Dong Hyun Sinn
https://orcid.org/0000-0002-7126-5554

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