Alanine aminotransferase (ALT) activity is the most widely used laboratory parameter in the evaluation of necroinflammatory activity in liver disease.^1–3 However, it is incorrect to evaluate the arithmetic or the annual mean values. If the ALT level is high, the measurement interval decreases, whereas if the ALT level is low, the interval increases. As a result, the arithmetic mean value increases in patients with increased ALT levels. We performed a more accurate evaluation by using the integration value of ALT. The aim of this study was to determine the utility of the integration value of ALT in predicting hepatic carcinogenesis in patients with the hepatitis C virus (HCV) infection.

A total of 1704 consecutive patients with follow-up periods of ⩾3 years, with no evidence of hepatocellular carcinoma (HCC) for ⩾3 years before the observation period, and interferon treatment completed ⩾3 year before the detection of HCC during …